LINC 2013 live case guide

Find all Live Cases and operators listed below.

Conference day 3

  • - , Technical Forum

    Case 77 – Complex AAA Aorto-Iliac Obstruction

    Center:
    Hamburg
    Case 77 – HAM 06: female 73 years
    Operators:
    • Hans Krankenberg,
    • P. Burchardt
    Clinical data
    POD Rutherford 4 left side / right side 5, little lesion dig. 1 right
    RF: current smoker, arterial hypertension, Apoplex,
    DVT left side 10/2012

    Angio
    Occlusion of infrarenal aorta, bilateral common/external iliac arteries

    Duplex
    Bilateral monophasic flow CFA
    ABI: left 0.5 / right not detectable

    Procedural steps
    1. Transbrachial approach left side
    - 6F Flexor Check Flo Performer Introducer
    Sheath, 90 cm (COOK)
    - 5F Pigtail diagnostic catheter, 110 cm (CORDIS)
    - 0.035" Radiofocus Terumo angeled soft guide wire 180 cm (TERUMO)

    2. Transbrachial recanalization bilateral with femoral wire extraction and exchange for a stiff wire
    - 0.018" V-18 control wire 300 cm (BOSTON SCIENTIFIC)
    - 0.035" Radiofocus angled + straight stiff guide wire, 260 cm (TERUMO)
    - 4 + 5F multipurpose guiding (custom made) Catheter, 125 cm (CORDIS)
    - 0.035" Supra core guide wire, 300 cm (ABBOTT)
    - Quick Cross Catheter 0.035", 135 cm (SPECTRANETICS)

    3. Transfemoral approach bilateral
    - Left: 7F Introducer Sheath, 23 cm (ST JUDE)
    - Right: 12F Introducer Sheath, 45 cm (COOK)

    4. Predilatation in kissing balloon technique
    - 4.0/120 mm Admiral Xtreme OTW Dilatation Catheter, 130 cm (MEDTRONIC)

    5. Stenting of the infrarenal aorta
    - CP STENT 2.8 cm (NUMED)
    - BIB Stent Placement Catheter 20mm/40mm (NUMED)

    6. Stenting and postdilatation in kissing-stent technique of aortic bifurcation/iliac arteries
    - 8.0/120 mm Complete SE Iliac 130 cm (Medtronic Invatec) or
    - 8.0/78 mm Scuba Peripheral CO-CR Stent 80 cmm (Medtronic Invatec)
    - Optional: ADVANTA V12 (Atrium) covered stents
  • - , Global Expert Exchange

    Case 86 – Renal denervation in drug resistant hypertension

    Center:
    Leipzig
    Case 86 – LEI 48: male, 63 years (H-R)
    Operators:
    • Matthias Ulrich,
    • Klaus Hertting
    Clinical data
    Office BP: 184/ 100 mmHg
    Ambulatory BP: 154/89 mmHg, non dipping profile
    Supraaortic disease: stenting left ICA 201
    Atrial fibrillation (oral anticoagulation)
    Renal function: GFR 56 ml/min
    LV Hypetrophy
    Medication: ACE-Inhibitor, AT1-Blocker, betablocker, diuretic Vasodilator, central acting angent (Moxonodine)

    Procedural steps
    1. Femoral access right groin 8F

    2. Placement of a 8F 55 cm EnligHTN Guide Catheter (RCD-1)

    3. Multielectrode Renal Denervation
    - EnligHTN Renal Denervation System (St. Jude Medical)
  • - , Main Arena 2

    Case 69 – Type-B-Dissection

    Center:
    Leipzig
    Case 69 – LEI 39: female, 65 years (R-W)
    Operators:
    • Andrej Schmidt,
    • Michael Piorkowski,
    • Michael Borger
    Clinical data
    Type -B- Dissection (max diameter descending aorta 40 mm) with dissection into the left subclavian artery
    Acute "Stabbing" back-pain with intermittent paraplegia (10 min) in 12/12, currently intermittent back pain
    Arterial hypertension (6 antihypertensive drugs)

