LINC 2015 live case guide

Find all Live Cases and Live Case Centers listed below.

Leipzig

33 livecase(s)
  • Tuesday, January 27th: - , Main Arena 1

    Case 01 – Calcified SFA occlusion left

    Center:
    Leipzig
    Case 01 – LEI 01: male , 60 years (U-S)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Claudication intermittens bilateral,
    150 meter walking capacity, calf-pain left > right
    Art. hypertension, former smoker

    ABI
    Left 0,52; right 0,66

    DUPLEX
    Severely calcified SFA bilateral

    ANGIOGRAPHY
    Short occlusion distal SFA left, severe calcification

    PROCEDURAL STEPS
    1. Right groin retrograde cross-over approach
    - 6F Balkin Up&Over 40 cm sheath (COOK)

    2. Passage of the occlusion
    - 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
    - SUPERA Interwoven Nitinol-Stent (ABBOTT)
    View image
  • Tuesday, January 27th: - , Main Arena 1

    Case 02 – SFA occlusion left

    Center:
    Leipzig
    Case 02 – LEI 02: male , 46 years (M-P)
    Operators:
    • Andrej Schmidt,
    • Sven Bräunlich
    CLINICAL DATA
    Severe claudication left leg, walking capacity 150 meters
    PTA of the right external iliac artery in 12/2014
    Thrombendartherectomy left groin 2012
    Failed recanalization-attempt lef SFA elsewhere 11/2014
    Art. hypertension, hyperlipoproteinemia

    ABI
    Left 0.67

    ANGIOGRAPHY
    During PTA right iliac artery: mid SFA-occlusion left, good run-off

    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. Passage of the occlusion
    - 0.035" Seeker supportcatheter, 135 cm (BARD)
    - 0.035" angled stiff glidewire 260 cm (TERUMO)
    - I n case of failure retrograde approach via the distal SFA

    3. PTA
    - Vascutrak 5.0/250 mm Balloon (BARD)
    - Lutonix Drug-Coated Balloon 6.0/150 mm (BARD)

    4. Stenting on indication
    in case of dissection:
    - INTACT VASCULAR Tack Endovascular Stapler™ (INTACT VASCULAR)
    View image
  • Tuesday, January 27th: - , Main Arena 1

    Case 02 – SFA occlusion left

    Center:
    Leipzig
    Case 02 – LEI 02: male , 46 years (M-P)
    Operators:
    • Andrej Schmidt,
    • Sven Bräunlich
    CLINICAL DATA
    Severe claudication left leg, walking capacity 150 meters
    PTA of the right external iliac artery in 12/2014
    Thrombendartherectomy left groin 2012
    Failed recanalization-attempt lef SFA elsewhere 11/2014
    Art. hypertension, hyperlipoproteinemia

    ABI
    Left 0.67

    ANGIOGRAPHY
    During PTA right iliac artery: mid SFA-occlusion left, good run-off

    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. Passage of the occlusion
    - 0.035" Seeker supportcatheter, 135 cm (BARD)
    - 0.035" angled stiff glidewire 260 cm (TERUMO)
    - I n case of failure retrograde approach via the distal SFA

    3. PTA
    - Vascutrak 5.0/250 mm Balloon (BARD)
    - Lutonix Drug-Coated Balloon 6.0/150 mm (BARD)

    4. Stenting on indication
    in case of dissection:
    - INTACT VASCULAR Tack Endovascular Stapler™ (INTACT VASCULAR)
    View image
  • Tuesday, January 27th: - , Main Arena 2

    Case 17 – Retrograde recanalization of an SFA occlusion after surgery left groin

    Center:
    Leipzig
    Case 17 – LEI 08: male 60 years (HJ-S )
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich,
    • Tomohara Dohi
    CLINICAL DATA
    Severe claudication left calf
    Stenting left iliac arteries and patch-plastic left groin 2008
    Unsuccessful recanalization attempt left SFA, failed guiewire-access
    into the SFA-occlusion 11/2014
    Arterial hypertension, diabetes mellitus type 2, smoker
    Renal insufficiency (GFR 56ml/min)

    ABI
    Left 0.46

    ANGIOGRAPHY
    Long occlusion left SFA, ostial stenosis of the deep femoral artery patent stents left iliac arteries.

