LINC 2013 live case guide

Find all Live Cases and operators listed below.

Conference day 1

  • - , Main Arena 1

    Case 01 – Subacute type B – dissection

    Center:
    Leipzig
    Case 01 – LEI 01: female, 55 years (L-W)
    Clinical data
    Symptomatic Type B Dissection with acute thoracic pain
    with malperfusion left kidney 12/2012
    Arterial hypertension, obesity (BMI 35 kg/m2)

    Procedural steps
    1. Cut down right common femoral artery

    2. Right brachial access
    - 6F, 25 cm Radiofocus Introducer (TERUMO)

    3. Zenith TX2 TAA Endovascular Graft (COOK)

    4. Stenting of the SMA on indication
    - Herculink 6,5/18 mm (ABBOTT)

    5. Implantation of a Zenith Dissection Endovascular Stent 46-164 mm (COOK)
  • - , Main Arena 1

    Case 02 – Asymptomatic high grade stenosis right internal carotid artery

    Center:
    Mercogliano
    Case 02 – MER 01: male, 69 years (Z-G)
    Operators:
    • Paolo Rubino,
    • Giovanni Sorropago,
    • Eugenio Stabile
    Clinical data
    Hypertension, COPD, hyperlipidaemia, former smoker

    Duplex
    Fibrotic plaque determining severe stenosis of the right ICA (3.4 m/sec.)

    Procedural steps
    1. Navigation of a diagnostic catheter into the Right ECA
    - 5F JR diagnostic catheter, 100 cm (CORDIS)
    - 0.035" Radifocus Terumo angled soft guide-wire, 180 cm (TERUMO)

    2. Introduction of the cerebral protection device and endovascular clamping
    - 9F–25 cm Radifocus Introducer II (TERUMO)
    - 0.035" Supra Core guide-wire, 300 cm (ABBOTT)
    - Endovascular Clamping Device – MoMa Ultra (MEDTRONIC)

    3. Passing of the lesion and stenting
    - 0.014" Balance Middle Weight guide-wire, 190 cm (ABBOTT)
    - 3.5/20 mm Falcon Bravo RX PTA Balloon Catheter (MEDTRONIC)
    - 8.0/40 mm Precise PRO Rx Carotid Stent (CORDIS)

    4. Postdilatation
    - 5.5/20 mm Falcon Bravo RX PTA Balloon Catheter (MEDTRONIC)#



    Clinical data
    Duplex
    Procedural steps
  • - , Main Arena 1

    Case 03 – Renal denervation in drug resistant hypertension

    Center:
    Leipzig
    Case 03 – LEI 02: female, 60 years (I-H)
    Operators:
    • Martin Werner,
    • Klaus Hertting
    Clinical data
    Office blood pressure: 180/95 mmHg
    Ambulatory BP
    Cerebrovascular disease: 70% stenosis ICA right
    LV Hypertrophy
    Renal function: GFR 93 ml/min
    Medikation: Ca++ Blocker, ACE Inhibitor, betablocker, diuretic

    Procedural steps
    1. Femoral access right groin

    2. Placement of a 8F 70 cm sheath (COOK)

    3. Wiring the renal arteries (0.014")

    4. Renal Denervation
    - Vessix V2 System (BOSTON SCIENTIFIC)
  • - , Main Arena 1

    Case 04 – Occlusion of the left SFA

    Center:
    Leipzig
    Case 04 – LEI 03: male, 67 years (H-K)
    Operators:
    • Andrej Schmidt,
    • Sven Bräunlich
    Clinical data
    PAOD Rutherford 3, claudication at 150 meters left calf
    CAD, PTCA 12/2012
    Hypertension, hyperlipidaemia, former smoker
    ABI left 0.71

    Procedural steps
    1. Cross-over-access from right to left
    - 7F 40 cm Flexor Check-Flo Introducer (COOK)

    2. Attempt to pass the lesion intraluminally
    - TruePath System (BOSTON SCIENTIFIC)
    - Supported by a TrailBlazer 0.018" 135 cm Support-Catheter (COVIDIEN)

    3. Introduction of a Spider-filter 6mm (COVIDIEN)

    4. Atherectomy
    - TurboHawk LX-C (COVIDIEN)

    5. PTA
    - Drug-eluting balloons: LEGFLOW® (CARDIONOVUM)
    In case of flow limiting dissection:
    - Tack-IT Endovascular Stapler SystemTM (INTACT VASCULAR)
  • - , Main Arena 1