    Procedural steps
    1. Surgical cut down right common femoral artery

    2. Left transbrachial approach
    - 7F 55cm Flexor Check-Flo Introducer (COOK)

    3. Implantation of a covered stent into the the left subclavian artery in "Chimney-technique"
    - 10/38mm, Advanta V12 (ATRIUM/Maquet Getinge Group)

    4. Implantation of a Thoracic Stentgraft System
    - Captiva (MEDTRONIC)
  • - , Main Arena 1

    Case 59 – Occlusion right common iliac artery

    Center:
    Leipzig
    Case 59 – LEI 33: male, 68 years (K-R)
    Operators:
    • Matthias Ulrich,
    • Johannes Schuster
    Clinical data
    PAOD Rutherford 3, walking capacity 100 m
    Claudication right thigh, ABI right 0.85
    Hypertension, current smoker (60 py)

    Procedural steps
    1. Left brachial access
    - 6F 90 cm Flexor Check-Flo Introducer (COOK)

    2. Antegrade Passage of the lesion
    - 0.035" Stiff Angled Terumo guide wire, 260 cm (TERUMO)
    - 5F Multipurpose, 125 cm (CORDIS)

    3. Right femoral access
    - 6F 25 cm destination introducer sheath (TERUMO)

    4. Snaring of the antegrade wire and exchanging for a
    - 0.035" SupraCore, 300 cm (ABBOTT)

    5. Predilation of the lesion
    - 0.035" Armada-Balloon 5/80 (ABBOTT)

    6. Kissing stent implantation
    - 9.0/59 mm Omnilink Elite Cobalt Chromium Stent (ABBOTT)

    7. Closure device of the access sites
    - Perclose Proglide (ABBOTT)
  • - , Main Arena 2

    Case 70 – Rapid progressive infrarenal aortic aneurysm 47mm

    Center:
    Ludwigsburg
    Case 70 – LUD 02: male, 82 years, (S-E)
    Operators:
    • Johannes Gahlen,
    • Wilko Staiger,
    • Pirkko Hettrich
    Clinical data
    Rapid progressive infrarenal aortic aneurysm
    Arterial hypertension, hyperlipidemia, obesity

    Procedural steps
    1. Placement of the distal part of the Endurant II Tube Endograft (Medtronic)

    2. Placement of the proximal part of the Endurant II Tube Endograft (Medtronic)

    3. Fixation of the proximal Endograft to the proximal aneurysm neck with HeliFX Endoscrews (Aptus Endosystems)

    4. Fixation of the distal Endograft to the distal aneurysm neck with HeliFX Endoscrews (Aptus Endosystems)
  • - , Global Expert Exchange

    Case 87 – Renal denervation using the ReCor© ultrasound balloon

    Center:
    Hamburg
    Case 87 – HAM 08: female, 75 years
    Operators:
    • Karl-Heinz Kuck,
    • Jaspers von Wedel,
    • Martin Bergmann
    Clinical data
    Dyspnea on exertion
    24h RR: mean systolic values: 182mmHg w/ peak of ~240mmHg
    Medication: Bisoprolol 1x 5mg, Torasemid 1x 10mg
    Candesartan 1x 32mg, Doxazosin 1x 2mg
    Risk factors: Hypercholesterinemia, s/p tobacco use
    Resistant hypertension for >10y

    Procedural steps
    1. 8F guiding catheter

    2. Wire distal A. renalis

    3. 3 ablation points with balloon 6mm, 2ATM

    4. 30 sec/ablation
  • - , Main Arena 1

    Case 60 – Re-occlusion of the left SFA

    Center:
    Leipzig
    Case 60 – LEI 34: male, 38 years (S-S)
    Operators:
    • Matthias Ulrich,
    • Klaus Hertting
    Clinical data
    PAOD Rutherford 3 (walking capacity 100 m) left
    ABI left 0.6
    PTA left SFA 12/2010, PTA right SFA 6/2011
    Coronary artery disease: stenting RCA, PLA 2010 and 2011
    Hypertension, hyperlipidemia (hereditary), former smoker (20 py)