    PROCEDURAL STEPS
    1. Right groin retrograde cross-over approach
    - 7F Balkin Up & Over 40 cm sheath (COOK)

    2. Retrograde access: puncture of the occluded mid SFA left
    - 18 Gauge 7 cm needle
    - 0.035" stiff angled guidewire 30 cm (TERUMO)
    - 6Fr 10 cm sheath (TERUMO)
    - 5F Judkins Right diagnostic catheter (CORDIS)
    - 0.018" Connect 250 T Guidewire 300 cm (ABBOTT)
    - In case of failure exchange to 0.014" Floppy ES 300 cm guidewire (ABBOTT).
    - Outback Reentry catheter (CORDIS)

    3. Balloon-angioplasty and stenting
    - After snaring of the retrograde guidewire PTA with Savvy 5/120mm Balloon (CORDIS)
    - Smart Control Selfexpanding stent (CORDIS)
    - In case of bleeding at the retrograde access-site or groin-patch: Viabahn 7/100 mm covered stentgraft (GORE)
    View image
  • Tuesday, January 27th: - , Main Arena 1

    Case 03 – Occlusion mid SFA right

    Center:
    Leipzig
    Case 03 – LEI 03: male , 55 years (E-S)
    Operators:
    • Sven Bräunlich,
    • Sabine Steiner
    CLINICAL DATA
    Severe claudication intermittens right leg
    walking-capacity 200 meters
    PTA with drug-eluting balloons left SFA 11/2014
    Diabetes mellitus type 2, hyperlipidaemia

    ABI
    Right 0.66

    ANGIOGRAPHY
    10 cm long occlusion mid SFA right

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

    2. Passage of the occlusion
    - 0.035" CXI-support-catheter, straight tip, 135 cm length (COOK)
    - 0.018" Connect Flex guidewire, 300 cm (ABBOTT)

    3. Balloon-angioplasty and stenting
    - Advance 18 5.0/120 mm balloon (COOK)
    - Zilver-PTX 6.0/100 mm (COOK)
    View image
  • Tuesday, January 27th: - , Main Arena 1

    Case 05 – Long SFA occlusion left leg

    Center:
    Leipzig
    Case 05 – LEI 04: male, 60 years (R-S)
    Operators:
    • Sven Bräunlich,
    • Andrej Schmidt,
    • Tomohara Dohi
    CLINICAL DATA
    PAOD with claudication intermittens and restpain at night left leg
    PTA right SFA with drug-eluting balloons 12/2014
    Thrombendartherectomy left common femoral artery 10/2014
    Arterial hypertension
    Hyperlipoprotaeinemia
    Smoker

    ABI
    Left 0.61

    ANGIOGRAPHY
    During PTA right leg: long SFA-occlusion, moderate calcification

    PROCEDURAL STEPS
    1. Right groin retrograde cross-over approach
    - 6F Balkin Up & Over 40 cm sheath (COOK)

    2. Guidewire passage
    - 0.035" QuickCross support-catheter 135 cm (SPECTRANETICS)
    - 0.035" TERUMO glidewire angled stiff, 300 cm (TERUMO)
    - 0.018" Victory 30g, 300 cm (BOSTON SCIENTIFIC)

    3. Predilatation and drug-eluting balloon treatment
    - Pacific 5/120 mm balloon (MEDTRONIC)
    - In.Pact 5.0/120 mm drug-coated balloon (MEDTRONIC)

    4. Stenting on indication
    - Complete 6.0/150 mm Selfexpanding Nitinol-stent (MEDTRONIC)
    View image
  • Tuesday, January 27th: - , Technical Forum