    Case 05 – Chronic Critical Limb Ischemia

    Center:
    Berne
    Case 05 – BER 01
    Operators:
    • Dai-Do Do
    Clinical data
    PAOD Rutherford 4, pretibial skin ulcers
    CAD, MI 2008; TIA, DVT right calf 2011
    10/2012: elsewhere successful PTA of the left SFA,
    however failure to recanalize the left popliteal artery
    Arterial hypertension, hyperlipidemia, GFR 50 ml/min

    Procedural steps
    1. Antegrade left femoral access and sheath insertion
    - 6F 10 cm Radiofocus Introducer (TERUMO)

    2. Passage of the lesion
    - 4 F Berenstein (MERIT MEDICAL)
    - 0.018" Connect Flex (ABBOTT)
    - Re-entry device OUTBACK (CORDIS) on indication
    - 0.014" HT Command (ABBOTT)

    3. Predilatation and Dilatation
    - Armada 14, Fox SV (ABBOTT)

    4. Stenting on indication
    - Absolute (above knee), Xpert (below knee) selfexpanding nitinol stents (ABBOTT)

    5. Retrograde access via ATA, if antegrade access fails
  • - , Main Arena 1

    Case 06 – Occlusion left anterior tibial artery

    Center:
    Leipzig
    Case 06 – LEI 04: male, 73 years (V-W)
    Operators:
    • Sven Bräunlich,
    • Michael Piorkowski
    Clinical data
    PAOD Rutherford 5, ulceration toe I left foot
    ABI left 0,4
    Stenting left proximal ATA with DES 4/2012
    Stenting right SFA 9/2012
    Coronary artery disease, stenting RCX, RCA, LAD 9/2012
    Atrial fibrillation with phenprocoumon-therapy
    Hypertension, hyperlipidemia, DM, former smoker (~60 py)

    Procedural steps
    1. Antegrade access left groin
    - 5F 55 cm Check Flo Introducer sheath, Ansel Modification (COOK)

    2. Guide wire Passage of the lesion with
    - Hi-Torque Command 300 cm (ABBOTT)

    3. Dilatation of the lesion
    - 2,5/200 mm Armada 14 PTA Catheter (ABBOTT)

    4. Stenting on indication
    - Xience Prime BTK Everolimus eluting stent (ABBOTT)

    5. Optionally PTA of the posterior tibial artery
  • - , Main Arena 2

    Case 13 – Renal denervation in resistant hypertension

    Center:
    Leipzig
    Case 13 – LEI 09: female, 75 years (M-O)
    Operators:
    • Martin Andrassy,
    • Klaus Hertting
    Clinical data
    Office BP: 170/ 80 mmHg
    Ambulatory BP: 147/ 78 mmHg
    non dipping profile
    Renal function: GFR 78 ml/min
    BMI 31 kg/m2, diabetes mellitus 2, Hyperlipidemia
    Secondary causes of HTN excluded
    Medication: AT1- Blocker, betablocker, diuretic, centrally acting agent (clonidine)
    Drug intolerance: ACE Inhibitor (allergic), Ca++ -blocker (peripheral edema)

    Procedural steps
    1. Femoral access right groin (7F)

    2. Placement of a 7F 70 cm guiding catheter
    - HS / IMA (Mach-1, BOSTON SCIENTIFIC)

    3. Buddy wire renal artery
    - 0.014" Hi-torque Spartacore 14 (ABBOTT)

    4. Renal artery denervation
    - Simplicity® RF Catheter (MEDTRONIC)
  • - , Technical Forum

    Case 18 – Occlusion of the aortic bifurcation

    Center:
    Leipzig
    Case 18 – LEI 11: male, 54 years (H-U)
    Operators:
    • Dierk Scheinert,
    • Sven Bräunlich,
    • Johannes Schuster
    Clinical data
    PAOD Rutherford 3, claudication at 50 meters both legs
    Art. hypertension, former smoker, diabetes mellitus
    ABI bilateral 0.65

    Procedural steps
    1. Left brachial approach
    - 5F Pigtail-catheter (CORDIS)
    - 0.035" angled soft Terumo 180 cm (TERUMO)
    - 0.035" 300 cm Supra Core (ABBOTT)
    - 6F – 90 cm Flexor Check-Flo Sheath (COOK)