    Procedural steps
    1. Right crossover femoral access
    - 8F Flexor Check-Flo Introducer Sheath, 45 cm (COOK)

    2. Wiring the occlusion
    - 0.018" V-18 Control guide wire, 300 cm (BOSTON SCIENTIFIC)
    - 0.035" Radiofocus Terumo angled soft guide-wire, 180 cm (TERUMO)

    3. Thrombectomy/ Atherectomy
    - SpiderFX Embolic Protection Device (COVIDIEN)
    - 6F Rotarex S Thrombectomy Catheter (STRAUB MEDICAL)

    4. PTA with DEB
    - In.Pact Pacific 6/120 DEB (MEDTRONIC)

    5. Stenting on indication
    - Life Stent (BARD)
  • - , Main Arena 2

    Case 71 – Abdominal aortic aneurysm

    Center:
    Leipzig
    Case 71 – LEI 40: male, 81 years (K-G)
    Operators:
    • Jost Philipp Schäfer,
    • Daniela Branzan,
    • Bernd-Michael Harnoss
  • - , Technical Forum

    Case 78 – Occlusion right superficial femoral artery

    Center:
    Münster
    Case 78 – MUE 05: female 89 years (S-E)
    Operators:
    • Arne Schwindt,
    • Konstantinos Donas
    Clinical data
    Recurrent PAOD, Rutherford 4, right leg

    Procedural steps
    1. Left femoral approach 5F 10 cm sheath (TERUMO)

    2. 7F 45 cm Destination x-over sheath via Advantage 0,035 wire (TERUMO)

    3. Cannulation Stenosis 0.014 Choice PT2 (BOSTON SCIENTIFIC)

    4. Placement 5mm Spiderfilter FX via 0,035 Trailblazer support catheter (COVIDIEN)

    5. Atherectomy with large tip Turbohawk smoothcutter (COVIDIEN)

    6. Post PTA with 4-5 x 120 IN.PACT Admiral balloon (MEDTRONIC)
  • - , Global Expert Exchange

    Case 88 – Renal denervation in resistant hypertension

    Center:
    Leipzig
    Case 88 – LEI 49: female, 69 years (B-K)
    Operators:
    • Martin Werner,
    • Klaus Hertting
    Clinical data
    Office BP: 160/ 95 mmHg
    Ambulatory BP: 143/ 91 mmHg, non dipping profile
    Stenting renal artery right 2000
    RI left:0.72, RI right:0.74
    Coronary artery disease; PAOD (Stenting SFA right)
    Renal function: GFR 45 ml/min
    Supraaortic disease: asymptomatic moderate ICA stenosis (60%) right

    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 with the Simplicity® RF Catheter (MEDTRONIC)
  • - , Main Arena 2

    Case 72 – Debranching and Stenting thoracic aortic aneurysm

    Center:
    Leipzig
    Case 72 – LEI 41: m
    Operators:
    • Marc van Sambeek,
    • Michael Piorkowski
    Clinical data
    Progressive aneurysm of the decending thoracic aorta
    CAD (CABG 2005)
    TEA left CFA 2008
    Arterial hypertension, hyperlipidemia

    Procedural steps
    1. Debranching of all supraaortal vessels

    2. Implantation of a stentgraft (C-TAG, GORE)
  • - , Main Arena 1

    Case 61

    Center:
    Hamburg
    Case 61 – HAM 01: male, 74 years
    Operators:
    • Sigrid Nikol,
    • Sven Bräunlich
  • - , Technical Forum

    Case 80 – Occlusion left common iliac artery, stenosis common femoral artery

    Center:
    Münster
    Case 80 – MUE 07: male, 64 years, (H-P)
    Operators:
    • Arne Schwindt,
    • Konstantinos Donas
    Clinical data
    PAOD Rutherford III left leg, ABI 0,5
    PTA/ BES right CIA 11/2012, frustrane retrograde recanalisation attempt left CIA
    Arterial hypertension, CAD; COPD

