TRICO 2009, the 5th annual TRICO (Transradial Intervention Course), was held in
Ahmedabad, India, January 3-4, 2009.

Because of a large festival in India in late January, TRICO 2009 was held earlier than usual which prevented several international speakers from attending

Still, our international faculty included many of the worlds top TRI experts, including Shigeru Saito from Japan, and John Coppola and Samir Pancholy from the US. Other top interventionalists such as Raj Makkar and Saibal Kar from the US; Christoph Naber from Germany; and Mithra Kumar from Sri Lanka were also present. The TCVS team rounded out the faculty.

Participants included 350 interventional cardiologists. We had to turn away 60 others due to our desire to keep TRICO a more intimate learning experience.

For the program, we featured 25 live cases including 9 CTOs, 7 bifurcations, and several peripheral interventions including renal-, subclavian-, and vertebral-artery stenting. The TRIs were performed at Krishna Heart Institute and transmitted live to Nirma University auditorium

On the first day, Dr. Patel and Shah first live case was an elderly lady with at least a six-year history of CTO of the proximal LAD. The case went smoothly and there was tremendous interaction between the expert panel and the operators. Immediately after that case, Drs. Saito and Ranjan gave an excellent live demonstration of a LAD diagonal bifurcation case.

The third case was a long CTO of the RCA by Drs. Patel and Shah. Drs. Saito and Ranjan performed a very complex proximal LAD trifurcation as the fourth case. Despite a long night journey and fatigue, Dr. Saito was at his usual best.

Drs. Patel and Shah performed the fifth case which was a long RCA lesion. Dr. Patel then gave a talk at Nirma auditorium. Meanwhile, Drs. Pancholy and Shah performed a complex RCA case.

Dr. Coppola followed with an elegant, live demonstration of complex LAD stenting.

Drs. Patel and Ranjan performed the last case before lunch and encountered a major complication in the form of severe left main dissection which extended in the aortic route. We had already done the stenting of a long LAD lesion, but the patient started becoming hemodynamically unstable. We successfully tackled the left main issue and sealed the dissection using a 4 mm stent, which everyone enjoyed seeing.

After lunch, Dr. Saito performed two more complex cases. Dr. Coppola demonstrated renal and subclavian stenting and I demonstrated one complex bifurcation case.

So, the first day we had 14 live demonstrations. In the afternoon, Dr. Pancholy delivered a wonderful talk on radial-artery occlusion. And we awarded certificates to Drs. Pushpendra Garg and Uttamkumar Saha from India, and Dr. Junya Matsumi from Japan, for successful completion of their TRICO Fellow and TRICO Visiting Fellow training.

The day wrap-up panel discussion on common TRI challenges was extremely interactive – like classroom teaching. That evening, we had the lovely Gala Dinner on the lawns of the Karnavati Club in Ahmedabad.

On the second day of the course, we started with a live demonstration of a complex instent stenosis of the LAD with diagonal bifurcation, performed by Drs. Makkar and Pancholy. Then Drs. Patel and Shah performed a complex case with a LAD lesion and a long dissection. Drs. Saito and Malhotra performed the third case – a CTO of the RCA; Dr. Saito very beautifully demonstrated the retrograde approach.

Three cases followed, including a complex vertebral stenting case by Drs. Patel and Shah. The last live demo was a LAD CTO case with intra-arterial collaterals. In this case, we had to struggle to find the true channel to enter the distal LAD and it generated a lot of discussion in the audience.

The angio panel discussion after lunch was exciting. Drs. Coppola, Pancholi, Makkar, Malhotra, Garg, and many others showed their most challenging case videos and there were excellent discussions.

This was our fifth consecutive TRICO. We are thrilled we have been instrumental in training young interventional cardiologists from around the world and we are excited about our thriving Fellowship program.

We are extremely grateful to our international guest faculty. Our special thanks goes to Dr. Saito.

Be sure to pencil in TRICO 2010 on your calendars for next January!


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