    2. Passage of the occlusion from brachial
    - 5F Multipurpose 125 cm diagnostic catheter (CORDIS)
    - 0.035" angled stiff Terumo 260 cm (TERUMO)

    3. Snaring of the Terumo via 7F groin sheath bilateral
    - 7F and 11F 25 cm Introducer Sheath (TERUMO)

    4. Exchange
    - to 0.035" SupraCore 300 cm guidewires via groin-access (ABBOTT)

    5. PTA of the occlusion
    - Armada 35 6/120 mm (ABBOTT)

    6. Stenting
    - Aorta: Sinus Aortic Stent 22/80 mm (OPTIMED)
    - Iliac arteries: Omnilink Elite Peripheral Stent System 8/59 mm (ABBOTT)
    Optional: Advanta 12 Covered Stent (ATRIUM/Maquet Getinge Group)
  • - , Main Arena 2

    Case 14 – Iliofemoral venous intervention

    Center:
    Berne
    Case 14 – BER 02: male, 60 years (Z-H)
    Operators:
    • Nils Kucher,
    • Gerard O'Sullivan
    Clinical data
    Severe post-thrombotic syndrome of the right leg with
    Venous claudication, varicose veins, leg swelling
    History of acute iliofemoral DVT right leg & massive
    PE 6 months ago
    DVT treated with anticoagulation & compression
    PE treated with catheter assisted thrombolysis

    Procedural steps
    1. Popliteal venous access with ultrasound guidance (7F-sheath)

    2. Phlebography

    3. Wire crossage
    - Astato 20 0.014"; Astato 30 0.018"; Conquest 0.014" (ASAHI)

    4. Predilation of lesion
    - Amphirion 0.014" 1.5-2.0 mm (MEDTRONIC)
    - Fox SV 0.018" 3.0-6.0 mm (ABBOTT)

    5. Implantation of dedicated venous stents over Terumo angled wire 0.035
    - Iliac veins: Sinus-Venous 14-18 mm (OPTIMED), Zilver Vena 14-16 mm (COOK)
    - Common femoral vein: Sinus-Super-Flex 12 mm (OPTIMED), Wallstent 12 mm (BOSTON SCIENTIFIC)

    6. High-pressure post-dilation of stents
    - Fox Cross 0.035" 8.0-12.0 (ABBOTT)
  • - , Main Arena 1

    Case 07 – Occlusion of the left popliteal artery, failed antegrade recanalization-attempt

    Center:
    Leipzig
    Case 07 – LEI 05: male, 68 years (D-K)
    Operators:
    • Andrej Schmidt,
    • Michael Piorkowski
    Clinical data
    PAOD Rutherford 4, claudication at 50 meters left calf
    ABI 0.4 left
    Antegrade recanalization attempt with failed distal re-entry 12/2012
    Hypertension, hyperlipidaemia, adipositas, diabetes mellitus, former smoker (25 py)
    Cerebrovascular disease: stroke 2006
    Chronic renal impairment (GFR 35 ml/min)
    Infrarenal AAA (max. diameter 39 mm)

    Procedural steps
    1. Antegrade access left groin
    - 6F 55 cm Flexor Check-Flo Introducer, Ansel Modification (COOK)

    2. Left peroneal artery retrograde sheathless approach
    - 21 Gauge 4 cm puncture needle (COOK)
    - Quick-Access Needle Holder (SPECTRANETICS)
    - 0.018" V-18 Control 300 cm guidewire (Boston Scientific) supported by
    - 0.018" Quick Cross support catheter, 90 cm (SPECTRANETICS)

    3. Snaring of the wire from antegrade access
    - Quick Cross Capture-Wire Connector (SPECTRANETICS)

    4. Predilation
    - Exchange to a 0.014" guidewire (PT2, Boston Scientific)
    - 2.5/80 mm Chocolate PTA Balloon Catheter (TriReme MEDICAL)