    Case 28 – Occlusion of the right iliac arteries, aneurysm left iliac

    Center:
    Leipzig
    Case 28 – LEI 09: male, 76 years (M-M)
    Operators:
    • Dierk Scheinert,
    • Matthias Ulrich,
    • Tomohara Dohi
    CLINICAL DATA
    Restpain right leg, Rutherford class 4
    History of surgical aorto-biiliac prosthesis 1972, report can not be found
    Minor stroke 2011 before CEA of carotid artery stenosis right, art. hypertension

    ABI
    Right 0.4

    CT
    Severe calcification of the aortic bifurcation, 32 mm aneurysm left common iliac artery
    Former aortoiliac bypass can not be seen on CT

    PROCEDURAL STEPS
    1. Retrograde access both common femoral arteries
    - 7F-10 cm sheath (TERUMO)
    Left brachial access:
    - 5F diagnostic pigtail-catheter (CORDIS)
    - 0.035" soft angled short glidewire (TERUMO)
    - 0.035" SupraCore Guidewire 300 cm (ABBOTT)
    - 6F-90 cm Check-Flow Performer Sheath (COOK)

    2. Guidewire passage of the iliac occlusion right
    via brachial access:
    - 5F-125 cm Judkins Right diagnostic catheter (CORDIS)
    - 0.035" stiff angled TERUMO glidewire, 260 cm (TERUMO)
    - or 0.018" Connect 300 cm guidewire (ABBOTT)
    - Snaring of the wire into the retrograde sheath and passage of the contralateral common iliac artery occlusion via the brachial access.

    3. After Guidewire-passage PTA via the femoral access bilateral
    - Admiral 6/40 mm-balloon, 90 cm (MEDTRONIC)

    4. Stenting
    - via left groin: Sinus aortic stent 24-80 mm (OPTIMED)
    Implantation of covered stents into the aortic bifurcation:
    - 9/59 mm Lifestream covered stents (BARD)
    - 9/100 mm Fluency covered stent right external iliac artery (BARD)
    View image
  • Tuesday, January 27th: - , Global Expert Exchange

    Case 33 – Retrograde recanalization of a tibioperoneal trunk occlusion

    Center:
    Leipzig
    Case 33 – LEI 10: male, 52 years (A-P)
    Operators:
    • Andrej Schmidt,
    • Sven Bräunlich
    CLINICAL DATA
    Critical limb ischemia left with toe-ulcerations Dig 2 and 3
    PTA and stenting left SFA and failed recanalization attempt
    left tibioperoneal trunk 1/2015
    Diabetes mellitus type 2, arterial hypertension
    CAD with PTCA 11/2013
    Former smoker, renal insufficiency with GFR 55ml/min

    ANGIOGRAPHY
    During PTA of left SFA: Occlusion of the tibioperoneal trunk the peroneal and anterior tibial artery

    PROCEDURAL STEPS
    1. Left antegrade access
    ■ 5F – 55 cm Ansel Sheath (COOK)
    Retrograde access to the posterior tibial artery:
    ■ 7 cm 21 Gauge needle (COOK)
    ■ 0.018" Connect Guidewire 300 cm (ABBOTT)
    ■ 0.018" CXC Support-Catheter 90 cm (COOK)

    2. Guidewire exchange
    ■ After retrograde guidewire-passage and snaring from antegarde exchange to 0.014" PT2 Guidewire 300 cm (BOSTON SCIENTIFIC)

    3. PTA and stenting
    ■ MiniTrek RX 4/20 mm PTCA Balloon (ABBOTT)
    ■ Cre8 4.0/48 mm Drug-Eluting Stent (ALVIMEDICA)
    View image
  • Tuesday, January 27th: - , Main Arena 1