    Procedural steps
    1. Surgical TEA left CFA

    2. Transbrachial Recanalisation left CIA
    - 6F 90 cm Shuttle sheath (COOK)

    3. Recanalisation
    - 0.035" Quickcross (SPECTRANETICS) and
    - 0.035" Glidewire stiff (TERUMO)

    4. Primary stenting
    - 8 mm Dynamic Balloon expandable stent (BIOTRONIK)
  • - , Main Arena 1

    Case 62 – Occlusion left EIA and left SFA

    Center:
    Leipzig
    Case 62 – LEI 35: female, 55 years (D-W)
    Operators:
    • Johannes Schuster,
    • Matthias Ulrich
    Clinical data
    PAOD Rutherford 3 (walking capacity 50 m) both thighs and left calf
    ABI left 0.43, right 0.72
    Hypertension, hyperlipidemia, current smoker (50 py)

    Procedural steps
    1. Left brachial approach for diagnostic angiograms
    - 5F Pigtail-catheter (CORDIS)
    - 0.035" angled soft Terumo 180 cm (TERUMO)
    - 0.035" 300 cm Supra Core (ABBOTT)
    - 5F MP catheter (CORDIS)

    2. Left femoral retrograde access
    - 6F Radiofocus introducer, 10 cm (TERUMO)

    3. Passage of the occlusion from retrograde
    - 5F Multipurpose 125 cm diagnostic catheter (CORDIS)
    - 0.035" Aquatrack Hydrophilic Guidewire (CORDIS)

    4. Redirection with a re-entry device
    - 0.014" Stabilizer Plus 300 cm Straight (CORDIS)
    - Outback Re-entry Catheter (CORDIS)

    5. PTA
    - Powerflex Pro PTA Dilatation Catheter, 5/40 mm (CORDIS)

    6. Stent implantation
    - Smart Control Iliac Stent system, 7/60 mm (CORDIS)

    7. Closure access site left groin
    - Exoseal Vascular Closure Device
  • - , Main Arena 2

    Case 73 – Infrarenal abdominal aortic aneurysm

    Center:
    Leipzig
    Case 73 – LEI 42: male, 66 years (T-W)
    Operators:
    • Jean-Paul de Vries,
    • Daniela Branzan,
    • Bernd-Michael Harnoss
    Clinical data
    AAA, diameter 54mm,
    Long CTO left SFA
    CAD, impaired left ventricula function (EF 38%), CABG 2011
    Arterial hypertension, former smoker (30py), hyperlipidemia

    Procedural steps
    1. Preclosing with Proglide Closure Devices both groins (ABBOTT)
    - 2.9F 10 cm Radiofocus Introducer II both groins (TERUMO)
    - 0.035" Archer Guide Wire, 200 cm (MEDTRONIC)

    4. Implantation of an AFX Endovascular AAA System (Endologix)
  • - , Technical Forum

    Case 81 – Occlusion of the left SFA, failed antegrade recanalization-attempt

    Center:
    Leipzig
    Case 81 – LEI 44: female, 68 years (I-T)
    Operators:
    • Andrej Schmidt,
    • Michael Piorkowski
    Clinical data
    PAOD Rutherford 3, claudication at 100 meters left calf
    Antegrade PTA-attempt 10/2012 with perforation
    Retrograde recanalization of the right SFA 12/2012 after perforation from during recanalization-attempt from antegrade
    Hypertension, hyperlipidaemia, adipositas

    Procedural steps
    1. Cross-over-access from right to left
    - 6F 40 cm Flexor Check-Flo Introducer (COOK)

    2. Retrograde puncture of the distal SFA
    - Quick-Access Needle Holder (SPECTRANETICS)
    - 21 Gauge / 15 cm needle (COOK) in coaxial technique through a 18 Gauge 7 cm needle
    - V-18 Control 300 cm guidewire (Boston Scientific)
    - QuickCross Support-Catheter 0.018" 90 cm (SPECTRANETICS)

    3. After retrograde passage of the guidewire snaring from antegrade
    - Quick Cross Capture-Wire Connector (SPECTRANETICS)