    5. PTA
    - 3.0/80 and 4.0/120 mm In.Pact Amphirion Drug Eluting Balloon (MEDTRONIC)

    6. Stenting on indication
    - Complete-SE for ATK, Maris Deep for BTK (MEDTRONIC)
  • - , Technical Forum

    Case 19 – Complex stenosis and occlusion of the left EIA, CFA and SFA

    Center:
    Leipzig
    Case 19 – LEI 12: female, 69 years (E-F)
    Operators:
    • Matthias Ulrich,
    • Daniela Branzan,
    • Bernd-Michael Harnoss
    Clinical data
    PAOD Rutherford 4, restpain and severe claudication left thigh and calf
    Aortic valve replacement 02/2011
    Interventional thrombectomy right groin 02/2011
    Arterial hypertension, former smoker (30py)

    Procedural steps
    1. TEA left common femoral artery

    2. Cross-over PTA/Stent of the external iliac artery
    - Armada 35 LL PTA Catheter 6/80 mm (ABBOTT)
    - Complete selfexpanding stent 7/100 mm (MEDTRONIC)

    3. Recanalization of the SFA and PTA with DEBs
    - InPact Pacific (MEDTRONIC)

    4. Stenting on indication
    - Innova selfexpanding nitinol stent (BOSTON SCIENTIFIC)
  • - , Main Arena 1

    Case 08 – Diffuse In stent restenosis of the right SFA

    Center:
    Mercogliano
    Case 08 – MER 02: male, 62 years (D-A)
    Operators:
    • Eugenio Stabile,
    • Vittoro Ambrosini,
    • Grigor Popusoi
    Clinical data
    PAOD, Rutherford 3, PTA/Stent right and left SFA 2010
    Claudication right limb
    Arterial hypertension, COPD, former smoker, hyperlipidaemia
    Diabetes mellitus
    CAD (Previous Anterior AMI and PCI LAD)

    Duplex
    Severe in stent stenosis right SFA (3.4 m/sec; PSVR: 4.67)

    Procedural steps
    1. Contralateral access and placement of a cross-over sheath
    - 5F JR4 Radifocus Angiographic Catheter (TERUMO)
    - 0.035" Radifocus Terumo angled soft guide-wire, 180 cm (TERUMO)
    - 0.035" Supra Core guide-wire, 300 cm (ABBOTT)
    - 8F – 45 cm Destination Guiding Sheath (TERUMO)

    2. Passage of the lesions
    - 0.014" Balance Middle Weight guide-wire, 300 cm (ABBOTT)

    3. Lesion debulking
    - Turbo Booster ELCA Laser Ablation Catheter (SPECTRANETICS)

    4. Drug Eluting Balloon Dilation
    - 5/120 mm Admiral IN.PACT Balloon Catheter (MEDTRONIC)
  • - , Global Expert Exchange

    Case 23 – Left critical limb ischemia due to anterior tibial artery occlusion and tibioperoneal trunk stenosis

    Center:
    Mercogliano
    Case 23 – MER 05: male, 47 years (C-C)
    Operators:
    • Angelo Cioppa,
    • Luigi Salemme,
    • Linda Cota
    Clinical data
    PAOD, Rutherford 4
    Arterial hypertension, former smoker, hyperlipidaemia, diabetes mellitus
    CAD (CABG 2009 and PCI 2011)

    Duplex
    Fibrotic Plaque determining severe stenosis of the tibioperoneal trunk and occlusion of the anterior tibial artery

    Procedural steps
    1. Contralateral access and placement of a cross-over sheath
    - 5F JR4 Radiofocus Angiographic Catheter (TERUMO)
    - 0.035" Radiofocus Terumo angled soft guide-wire, 180 cm (TERUMO)
    - 0.035" Supra Core guide-wire, 300 cm (ABBOTT)
    - 6F-90 cm Destination Guiding Sheath (TERUMO)

    2. Passage of the lesions and predilation
    - 0.014" Balance Middle Weight guide-wire, 300 cm (ABBOTT)
    - 3/80 mm Amphirion DEEP Balloon Catheter (MEDTRONIC)

    3. Drug Eluting Balloon Dilation, Intravascular Ultrasound Assessment and Bail-Out Stenting
    - 3/80 mm Amphirion IN.PACT Balloon Catheter (MEDTRONIC)
    - Eagle Eye Platinum RX digital IVUS Catheter (VOLCANO)
    - Stenting on indication Inperia Advance (CID)
  • - , Main Arena 2