    Case 08 – In-stent reocclusion left distal SFA / popliteal artery

    Center:
    Leipzig
    Case 08 – LEI 05: male, 72 years (R-T)
    Operators:
    • Andrej Schmidt,
    • Yvonne Bausback,
    • Tomohara Dohi
    CLINICAL DATA
    Severe claudication left calf, walking capacity 50 meters
    PTA of a restnosis of the SFA-ostium left with drug.-coated ballon 12/2014
    Stenting left SFA / popliteal artery 10/2013
    Thrombendartherectomy left groin /2013
    CAD and PTCA LAD 9/2013
    Arterial hypertension, diabetes mellitus, type 2, former smoker

    ABI
    Left 0.43

    ANGIOGRAPHY
    In-Stent occlusion distal SFA and P1/P2 popliteal artery left
    P3-segment significantly stenosed

    PROCEDURAL STEPS
    1. Left antegrade approach
    - 7F 55 cm Ansel sheath (COOK)

    2. Guidewire passage
    - 0.035" QuickCross support-catheter 90 cm (SPECTRANETICS)
    - 0.035" Half stiff J-angled 300 cm (TERUMO)
    - exchange to 0.014" Floppy ES Guidewire 300 cm (ABBOTT)

    3. Filter-protection
    - WirionTM EPD-System (GARDIA MEDICAL)

    4. Laser-atherectomy
    - 7F Tandem Booster-Laser (SPECTRANETICS)

    5. PTA with drug-coated balloons
    - LegFlow OTW Drug-Coated Balloon (CARDIONOVUM)
    View image
  • Tuesday, January 27th: - , Global Expert Exchange

    Case 34 – Percutaneous deep venous arterialization (LimFlow procedure) - RECORDED CASE FROM SINGAPORE

    Center:
    Leipzig
    Case 34 – SIN 01: male 60 years
    Operators:
    • Steven Kum,
    • Andrej Schmidt
    CLINICAL DATA
    Left CLI (non healing forefoot wound)
    SFA TFT DES 8/2010
    SFA TFT Peroneal DEB 7/2011
    SFA Rotarex Peroneal POBA 4/2014
    SFA TFT Peroneal DEB 5/2014
    Failed retrograde DP 9/2014

    RISK FACTORS
    DM hypertension, CAD EF 45%, hyperlipidemia, smoker

    PROCEDURAL STEPS
    1. Antegrade 7F access
    - Retrograde posterior tibial vein (PTV) access (Ultrasound guided) micropuncture followed by COOK 5F x 45 cm Ansel sheath

    2. Antegrade LimFlow ‘Send’ Catheter 7F

    3. Retreograde LimFlow ‘Receive’ Catheter 5F

    4. Align and Crossover

    5. Predilatation crossover point

    6. Stent from TFT to PTV
    - Atrium 5 mm x 38 and Viabahn 5 mm

    7. Percutaneous Reverse Valvulotome
    View image
  • Tuesday, January 27th: - , Main Arena 1

    Case 09 – Severely calcified restenosis (partially in-stent) left SFA

    Center:
    Leipzig
    Case 09 – LEI 06: male, 72 years (L-K)
    Operators:
    • Sven Bräunlich,
    • Andrej Schmidt
    CLINICAL DATA
    Severe claudication left calf
    Stenting of the SFA left 2009 (Samba-stent)
    Thrombenarthererctomy left groin 2010
    PTA of the right SFA / stenting 1/2015
    CAD, multiple PTCAs
    Chronic heart failure (NYHA II)
    Chronic renal insufficiency (GFR 70ml/min)
    Art. hypertension, diabetes mellitus type 2

    ABI
    Left 0.64; right 0.82 (post stenting)

    ANGIOGRAPHY
    During PTA right SFA: in-stent reocclusion and severe calcification left SFA

    PROCEDURAL STEPS
    1. Right groin and cross-over access
    - 7F 40 cm balkin Up & Over sheath (COOK)

    2. Guidewire passage
    attempt to pass the occlusion from antegrade
    - QuickCross 0.035" 135 cm Supportcatheter (SPECTRANETICS)
    - 0.035" stiff angled glidewire, 260 cm (TERUMO)

