LINC 2014 live case guide

Find all Live Cases and operators listed below.

Leipzig

1 livecase(s)
  • Tuesday, January 28th: - , Main Arena 1

    Case 01 – Chronic occlusion right SFA

    Center:
    Leipzig
    Case 01 – LEI 01: female, 55 years (P-B)
    Operators:
    • Andrej Schmidt,
    • Sven Bräunlich
    Clinical data
    PAD Rutherford Class 3, severe claudication right calf
    ABI right 0.64
    PTA of the left popliteal artery / stenting right CIA 12/2013

    Risk factors
    Current smoker, art. hypertension

    Angio
    SFA-occlusion right

    Procedural steps
    1. Left groin retrograde cross-over approach
    - 6F Balkin Up&Over 40 cm sheath (COOK)

    2. Passage of the SFA-occlusion right
    - 0.035" stiff angled Terumo guidewire, 300 cm (TERUMO)
    - Armada 35 5/120 mm Balloon (ABBOTT)
    - Exchange to a 0.018" SteelCore guidewire (ABBOTT)

    3. Stenting on indication
    - Distal: SUPERA Interwoven Nitinol-Stent (ABBOTT)
    - Proximal: Absolute Selfexpanding Nitinol-Stent (ABBOTT)
    View image

Berlin

1 livecase(s)
  • Tuesday, January 28th: - , Main Arena 2

    Case 02 – BTK occlusion right leg in a CLI patient

    Center:
    Berlin
    Case 02 – AAL 01: male, 75 years
    Operators:
    • Koen Deloose,
    • Lieven Maene
    Clinical data
    Cardiovascular history: TIA, diabetic ulcer right foot

    Risk factors
    Arterial hypertension, IDDM type 2 (with retinopathy/nephropathy)

    Present state
    non healing trophic ulcer D2 right.
    Bilateral femoral pulses, no distal pulses and ABI bilateral 0.54

    Procedural steps
    1. Anterograde right common femoral access
    - 18G needle (CORDIS)
    - 6F brite tip sheath 12 cm (CORDIS)
    - Angled-stiff Terumo glide wire 0.035" (TERUMO)
    - 4F RIM (COOK)
    - Destination-sheath 6F – 45 cm (TERUMO)

    2. Right anterior tibial passage
    - 0.014" Command ES wire (ABBOTT)
    - CXI 0.014" 90 cm (COOK)

    3. Dilatation anterior tibial
    - Armada 0.014/XT (ABBOTT)

    4. Spot-stenting anterior tibial if necessary
    - Multilink Vision/Xpert Pro 0.014" (ABBOTT)

    5. In case of passage failure, sheathless retrograde anterior tibial access
    - 0.014" Command ES Abbott, Armada XT 0.014" (ABBOTT)

    6. Passage right peroneal artery
    - Command ES 0.014" Abbott, CXI 0.014" 90 cm (Cook)

    7. Stenting right peroneal artery
    - Xience prime 0.014" (Abbott)
    View image

Münster

1 livecase(s)
  • Tuesday, January 28th: - , Technical Forum

    Case 03 – Subacute type B - Dissection

    Center:
    Münster
    Case 03 – LEI 02: male, 44 years (S-S)
    Operators:
    • Andrej Schmidt,
    • Michael Piorkowski,
    • Bernd-Michael Harnoss
    Clinical data
    Type B dissection with onset 1 month ago
    Poorly controlled art. hypertension with intermittend recurrence of pain

    Risk factors
    Arterial hypertension, current smoker

    Procedural steps
    1. Percutaneous approach right groin with preloading of two Proglide-closure-devices (ABBOTT)

    2. Left groin access with 5F for angiography during implantation

    3. IVUS -examination to verify guidewire-position in the true lumen Visions PV 0.035" Digital IVUS Catheter (VOLCANO)

    4. Right ventricular overdrive pacing during implantation of the stentgraft

    5. Valiant® Thoracic stentgraft with Captiva Delivery System (MEDTRONIC)
    View image

Bad Krozingen

1 livecase(s)
  • Tuesday, January 28th: - , Discussion Forum

    Case 04 – Renal denervation in uncontrolled arterial hypertension

    Center:
    Bad Krozingen
    Case 04 – BLN 01: female, 73 years (A-H)
    Operators:
    • Ralf Langhoff,
    • Andrea Behne
    Clinical data
    Chronic heart failure NYHA II-III
    Atrial fibrillation
    Uncontrolled arterial hypertension
    Office blood pressure: 176/95 mmHg
    Medication: 6 antihypertensive drugs