    Case 15-1 – Iliofemoral venous intervention

    Center:
    Berne
    Case 15 – BER 03: male, 50 years (B-F)
    Operators:
    • Nils Kucher,
    • Gerard O'Sullivan
    Clinical data
    Chronic venous insufficiency (C5-6EsAd9Po) right leg with
    – Recurrent venous ulcers
    – Leg swelling despite compression
    Pelvic Vein Thrombosis 01/1995
    Right Renal Vein Thrombosis 1962
    – Nephrectomy right kidney 1963
    Suspected coagulation disorder treated with
    Permanent oral anticoagulation
    PTS treated with compression hosiery

    Procedural steps
    1. Bilateral popliteal venous access with ultrasound guidance
    (10F-sheath), may use additional jugular vein access (6F-sheath), general anaesthesia

    2. Phlebography

    3. Wire crossage
    - Astato 20 0.014"; Astato 30 0.018"; Conquest 0.014" (ASAHI)

    4. Predilation of lesion
    - Amphirion 0.014" 1.5-2.0 mm (MEDTRONIC)
    - Fox SV 0.018" 3.0-6.0 mm (ABBOTT)

    5. Implantation of dedicated venous stents over Terumo angled wire 0.035
    - Iliac veins: Sinus-Venous 14-18 mm (OPTIMED), Zilver Vena 14-16 mm (COOK),
    - Common femoral vein: Sinus-Super-Flex 12 mm (OPTIMED), Wallstent 12 mm (BOSTON SCIENTIFIC),
    - IVC: Optimed XL 18-22 mm (OPTIMED)

    6. High-pressure post-dilation of stents
    - Fox Cross 0.035" 8.0-12.0 (ABBOTT)
  • - , Main Arena 1

    Case 09 – Occlusion of the right tibio-peroneal trunk, CLI

    Center:
    Leipzig
    Case 09 – LEI 06: male, 65 years (V-S)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    Clinical data
    PAOD Rutherford 5, ulceration right heel
    Stenting right SFA 2009, left SFA 2010
    History of myocardial infarction, CAD, CABG 2002
    Arterial hypertension, obesity, former Smoker (30py)

    Procedural steps
    1. Right antegrade access
    - 6F 55 cm Flexor Check-Flo Performer (COOK)

    2. Antegrade passage of the popliteal lesion

    3. PTA and implantation of a Supera-Stent into the popliteal artery (IDEV)

    4. Antegrade attempt to pass the TPT occlusion
    - 0.018" CXI Support-Catheter 90 cm (COOK)
    - 0.014" Approach Hydro ST Guide wire, 300 cm (COOK)

    5. In case of failure retrograde approach via posterior tibial artery
    - Micropuncture® Transpedal Access Set (COOK) with
    - 21 Gauge 4 cm needle and 3F Sheath (COOK)
    - 0.018" CXI Support-Catheter 90 cm (COOK)
    - 0.014" Approach CTO Guidewire 18 g, 300 cm (COOK)

    6. PTA of TPT and PA from retrograde with
    - Advance Micro 14 Balloon (COOK)

    7. Optional drug-eluting balloon PTA
    - In.Pact Deep (MEDTRONIC)
  • - , Main Arena 1

    Case 10 – Popliteal aneurysm right leg

    Center:
    Miami
    Case 10 – MIA 01: female patient
    Operators:
    • Barry Katzen,
    • Alex Powell
    Clinical data
    St.p. AAA (Gore Excluder Endograft 2006)
    Contralateral PAA treated 2012
    Art. hypertension, hyperlipidemia, smoking (quit 6 years ago)
    St.p. colon cancer (42 years ago)
    St.p. breast cancer (2009), TURP (1997)
    St.p. pacemaker due to arrhythmia
    Hiatal hernia, gastritis / GERD, mild COPD

    Procedural steps
    1. Right antegrade access
    - 6F vascular sheath
    - straight marking catheter
    - torque wire

    2. Exchange to 7F/8F sheath and 0.018 BMW wire (ABBOTT)

    3. 7 x 15 Viabahn stent (GORE)

    4. 8 x 15 Viabahn stent (GORE)

    5. Balloon dilatation with 8 x 4 Cook balloon (COOK)

    6. AngioSeal (St. Jude Medical)
  • - , Main Arena 2

    Case 16 – Highgrade stenosis left popliteal artery

    Center:
    Leipzig
    Case 16 – LEI 10: male, 56 years (M-G)
    Operators:
    • Matthias Ulrich,
    • Klaus Hertting
    Clinical data
    PAOD Rutherford 5, ulceration left D1
    Claudication at 150 meters left calf
    Stenting left SFA 09/2011
    PTA right SFA and popliteal artery 12/2012
    Art. hypertension,
    ABI left 0.41