    3. In case of failure retrograde stent-puncture
    - 7 cm 18 Gauge needle and
    - QuickCross 0.035" 135 cm Supportcatheter (SPECTRANETICS)
    - 0.035" stiff angled glidewire, 260 cm (TERUMO)
    - Snaring of the guidewire from above

    4. PTA
    - Armada 35 5.0/120 mm Ballon (ABBOTT)
    - Potentially high-pressure balloon: Conquest 6/20 mm (BARD)

    5. Stenting
    - Supera interwoven nitinol-stent (ABBOTT)
    View image
  • Wednesday, January 28th: - , Main Arena 1

    Case 35 – Subacute occlusion rigth SFA

    Center:
    Leipzig
    Case 35 – LEI 11: male, 68 years (H-K)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich,
    • Tomohara Dohi
    CLINICAL DATA
    Acute onset of severe claudication right and left calf 1-2 months ago (right > left)
    Eversionatherectomy of a symptomatic internal carotid artery stenosis right 12/2014
    Arterial hypertension, diabetes mellitus type 2, former smoker

    ABI
    Right 0.55; left 0.57

    ANGIOGRAPHY
    Bilateral occlusion of the SFA, non calcification
    Thrombotic subtotal occlusion of the right carotid artery before surgery

    PROCEDURAL STEPS
    1. Right femoral retrograde and cross-over access
    - 8F 40 cm Balkin Up & Over sheath (COOK)

    2. Guidewire passage
    - 0.018" CXI angled support-catheter 135 cm (COOK)
    - 0.018" V-18 COntrol Guidewire, 300 cm (BOSTON SCIENTIFIC)

    3. Thrombectomy
    - Rotarex 8F Thrombectomy Catheter (STRAUB MEDICAL)

    4. PTA and stenting on indication
    - if residual thrombus: local thrombolysis with Actilysis
    - if residual arteriosclerotic lesions: balloon-angioplasty/stenting
    - Lutonix drug coated balloon 5.0/150 mm (BARD)
    - Epic-Stent 6.0/150 mm (BOSTON SCIENTIFIC)
    View image
  • Wednesday, January 28th: - , Main Arena 1

    Case 36 – In-stent reocclusion left SFA

    Center:
    Leipzig
    Case 36 – LEI 12: male, 64 years (W-K)
    Operators:
    • Sven Bräunlich,
    • Yvonne Bausback
    CLINICAL DATA
    Severe claudicatio with worsening 3 months ago
    Stenting of the SFA left 12/2013
    CAD and PTCA 11/2014
    Art. hypertension, diabetes mellitus type 2, former smoker

    ABI
    Left 0.62

    ANGIOGRAPHY
    During coronary angiography: In-stent reocclusion left with stent-fractures.

    PROCEDURAL STEPS
    1. Right femoral retrograde and cross-over access
    - 8F 40 cm Balkin Up & Over sheath (COOK)

    2. Guidewire passage
    - 0.035" stiff angled glidewire, 260 cm (TERUMO)
    - Judkins Right 5F diagnostic catheter (CORDIS)
    - Exchange to 0.018" guidewire coming with the Rotarex-catheter (STRAUB MEDICAL)

    3. Thrombectomy
    - 8F Rotarex-Thrombectomy (STRAUB MEDICAL)

    4. PTA with drug-eluting balloons
    - In-Pact Pacific 5.0/120 mm (MEDTRONIC)

    5. Stenting of areas with stent-fracture
    - Supera Interwoven Nitinol Stent 5.0/100 mm (ABBOTT)
    View image
  • Wednesday, January 28th: - , Main Arena 1

    Case 37 – CLI and total occlusion of all BTK arteries right

    Center:
    Leipzig
    Case 37 – LEI 13: male, 82 years (W-K)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich,
    • Sabine Steiner
    CLINICAL DATA
    Critical ischemia with ulcerations right forefoot (Dig 3 and 4 and lateral)
    PTA of a SFA-stenosis 12/2014 with drug-eluting balloon
    CAD with CABG 2008
    Diabetes mellitus type 2, art. hypertension

    ABI
    Right 0.2

    ANGIOGRAPHY
    5 cm occlusion of the proximal peroneal artery and long tibial occlusions (ATA and PTA).