    4. Antegrade angioplasty
    - 5/120 Mustang Balloon (Boston Scientific)

    5. Implantation of selfexpanding nitinol-stents
    - Supera Interwoven Nitinol Stent (IDEV)
  • - , Main Arena 1

    Case 63 – Long occlusion right superficial femoral artery

    Center:
    Hamburg
    Case 63 – HAM 02: female, 60 years
    Operators:
    • Hans Krankenberg,
    • P. Burchardt
    Clinical data
    POD Rutherford 3, walking distance 50 m right calf,
    Long bilateral SFA occlusion with recanalisation/2 nitinol stents left SFA 11.12
    Failed recanalisation right SFA 12.12
    Arterial hypertension, diabetes mellitus, former smoker (40 py)
    Stroke 05/2012

    Procedural steps
    1. Contralateral access and placement of a cross-over sheath left groin, 5F (COOK)
    - 5F Hook Catheter (COOK)

    2. Bringing the patient in a prone position

    3. Puncture right AP under road map control
    - 6F sheath, 10 cm (St Jude Medical)

    4. Passage of the lesion
    - 0.035" Aquatrack angled stiff guide-wire, 180 cm (Cordis)
    - 0.035" Glidecath Catheter, straight, 65 cm (TERUMO)

    5. After passage of the lesion change to
    - 0.018" Steel Core, 300 cm (Abbott)
    - Optional: Outback Catheter - 0.014 Ironman, 300 cm (Cordis)

    6. Predilation
    - 0.035" Powerflex Pro 4 mm (Cordis)

    7. Stentimplantation
    - SMART (Cordis)
  • - , Technical Forum

    Case 82 – 3-Vessel occlusion right BTK, CLI

    Center:
    Leipzig
    Case 82 – LEI 45: male, 76 years (A-R)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    Clinical data
    PAOD Rutherford 4, restpain right
    Recurrent occlusions right SFA
    Failure to pass the BTK-occlusions right from antegrade 12/2012
    ABI right 0.46
    SFA-Angioplasty right 2011 and 2012
    Bypass left with recurrent reocclusion
    Art. hypertension,
    Chronic renal insufficiency (GFR 55ml / min)

    Procedural steps
    1. Antegrade Access right groin
    - 6F 55 cm Flexor Check-Flo Introducer (COOK)

    2. Retrograde puncture of the peroneal artery
    - Quick-Access Needle Holder (SPECTRANETICS)
    - 21 Gauge / 7 cm needle (COOK)
    - V-18 Control 300 cm guidewire (BOSTON SCIENTIFIC)
    - QuickCross Support-Catheter 0.018" 90 cm (SPECTRANETICS)

    3. After retrograde passage of the guidewire snaring from antegrade
    - Quick Cross Capture-Wire Connector (SPECTRANETICS)

    4. Antegrade angioplasty (Predilatation)
    - 3.0/80 mm Chocolate PTA Balloon (TriReme MEDICAL)

    5. In.Pact Pacific 4.0/120 mm (MEDTRONIC)
  • - , Main Arena 1

    Case 64 – Renal denervation with OneShot balloon (Re – Do)

    Center:
    Hamburg
    Case 64 – HAM 03: male, 55 years
    Operators:
    • Karl-Heinz Kuck,
    • Jaspers von Wedel,
    • Martin Bergmann
    Clinical data
    55 y male w/ resistant hypertension for >10y
    s/p renal denervation w/ Simplicity© cath. 02/2012
    Systolic mean 24h RR-values remain ~148 mmHg resulting in headaches and dyspnea on exertion.
    Invasive r/o of CHD 02/2012
    Medikation: Metoprolol 2 x 100mg, Felodipin 2 x 5mg,
    Candesartan 1 x 32 mg, Urapidil 90 mg 1 x 1, Dihydralazin 2 x 12.5mg

    Procedural steps
    1. Analgosedation w/ Midazolam, Fentanyl, Propofol

    2. Right femoral access (8F, 7.500 IE Heparin)

    3. 8F RDC Guiding catheter (CORDIS)

    4. 0.014" Sion blue guidewire (ASAHI)

