TRICO 2013, the 9th International Transradial Intervention Course was held on 19th and 20th of October, this year. Again, the venue was Nirma University Auditorium and the live transmission was from Apex Heart Institute, Ahmedabad.
We started the preparation for TRICO 2013 since the beginning of this year, and our old friends including Samir Pancholy, John Coppola, Mitchell Krucoff, Tejan Patel, Ian Gilchrist and Kintur Sanghvi agreed to be on international guest faculty. Unfortunately, Sunil Rao, Josef Ludwig and Olivier Bertrand could not make it this time. We also invited Ling Ong, Ramon Quesada, Michael Cowley, Mauricio Cohen (all from US) and Sanjit Jolly from Canada on international guest faculty. It was an honor for us once again to have Dr. Shigeru Saito as Course Director alongwith me and Sanjay. We accumulated 20 very complex cases of coronary interventions and all of them got admitted on 18th October, 2013, at Apex. The response of participants for registration was overwhelming and before we realized, 515 participants were registered and we had to stop registering new participants almost two weeks before TRICO 2013. We refused 138 registrations in last week. To our surprise, last moment dropout rate was only 8%. Most participants and international guests arrived on 18th October, 2013. We were all set for the power packed course.
On 19th October, 2013 at 8.45 a.m. sharp, we started live demo of the first case. It was a complex LMCA bifurcation stenosis. Sanjay assisted me. In this case, we showed utility of OCT. We also showed a good demonstration of radial puncture technique. In the beginning, we noticed that patient had perforation of radial artery and we demonstrated balloon assisted tracking (BAT) in live demo, to track the 7F EBU guide catheter through the perforated segment. We had very good discussion during the live demo. End result was optimal using Xience Expedition stent. The next case was a LAD-D1 bifurcation stenosis. It was performed by great Dr. Saito and was assisted by Rajni. He actually made complex looking case very simple and was done in less than 30 minutes time using Resolute integrity stent. He used IVUS for this case. The third case was CTO of proximal LAD. LMCA was arising from right coronary cusp, which made the situation quite complex. I was the primary operator and Sanjay assisted me. We used a 6F EBU guide to cannulate LMCA and Progress 40 guide wire to cross CTO. We used Maverick 1.5 mm balloon to cross and dilate the CTO. End result was perfect using Resolute Integrity stent. Fourth case was a very complex RCA CTO. Dr. Saito struggled for quite long time, but, he could make it using Promus Element Plus stent. The audience was absolutely spell bound. The fifth live case was done by Dr. Samir Pancholy, who was assisted by Surender. Patient had two type C lesions in large caliber, long RCA. As usual, Samir did a very systematic live demonstration using long Promus Element Plus stents. End result was evaluated using OCT. Before lunch break, there were two didactic talks, one by Sanjit Jolly and the other by me.
After lunch break, sixth case was done by Mitchell Krucoff and Sanjay. Patient had two lesions in RCA and LAD-D-1 bifurcation stenosis. Promus Element Plus and Biomatrix Flex stents were used. As it was a long case, there was lot of discussion during the case. It ended well. Final result was confirmed using IVUS. Seventh case was done by me and assisted by Rajni. Patient had critical LAD and OM lesions. Absorb (Bioresorbable scaffold) were used. For many in the audience including most international guests, it was a new device. We had good discussions on pros and cons of this implant. Final result was good and confirmed by OCT. Eighth case was done by Dr. Saito and Sanjay. Again it was a complex LAD-D-1 bifurcation. Dr. Saito did an elegant demonstration of Absorb implantation in bifurcation situation. He received lot of questions from panel and he answered them in his own signature style. Ninth case was a critical LMCA osteal stenosis. Patient was short statured lady having arteria lusoria situation. I did that case and showed our technique of working through arteria lusoria. We used Resolute Integrity with satisfactory end result. This was an end of the first day live demo session. We had to do three cases off-live. From 4.15 p.m. onwards, we had a lecture session. In this session, great didactic talks were delivered by Michael Cowley, Martial Hamon, Ling Ong and Mauricio Cohen. We had adjourned at 5.30 p.m. We had a memorable galla dinner in Karnavati Club Lawn from 8.30 p.m. onwards.
Second day we started at 9.00 a.m. sharp. The first case was a type-C LAD lesion starting from ostium. It was performed by Ian Gilchrist, who was assisted by Chirayu. He used Xience Expedition stent. The result was excellent and was confirmed by IVUS examination. The second case was done by Tejan Patel, who was assisted by Rajni. He very elegantly performed stenting of LMCA to LAD lesion using Resolute Integrity. The result was confirmed using OCT. The third case was a diffuse proximal LAD in-stent stenosis. I did this case and Sanjay assisted me. We used rotational atherectomy and deployed Absorb. The result was confirmed using OCT. There was a long discussion on use of Absorb in this case. The fourth case was done by Dr. Saito and Sanjay. It was a complex LCX-OM bifurcation stenosis. The end result was excellent using Xience Expedition stents. The fifth case was done by John Coppola and Sanjay. They fixed two LAD lesions and one RCA total occlusion using Promus Element Plus and BioMatrix Flex stents. The end result was good, which was confirmed using IVUS. This was an end of live demo session of the second day. Before lunch, we had excellent talks delivered by Ramon Quesada, Rajiv Gulati and Mauricio Cohen.
In post lunch session, we had important talks delivered by Ian Gilchrist, Samir Pancholy, Mitchell Krucoff, Kintur Sanghvi and Sanjay Chugh. In angio session, few angiograms were shown by the presenters and the discussion was done on each. We had our concluding remarks at 4.45 p.m. I have announced the dates of TRICO 2014 i.e. 11th and 12th October, 2014.
I am grateful to all my international friends, national guest faculties and participants for making this course a grand success.