    PROCEDURAL STEPS
    1. Right antegrade access
    - 5F 55 cm Ansel Sheath (COOK)

    2. Guidewire passage of the occlusion(s)
    - 0.014" PT2 guidewire, 300 cm (BOSTON SCIENTIFIC)
    - Amphirion Deep Balloon 2.5/120 mm - 120 cm (MEDTRONIC)
    In case of failure exchange to:
    - 0.018" V-18 Control guidewire 300 cm (BOSTON SCIENTIFIC)
    - supported by TrailBlazer 0.018" 90 cm (COVIDIEN)

    3. PTA and drug administration
    - Amphirion Deep 2.5/120 mm Balloon (MEDTRONIC)
    - BullFrog Micro-infusion catheter for administration of Dexamethason into the arterial wall (MERCATOR MedSystems)
    View image
  • Wednesday, January 28th: - , Technical Forum

    Case 55 – SIRT – Selective internal radiotherapy

    Center:
    Leipzig
    Case 55 – LEI 21: male, 58 years old
    Operators:
    • Michael Moche,
    • Jochen Fuchs,
    • Sandra Purz,
    • Bernhardt Sattler
  • Wednesday, January 28th: - , Main Arena 1

    Case 37 – CLI and total occlusion of all BTK arteries right

    Center:
    Leipzig
    Case 37 – LEI 13: male, 82 years (W-K)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich,
    • Sabine Steiner
    CLINICAL DATA
    Critical ischemia with ulcerations right forefoot (Dig 3 and 4 and lateral)
    PTA of a SFA-stenosis 12/2014 with drug-eluting balloon
    CAD with CABG 2008
    Diabetes mellitus type 2, art. hypertension

    ABI
    Right 0.2

    ANGIOGRAPHY
    5 cm occlusion of the proximal peroneal artery and long tibial occlusions (ATA and PTA).

    PROCEDURAL STEPS
    1. Right antegrade access
    - 5F 55 cm Ansel Sheath (COOK)

    2. Guidewire passage of the occlusion(s)
    - 0.014" PT2 guidewire, 300 cm (BOSTON SCIENTIFIC)
    - Amphirion Deep Balloon 2.5/120 mm - 120 cm (MEDTRONIC)
    In case of failure exchange to:
    - 0.018" V-18 Control guidewire 300 cm (BOSTON SCIENTIFIC)
    - supported by TrailBlazer 0.018" 90 cm (COVIDIEN)

    3. PTA and drug administration
    - Amphirion Deep 2.5/120 mm Balloon (MEDTRONIC)
    - BullFrog Micro-infusion catheter for administration of Dexamethason into the arterial wall (MERCATOR MedSystems)
    View image
  • Wednesday, January 28th: - , Main Arena 2

    Case 49 – Abdominal aneurysm 5.7 cm

    Center:
    Leipzig
    Case 49 – LEI 19: male, 52 years (M-S)
    Operators:
    • Andrej Schmidt,
    • Daniela Branzan
    CLINICAL DATA
    Incidental finding of an abdominal aneurysm
    Since 2 years recurrent abdominal pain

    RISK FACTORS
    Art. hypertension, smoker

    CT
    57 mm abdominal aneurysm, neck-kink of 60Æ

    PROCEDURAL STEPS
    1. Proglide closure-device preloading both groins
    - 9F – 10 cm sheath both groins (TERUMO)

    2. Implantation of the main body
    - 0.035" Lunderquist 180 cm guidewire via right groin (COOK)
    - Aorfix abdominal endovascular stentgraft (LOMBARD MEDICAL)