    5. OneShot™ Ballon (COVIDIEN): left 7 mm (or 2 x 6 mm?) / right 6 mm
  • - , Main Arena 2

    Case 74 – Infrarenal abdominal aortic aneurysm

    Center:
    Münster
    Case 74 – MUE 03: male, 78 years (W-E)
    Operators:
    • Martin Austermann,
    • Bernd Gehringhoff
    Clinical data
    CAD, CABG 2001
    Art. hypertension
    Hostile abdomen after colon resection
    Aneurysm diameter 55 cm
    Very short neck

    Procedural steps
    1. Percutanous approach both groins Prostar XL (Abbott) and 14 F sheath (COOK)

    2. Placement of the Endurant bifurcated endograft (Medtronic) just below the renal arteries.

    3. Additional fixation of the Endograft with HeliFXTM
    Aortic Securement System (Aptus)
  • - , Technical Forum

    Case 83 – Occlusion of the left SFA, failed antegrade recanalization-attempt

    Center:
    Leipzig
    Case 83 – LEI 46: male, 45 years (E-L)
    Operators:
    • Kazushi Urasawa,
    • Michael Piorkowski
    Clinical data
    PAOD Rutherford 3, claudication at 100 meters left calf
    Elsewhere failed antegrade PTA attempt left SFA 12/2012
    PTA/stenting left EIA 12/2012
    Hyperlipidaemia, current smoker

    Procedural steps
    1. Cross-over-access from right to left
    - 6F 40 cm Flexor Check-Flo Introducer (COOK)

    2. Retrograde passage of the lesion via Profunda-branch
    - 0.014" Regalia XS 1.0 Guidewire (ASAHI INTECC) or Fielder FC 300 cm (ASAHI INTECC)
    - Asahi Corsair Support Catheter (ASAHI INTECC)

    4. After retrograde passage of the guidewire snaring from antegrade

    5. Antegrade angioplasty
    - 5/120 Pacific Extreme PTA Balloon Catheter (MEDTRONIC)

    6. Implantation of selfexpanding nitinol-stents
    - Zilver PTX-Stent (COOK)
  • - , Main Arena 1

    Case 65 – Renal Denervation in resistant hypertension

    Center:
    Leipzig
    Case 65 – LEI 36: male, 53 years (A-S)
    Operators:
    • Klaus Hertting
  • - , Main Arena 1

    Case 66 – Carotid artery stenting with cerebral embolic protection

    Center:
    Hamburg
    Case 66 – HAM 04: female, 73 years
    Operators:
    • Joachim Schofer,
    • Klaudija Bijuklic
    Clinical data
    Symptomatic 70% stenosis right ICA
    Amaurosis fugax and dyphasia
    Risk factors: hypercholesterinemia
    Medication: Clopidogrel 75 mg /die (starting 5 days prior to procedure)
    Simvastation 20mg /die

    Procedural steps
    1. Long sheath

    2. Filter protection (because of incomplete circle of Willis)

    3. Stenting

    4. Postdilatation
  • - , Technical Forum

    Case 84 – 3-Vessel occlusion left BTK

    Center:
    Leipzig
    Case 84 – LEI 47: female, 78 years (W-B)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    Clinical data
    PAOD Rutherford 4, restpain right
    Failure to pass the BTK-occlusions left from antegrade 12/2012
    ABI right 0.3
    Pulmonary embolism 10/2011
    Recurrent swelling the lower leg both sides
    Art. Hypertension

    Procedural steps
    1. Antegrade access left groin
    - 5F 55 cm Flexor Check-Flo Introducer (COOK)

    2. Retrograde puncture of the posterior and anterior tibial artery
    - Quick-Access Needle Holder (SPECTRANETICS)
    - 21 Gauge / 7 cm needle (COOK)
    - V-18 Control 300 cm guidewire (BOSTON SCIENTIFIC)
    - QuickCross Support-Catheter 0.018" 90 cm (SPECTRANETICS)

    3. After retrograde passage of the guidewire snaring from antegrade
    - Quick Cross Capture-Wire Connector (SPECTRANETICS) or
    - Judkins Right 5F catheter (CORDIS)