    Duplex
    RI: 0.75 bilateral
    Absence of renal artery stenosis

    CTA
    Singular bilateral renal arteries with slightly steep offspring of the right renal artery

    Procedural steps
    1. Right femoral access with 8F Cook Ansel sheath

    2. Navigation of 0.014" guide wire (Terumo Advantage angled 180 cm) into the right RA

    3. If direct probing fails support with a Cobra Catheter (CB1 Cordis 4F)

    4. Removing the diagnostic catheter

    5. Advancing a Vessix 6 mm renal denervation balloon into the right RA (Boston Scientific)

    6. Calibrating the Vessix Denervation console

    7. Activating and inflating the balloon for at least 30 seconds

    8. Remove the balloon

    9. Probing the sheath into the left RA

    10. Following once again steps 4-8.

    11. Device retrieval

    12. Access closure with Angioseal 8F (St. Jude) or Proglide 6F (Abbott)
    View image

Berne

1 livecase(s)
  • Tuesday, January 28th: - , Scientific Posters

    Case 05 – In-Stent Occlusion right SFA

    Center:
    Berne
    Case 05 – LEI 03: male, 61 years (T-R)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich,
    • Sabine Steiner
    Clinical data
    PAOD Rutherford 3, claudication right calf at 100 meters
    PTA right SFA and stenting for claudication 11/2012
    Failed recanalization-attempt 01/2014 right SFA
    Inability to direct the guidewire into the stent
    Diabetes mellitus type 2, art. hypertension, hyperlipidaemia

    Procedural steps
    1. Left femoral access and cross-over approach

    2. 6Fr Balkin Up & Over Contralateral Flexor Check-Flo Performer 40 cm (COOK)

    3. Retrograde puncture of the SFA-stent
    - 18 Gauge 7 cm needle (COOK)
    - Quick-Access Needle Holder (SPECTRANETICS)
    - 0.035" stiff, angled Terumo, 300 cm

    4. Retrograde passage of the stent and snaring from antegrade
    - CXC-support-catheter, 90 cm 0.035" (COOK)

    5. PTA / stenting from antegrade
    - Advance PTX 18 Balloon (COOK)
    - Zilver-PTX stents (COOK)
    View image

Heidelberg

1 livecase(s)
  • Tuesday, January 28th: - , Global Expert Exchange

    Case 06 – Chronic SFA-Occlusion right leg

    Center:
    Heidelberg
    Case 06 – AAL 02: female patient, 69 years
    Operators:
    • Koen Deloose,
    • Lieven Maene
    Clinical data
    Cardiovascular history: PTA - Stenting left common iliac artery

    Risk factors
    Arterial hypertension

    Present state
    Bilateral claudication RB 3
    Bilateral femoral pulses
    No popliteal/distal pulses and ABI bilateral 0.8

    Procedural steps
    1. Left common femoral access
    - 18G needle (CORDIS),
    - 6F brite tip sheath 12 cm (CORDIS)

    2. Cross over procedure
    - Angled-stiff Terumo glide wire 0.035" (TERUMO)
    - 5F RIM (COOK)
    - Destination-steath 6F – 45 cm (TERUMO)

    3. Right SFA passage
    - Terumo glide wire 0.035" angled-stiff (TERUMO)
    - CXI 0.035" 90 cm (COOK)

    4. Predilatation right SFA
    - 0.018" Advantage wire (TERUMO)
    - Advance 18LP PTA (COOK)

    5. Stenting right SFA
    - Zilver PTX SE stent (COOK)

    6. Dilatation right popliteal artery
    - Advance 18LP PTX PTA (COOK)

    7. In case of anterograde passage failure, right retrograde distal posterior access
    - pedal micropuncture access kit (COOK)
    View image

Palermo

1 livecase(s)
  • Tuesday, January 28th: - ,

    Case 07 – Chronic occlusion left SFA

    Center:
    Palermo
    Case 07 – LEI 04: male, 69 years (HJ-A)
    Operators:
    • Matthias Ulrich,
    • Yvonne Bausback,
    • Saulius Korsakas
    Clinical data
    Rutherford 3, severe claudication left calf
    ABI right 0.56
    PTA of the right distal SFA with DEB 1/2014
    CAD, CABG 2008

    Risk factors
    Art. hypertension, former smoker, diabetes mellitus

    Angio
    Occlusion left SFA

    Procedural steps
    1. Right groin retrograde cross-over approach with 6F sheath
    - 6F Balkin Up & Over Contralateral Flexor Check-Flo Performer 40 cm (COOK)

