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April 25, 20260 citationsOpen Access

Very Elderly Patient, Very Difficult Ostial RCA Lesion (Tips and Tricks for a Quick PCI With Minimal Complications

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SRSurenthiran RamanathanCLChay Shien Richard LongCEChee Kent Er

Key Points

  • The aim is to demonstrate effective strategies for performing PCI in elderly patients with difficult lesions.
  • Engagement techniques using various tips and tricks to facilitate PCI completion successfully.
  • Preparedness to convert to femoral access and use additional devices if complications arise.
  • The approach successfully completed the PCI while minimizing complications, despite the challenges presented.
  • An undersized segment was accepted, emphasizing the importance of pragmatism over perfection in procedural success.

Abstract

As titled, this case highlighted: (1) A very elderly patient - who he can deteriorate and if so, will be difficult to recover (2) OstiumRCA lesion which made engagement impossible and also fatal if not carefulWe employed many tips and tricks with the solepurpose of completing the PCI in the quickest yet safest option possible - as illustrated above. In any case, if anythingunfavourable occurred, we must be prepared to convert to femoral access, get help, use more devices and standbyhaemodynamic support. The last part, when we accepted the slightly undersized segment, clearly showed nothing can beperfect and 'chasing' endless results, may lead to the PCI not being completed successfully. https: //www. summit-tctap. com/2026/eposter/epostercaseᵥiew. php? code=CASE20251004₀01#

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Cite This Study

Ramanathan et al. (2026) studied this question.

synapsesocial.com/papers/69ec5aa788ba6daa22dac396https://doi.org/10.5281/zenodo.19708615
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  5. 5Challenging Primary PCI in Anomalous Origin of Right Coronary Artery: A Case Report and Literature Review2025 · 1 citations