    3. Cannulation of the contralateral limb
    - Amplatz left I diagnostic catheter 5F (CORDIS)
    - 0.035" soft angled TERUMO guidewire (TERUMO)
    - 0.035" Lunderquist 180 cm guidewire via right groin (COOK)

    4. Implanation of the contralateral limb (LOMBARD MEDICAL)
    - PTA of the graft with a Reliant-balloon (MEDTRONIC) via 12F 12 cm sheaths (COOK)
    View image
  • Wednesday, January 28th: - , Main Arena 1

    Case 39 – Critical limb ischemia with distal SFA occlusion left /restenosis

    Center:
    Leipzig
    Case 39 – LEI 14: female, 82 years (I-U)
    Operators:
    • Matthias Ulrich,
    • Yvonne Bausback,
    • Tomohara Dohi
    CLINICAL DATA
    Criticl limb ischemia, ulceration left lower leg and Dig 2
    CLI right leg with heel-ulceration
    PTA right SFA 1/2015
    PTA left SFA 2011 for CLI-treatment
    Atrial fibrillation
    CAS left ICA 4/2006

    ANGIOGRAPHY
    During treatment of CLI right leg: 10 cm long distal SFA-occlusion left
    Below-the-knee peroneal artery patent

    ABI
    0.34

    PROCEDURAL STEPS
    1. Right groin retrograde access and cross-over sheath placement
    - IMA 5F diagnostic catheter (CORDIS)
    - 0.035" soft angled TERUMO glidewire (TERUMO)
    - 0.035" SupraCore 190 cm (ABBOTT)
    - 6F 55 cm Ansel Sheath (COOK)

    2. Guidewire passage and balloon-angioplasty
    - 0.018" Connect 300 cm Guidewire (ABBOTT)
    - supported by CXC 0.018" Catheter, 135 cm (COOK)
    In case of failure exchange to:
    - 0.018" Connect 250 T Guidewire, 300 cm (ABBOTT)

    3. Balloon-angioplasty and stenting
    - Pacific 5.0/80 mm Balloon, 135 cm (MEDTRONIC)
    - Tigris GORE Vascular Stent 6.0/100 mm stent (GORE)
    View image
  • Wednesday, January 28th: - , Main Arena 1

    Case 40 – Occlusion right common iliac artery

    Center:
    Leipzig
    Case 40 – LEI 15: female, 64 years (R-F)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudicatio both legs right > left, worsening 1 month ago
    CAD, intermittend atrial fibrillation
    Art. hypertension, diabetes mellitus type 2

    CT
    Occlusion right common iliac artery, partially thrombotic.

    PROCEDURAL STEPS
    1. Bilateral retrograde groin access
    - 7F 25 cm sheath (TERUMO)

    2. Passage of the occlusion from antegrade and retrograde
    Left:
    - SOS-catheter 5F (COOK)
    - 0.035" stiff straight TERUMO 260 cm (TERUMO)
    Right:
    - 0.018" Connect Flex 300 cm (ABBOTT)

    3. Guidewire exchange to
    - 0.035" SupraCore Guidewire (ABBOTT)

    4. Predilatation right
    - 5.0/40 mmm Armada 35 balloon (ABBOTT)

    5. Implantation of covered stents in kissing-technique
    - Advanta V-12 (MAQUET GETINGE GROUP)
    View image
  • Wednesday, January 28th: - , Main Arena 1

    Case 41 – SFA occlusion right

    Center:
    Leipzig
    Case 41 – LEI 16: male, 73 years (H-J)
    Operators:
    • Sven Bräunlich,
    • Sabine Steiner
    CLINICAL DATA
    Severe claudication right calf
    PTA and stenting left SFA 12/2014
    Art. hypertension, diabetes mellitus type 2
    Renal insufficiency (GFR 65ml/min), former smoker
    CAD with PTCA 11/2013

    ANGIOGRAPHY
    During PTA left SFA: long SFA-occlusion right.