    4. Antegrade angioplasty
    - 3.0/80 Pacific (MEDTRONIC)

    5. Guidewire exchange
    - 0.014" guidewire Floppy ES (ABBOTT)

    6. Drug-eluting balloon angioplasty of the posterior tibial artery
    - Freeway (EUROCOR)
  • - , Technical Forum

    Case 85 – Chronic total occlusion of right popliteal artery and trifurcation

    Center:
    Hamburg
    Case 85 – HAM 07: female
    Operators:
    • Sigrid Nikol,
    • Sven Bräunlich
  • - , Main Arena 1

    Case 67 – Asymptomatic high grade stenosis right internal carotid artery

    Center:
    Leipzig
    Case 67 – LEI 37: male, 76 years, (W-W)
    Operators:
    • Dierk Scheinert,
    • Matthias Ulrich
    Clinical data
    PTA/Stent high grade ICA-stenosis left 11/2012
    Intracerebral cross-flow von right to left
    CAD, PTCA/Stent of LAD/D1, RCX/PLA2 and RCA
    Arterial hypertension, diabetes mellitus, hyperlipidaemia
    Renal insufficiency

    Procedural steps
    1. Right femoral access
    - 9F sheath, Radiofocus introducer, 25 cm (TERUMO)

    2. Introduction of protection device
    - 9F Endovascular Clamping Device – MoMa Ultra (Medtronic)

    3. Passing of the lesion
    - Galeo ES 0.014" ES Guidewire, 185 cm (BIOTRONIK)

    4. 3.5/20 mm MiniTrek RX PTA Balloon Catheter (ABBOTT)

    5. 7-10/40 mm Xact Carotid Self-Expanding Stent-System, 135 mm(ABBOTT)

    6. 5/20 mm Viatrac RX PTA Balloon Catheter (ABBOTT)
  • - , Main Arena 2

    Case 75 – Pararenal abdominal aortic aneurysm

    Center:
    Münster
    Case 75 – MUE 04: male, 78 years (W-HH)
    Operators:
    • Martin Austermann,
    • Bernd Gehringhoff
    Clinical data
    Arterial hypertension, atrial fibrillation with oral anticoagulation
    Diabetes mellitus, impaired renal function, shrinkage of right kidney
    Aneurysm diameter 64 cm
    Narrow and calcified iliac arteries

    Procedural steps
    1. Percutanous approach left groin Prostar XL (Abbott), 14 F sheath (COOK)

    2. Percutanous approach right groin 8 F sheath (COOK)

    3. Cannulation of the SMA and the left renal artery (8F shuttle sheath, COOK) via left axillary a (cut down)

    4. Deployment of three Endurant tube endografts (Medtronic) just below the celiac trunk

    5. Placement of chimney stent-grafts (Advanta V12, Atrium) in the SMA and left renal artery
  • - , Main Arena 2

    Case 76 – Juxtarenal Aortic Aneurysm

    Center:
    Hamburg
    Case 76 – HAM 05: male, 76 years
    Operators:
    • Hans Krankenberg,
    • P. Burchardt
    Clinical data
    Asymptomatic juxtrarenal aortic aneurysm / 5.6 cm
    Y-prosthesis infrarenal aorta 1/2001
    Coronary artery disease: D1 90%
    Atrial fibrilation
    RF: Hypertension

    Procedural steps
    1. Transbrachial approach left side
    - 7F Flexor Check Flo Performer Introducer Sheath, 90 cm (COOK)
    - 5F Pigtail diagnostic catheter, 110 cm (CORDIS)
    - 0.035`` Radiofocus Terumo angeled soft guide wire 180 cm (TERUMO)

    2. Bilateral femoral surgical cut-down

    3. Stentgraft implantation
    - Implantation of the JOTEC E-extra fenestrated graft (JOTEC)
    - Implantation of 4 covered V12 Advanta Stents (ATRIUM) in Coeliac trunk, AMS and both renal arteries
  • - , Main Arena 1

    Case 68

    Center:
    Leipzig
    Case 68 – LEI 38: female, 86 years
    Operators:
    • Axel Linke,
    • Gerhard Schuler