    Procedural steps
    1. Left antegrade access
    - 8F 10 cm Sheath (TERUMO)

    2. PTA of the In-Stent Restenosis
    - DEB, Lutonix Drug-Coated-Balloon 5/80 (BARD)

    3. Guide wire Passage of the Popliteal artery
    - V18 Control wire (BOSTON SCIENTIFIC)

    4. Atherectomy
    - Jetstream Navitus Atherectomy Catheter (BAYER HEALTH CARE)

    5. PTA
    - Drug-eluting balloons: In.Pact Deep 4.0/120 mm (MEDTRONIC)

    6. Stenting on indication
    - LifeStent (BARD)
  • - , Technical Forum

    Case 20 – Occlusion of all BTK arteries right leg

    Center:
    Leipzig
    Case 20 – LEI 13: male, 67 years (WR-B)
    Operators:
    • Andrej Schmidt,
    • Sven Bräunlich
    Clinical data
    PAOD Rutherford 5, CLI, forefoot-gangrene
    Diabetes mellitus
    Hypertension, former smoker
    ABI right not measurable
    CAD with urgent CABG 1/2013

    Procedural steps
    1. Right antegrade approach
    - 5F 55 cm Flexor Check-Flo Performer Introducer Sheath (COOK)

    2. Intraluminal passage of the occlusion of the peroneal artery
    - Command 0.014" GW 300 cm (ABBOTT)
    - Armada 14 2.5/120 mm 120 cm (ABBOTT)

    3. In case of failure exchange to
    - Winn 80 or 200 T 0.014" guidewire 300 cm (ABBOTT)

    4. PTA and potentially implantation of a DES (P3-stenosis)
    - Xience Prime BTK 3.5/38 mm (ABBOTT)
  • - , Technical Forum

    Case 21 – Asymptomatic high grade in stent restenosis right internal carotid artery

    Center:
    Mercogliano
    Case 21 – MER 03: male, 57 years (G-G)
    Operators:
    • Stephen Ramee,
    • Eugenio Stabile,
    • Tullio Tesorio
    Clinical data
    Hypertension, hyperlipidaemia, NIDDM
    03/99 AMI and CABG; 10/12 PCI RCA
    10/01 Right CEA; 02/02 Right CAS
    08/09 PAD (Aorto – Right CFA Graft)

    Duplex
    Fibrotic hyperplasia determining severe stenosis of the left ICA (3.2 m/sec.)

    Procedural steps
    1. Introduction of the carotid guiding sheath and cerebral protection device
    - 6F-90 cm Destination Carotid Guiding Sheath (TERUMO)
    - 0.035" Supra Core guide-wire, 300 cm (ABBOTT)
    - 0.014" Balance Middle Weight guide-wire, 190 cm (ABBOTT)
    - 5.0 Spider Fx Embolic Protection System (ev3)

    2. Passing of the lesion, intravascular ultrasound evaluation and stenting
    - 0.014" Balance Middle Weight guide-wire, 190 cm (ABBOTT)
    - Eagle Eye Platinum RX digital IVUS Catheter (VOLCANO)
    - 3.5/20 mm Falcon Bravo RX PTA Balloon Catheter (MEDTRONIC)
    - 8.0 – 10.0 / 40 mm XACT Carotid Stent System (ABBOTT)

    3. Postdilatation
    - 5.5/20 mm Falcon Bravo RX PTA Balloon Catheter (MEDTRONIC)
  • - , Main Arena 1

    Case 11 – Occlusion of the left distal SFA

    Center:
    Leipzig
    Case 11 – LEI 07: male, 62 years (G-P)
    Operators:
    • Sven Bräunlich,
    • Matthias Ulrich,
    • Martin Werner
    Clinical data
    PAOD Rutherford 3, claudication left calf at 150 meters, ABI 0.67
    Stenting left common iliac artery 10/2012 for restpain
    PTA right SFA for claudication 11/2012
    Bilateral groin hematoma and dissection 11/2012
    Diabetes mellitus type 2, art. hypertension, current smoker

    Procedural steps
    1. Right brachial access
    - 5F Flexor 110 cm Check-Flo Performer Tibial sheath (COOK)

