Lots of interesting abstracts and cases were submitted for TCTAP 2026. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge!
CASE20251114_045
Successful Retrieval of Entrapped Wire During Primary Percutaneous Intervention
By Samrany San, Sokha Chan, Chour Sok
Presenter
Samrany San
Authors
Samrany San1, Sokha Chan1, Chour Sok2
Affiliation
Calmette Hospital, Cambodia1, Cambodia Ministry of Health , Cambodia2
View Study Report
CASE20251114_045
Coronary - Complication Management
Successful Retrieval of Entrapped Wire During Primary Percutaneous Intervention
Samrany San1, Sokha Chan1, Chour Sok2
Calmette Hospital, Cambodia1, Cambodia Ministry of Health , Cambodia2
Clinical Information
Relevant Clinical History and Physical Exam
A 51-year-old man hospitalized for STEMI with 5 hours onset. He had a history of ex-smoker, cessation 1 year without hypertension neither diabetus. Physical examinations is unremarkable. Emergency coronary angiography is proceed.
Relevant Test Results Prior to Catheterization
ECG showed ST elevation V1 to V5. Heart ultrasound revealed low LVEF 30-35%.
Relevant Catheterization Findings
Right femoral access was obtained with 6 french JL 4.0 sheaths. The left main coronary artery with 6 french guide catheter revealed a total occlusion with calcification of ostial LAD.
Entrapped 1.mp4
Entrapped 1.mp4Interventional Management
Procedural Step
A wire advanced through the lesion. After pre-dilatation by Balloon 2.5x20mm at 16atm, revealed lesion on bifurcation with diagonal, MEDINA 1-1-0. Other wire was used to protect side branch. Due to impossible delivery of a long DES stent (3.0x34mm), parallel wire was used to insert the stent into that. In angiography, stent under-expansion was revealed.So, additional balloon inflation was performed to fully expansion. And then, the parallel guidewire could not be withdrawn, entrapped and knocking making deformed distal stent. Attempts were made to push and pull for free the etranppbed guide wire. Small balloon inflation through trapped wire were performed. Multiple retrieval attempts were successful, resultant no reflow. Escalation balloons were used to open deformed distal stent, after that revealed stent fracture. Other stent was implanted. Final angiography showed good result, TIMI 3 flow.
Entrapped 2.mp4
Entrapped 3.mp4
Entrapped 4.mp4
Entrapped 2.mp4 Entrapped 3.mp4 Entrapped 4.mp4Case Summary
Entrapment and fracture of coronary guide-wire is rare complication of percutaneous coronary interventions (PCI). The incidence of such complication in PCI is reported 0.2-0.8%. However, the entrapped guide-wire leads to serious complication such as thrombosis, occlusion of the coronary vessel or systemic embolism. Risk of guide-wire disruption could be decreased by minimizing the number, manipulation and by removing side branch wire before main branch stenting or post-dilatation. Clear stent (Stent Boost) is helpful even in the absence of imaging, it may lead you to the proper direction.