    2. Second attempt to pass the occlusion
    - 0.035" stiff, angled Terumo guidewire, 260 cm (TERUMO)
    - 4/120mm Admiral-balloon (MEDTRONIC)
    - Exchange to a 0.018" guidewire (SteelCore (ABBOTT))

    3. PTA with drug-eluting balloons
    - In.Pact Pacific (MEDTRONIC)

    4. In case of dissections implantation of
    - Complete Selfexpanding Nitinol-Stent (MEDTRONIC)
    View image

Galway

1 livecase(s)
  • Tuesday, January 28th: - ,

    Case 08 – Chronic occlusion right SFA

    Center:
    Galway
    Case 08 – LEI 05: female, 69 years (E-B)
    Operators:
    • Sven Bräunlich,
    • Johannes Schuster,
    • Sabine Steiner
    Clinical data
    Rutherford 3, claudication right calf, walking capacity < 100 m
    Stenting right iliac arteries 11/2013
    Frustaneous attempt to recanalize from antegrade 2013
    CAD with former stenting 06/2013
    Atrial fibrillation

    Risk factors
    art. hypertension, diabetis mellitus, hyperlipidemia

    Angio
    Occlusion right SFA

    Procedural steps
    1. Right groin retrograde cross-over approach (6F)

    2. Second attempt to pass the occlusion from antegrade

    3. PTA with drug-eluting balloons

    4. IStenting on indication (self expanding nitinol stents)
    View image

Columbus

1 livecase(s)
  • Tuesday, January 28th: - ,

    Case 09 – Chronic occlusion left distal SFA / P1-Segment

    Center:
    Columbus
    Case 09 – LEI 06: male, 50 years (A-S)
    Operators:
    • Sven Bräunlich,
    • Matthias Ulrich
    Clinical data
    Rutherford 3, severe claudication left calf
    Painfree walking distance 50 meters
    ABI right 0.65

    Risk factors
    Art. hypertension, smoker

    Angio
    Occlusion left SFA

    Procedural steps
    1. Retrograde cross-over approach with 6F sheath
    - 6F Balkin Up & Over Contralateral Flexor Check-Flo Performer 40 cm (COOK)

    2. Passage of the occlusion and dilation
    - 0.035" stiff, angled Terumo guidewire, 260 cm (TERUMO)
    - 4/120 mm Mustang-balloon (BOSTON SCIENTIFIC)
    - Exchange to a 0.018" SteelCore guidewire, 300 cm (ABBOTT)

    3. PTA with drug-eluting balloons
    - Lutonix 5/100 mm DEB (BARD)

    4. In case of dissections implantation of
    - Intact Vascular Tack-IT Endovascular Stapler™ (INTACT VASCULAR)
    View image

São Paulo

1 livecase(s)
  • Tuesday, January 28th: - ,

    Case 10 – Multilevel-disease left leg

    Center:
    São Paulo
    Case 10 – LEI 07: male, 63 years (H-T)
    Operators:
    • Arne Schwindt,
    • Michael Piorkowski,
    • Bruno Freitas
    Clinical data
    Rutherford 5, chronic, minor gangrene left dig 3/4
    Painfree walking distance 150 meters
    ABI left 0.44
    Chronic heartfailure, EF 35%,
    CAD, MI 11/2012, PTCA, repeat coronary angiography 1/2014
    Atrial fibrillation,
    Renal insufficiency (GFR 54 ml/min)

    Risk factors
    Art. hypertension, diabetes mellitus

    Angio
    Left: stenosis CFA, occlusion distal SFA, stenosis P2 and P3

    Procedural steps
    1. Right groin retrograde cross-over approach with 7F sheath
    - 7F Check-Flo Performer 55 cm (COOK)

    2. Passage of the SFA-occlusion and positioning of a protection-systeme
    - 0.018" 18g Victory guidewire, 300 cm (BOSTON SCIENTIFIC)
    - TrailBlazer Support-Catheter, 135 cm (COVIDIEN)
    - Spider-Filter 6 mm (COVIDIEN)

    3. Atherectromy
    - CFA and SFA: L-SC, large-vessel TurboHawk 6 cm-tip (COVIDIEN)
    - Popliteal artery: S-SM, Small-vessel TurboHawk (COVIDIEN)

    4. Drug-eluting balloon treatment
    - Lutonix DEB (BARD)
    View image