    2. Passage of the occlusion
    - 0,035" stiff angeled Terumo Glidewire 300 cm (TERUMO)
    - Supported by a Trailblazer 0,035", 150 cm (COVIDIEN)

    3. Exchange
    - for a V18 control guide wire (BOSTON SCIENTIFIC)

    4. PTA
    - Powercross PTA Balloon catheter 5/150 mm, 150 cm (COVIDIEN)

    5. Implantation
    - of a 6/120 mm Everflex Self-expanding Peripheral Stent with 5 French Entrust Delivery System (COVIDIEN)
  • - , Main Arena 2

    Case 17 – Iliofemoral venous intervention

    Center:
    Berne
    Case 17 – BER 04: female, 73 years (A-P)
    Operators:
    • Nils Kucher,
    • Gerard O'Sullivan
    Clinical data
    Recurrent left sided varicosis with
    – Leg & groin discomfort
    – Swelling of the leg
    Recurrent PE’s & femoro-popliteal DVT’s treated with anticoagulation & compression
    Symptomatic varicose veins
    Stripping of left GSV

    Procedural steps
    1. Popliteal venous access with ultrasound guidance (7Fr-sheath)

    2. Phlebography

    3. Wire crossage
    - Terumo angled wire 0.035", may use Astato 0.018" 30 (ASAHI)

    4. IVUS only if angiographic significance of lesion is doubtful

    5. Implantation of dedicated venous stent over Terumo angled wire 0.035
    - Iliac vein: Sinus-Venous 14-18 mm (OPTIMED), or Zilver Vena 14-16 mm (COOK)

    6. High-pressure post-dilation of stent
    - Fox Cross 0.035" 10.0-12.0 (ABBOTT)
  • - , Technical Forum

    Case 22 – Symptomatic high grade stenosis of ostial left CCA and proximal left ICA

    Center:
    Mercogliano
    Case 22 – MER 04: female, 75 years (E-A)
    Operators:
    • Giovanni Sorropago,
    • Paolo Rubino,
    • Eugenio Stabile
    Clinical data
    12/12 TIA (Dysarthria and right hand paresis)
    Hypertension, hyperlipidaemia, NIDDM
    06/12 ACS – PCI LM (DES)

    Duplex
    Fibrolipidic Plaque determining severe stenosis of the Left ICA (1.8 m/sec)
    Calcific plaque determining severe stenosis of the ostial left CCA

    Procedural steps
    1. Introduction of the Carotid Guiding Catheter and cerebral protection device
    - 8F JR4 4.0 Launcher Guiding Catheter (TERUMO)
    - 4.0 – 7.0 Emboshield NAV Embolic Protection System (ABBOTT)

    2. Stenting the lesions
    - 3.5/20 mm Falcon Bravo RX PTA Balloon Catheter (MEDTRONIC)
    - 8.0/19 mm PALMAZ GENESIS Peripheral Stent (CORDIS) for CCA
    - 8.0/40 mm Precise PRO Rx Carotid Stent (CORDIS) for ICA

    3. Postdilatation
    - 5.5/20 mm Falcon Bravo RX PTA Balloon Catheter (MEDTRONIC)
  • - , Main Arena 1

    Case 12 – Occlusion of the right medial SFA

    Center:
    Leipzig
    Case 12 – LEI 08: male, 54 years (A-R)
    Operators:
    • Andrej Schmidt,
    • Michael Piorkowski
    Clinical data
    PAOD Rutherford 3, claudication right calf at 100 m, ABI 0.69 right
    Failure to recanalize the occlusion 12/2012
    Arterial hypertension, current smoker (40py)

    Procedural steps
    1. Left femoral cross-over approach
    - 5F, 55 cm, Flexor Check-Flo Introducer (COOK)

    2. Second attempt to pass the occlusion from antegrade:
    Subintimal passage of the occlusion
    - 0.035" Terumo Guidewire 260 cm (TERUMO)
    - and 0.035" Trailblazer Support Catheter, 135 cm (COVIDIEN)
    - Reenter the true lumen with the Enteer Re-Entry System (COVIDIEN)

    3. PTA
    - Powercross PTA Balloon Catheter 5/100 mm Balloon (COVIDIEN)

    4. Implantation
    - of a 5F compatible Stent (7/120 cm) Everflex Self-expanding Peripheral Stent with Entrust Delivery System (COVIDIEN)