    ABI
    Right 0.56

    PROCEDURAL STEPS
    1. Left femoral retrograde and cross-over access
    - 6F 40 cm Balkin Up & Over sheath (COOK)

    2. Guidewire passage of the SFA-occlusion
    - 0.035" stiff angled glidewire, 260 cm (TERUMO)
    - 0.015" Seeker Support-Catheter, 135 cm (BARD)
    - Exchange to a 0.018" guidewire SteelCore 300 cm (ABBOTT)

    3. PTA
    - Vascutrak Balloon 5.0/250 cm (BARD)
    - Lutonix 5.0/150 mm drug-coated balloon (BARD)

    4. Stenting on indication
    - LifeStent selfexpanding Nitinol-stent (BARD)
    View image
  • Wednesday, January 28th: - , Main Arena 1

    Case 42 – Reocclusion of the right tibioperoneal trunk

    Center:
    Leipzig
    Case 42 – LEI 17: male, 50 years (G-S)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Critical limb ischemia with ulceration dig 5 right
    PAOD with stenting right SFA 11/2010 and restenosis 12/2014
    PTA with drug-eluting balloons 12/2014
    Failure to pass the TTF-occlusion from antegrade 12/2014

    ANGIOGRAPHY
    12/2014: calcified TTF-occlusion, stenosis of the proximal peroneal artery

    PROCEDURAL STEPS
    1. Antegrade access right groin
    - 5F 55 cm Ansel Sheath (COOK)

    2. Guidewire passage
    retrograde access via the peroneal artery:
    - 7 cm 21 Gauge puncture needle (COOK)
    - 0.018" V-18 Control Guidewire 300 cm (BOSTON SCIENTIFIC)
    - Seeker 0.018" 90 cm support-catheter (BARD)

    3. Guidewire exchange
    After snaring of the guidewire from antegrade PTA of the lesion:
    - Exchange to a 0.014" guidewire (Floppy ES ABBOTT)
    - Vascutrak 3.5/40 mm Balloon (BARD)
    - Lutonix Drug-Coated Balloon 3.5/120 mm (BARD)
    View image
  • Wednesday, January 28th: - , Main Arena 2

    Case 51 – Abdominal aneurysm 5.5 cm with irregular neck

    Center:
    Leipzig
    Case 51 – LEI 20: male, 76 years (H-D)
    Operators:
    • Andrej Schmidt,
    • Daniela Branzan,
    • Tomohara Dohi
    CLINICAL DATA
    Progression of an abdominal aneurysm to 55mm
    CAD with PTCA 2008
    Mitral valve moderate insufficiency
    Art. hypertension, diabetes mellitus type 2

    CT
    55 mm abdominal aneurysm with irregaular neck, thrombus

    PROCEDURAL STEPS
    1. Proglide closure-device preloading both groins
    - 9F – 10 cm sheath both groins (TERUMO)

    2. Implantation of the main body
    - 0.035" Lunderquist 180cm guidewire via right groin (COOK)
    - Ovation abdominal endovascular stentgraft (TRIVASCULAR)

    3. Cannulation of the contralateral limb
    - Amplatz left I diagnostic catheter 5F (CORDIS)
    - 0.035" soft angled TERUMO guidewire (TERUMO)
    - 0.035" Lunderquist 180 cm guidewire via right groin (COOK)

    4. Implanation of the contralateral limb (TRIVASCULAR)
    - PTA of the graft with a Reliant-balloon (MEDTRONIC) via 12F 12 cm Sheaths (COOK)
    View image
  • Wednesday, January 28th: - , Main Arena 1

    Case 45 – Chronic occlusion left aneurysmatic popliteal artery

    Center:
    Leipzig
    Case 45 – LEI 18: male, 62 years
    Operators:
    • Andrej Schmidt,
    • Sven Bräunlich
    CLINICAL DATA
    Recurrent ulceration left foot, claudication intermittens, walking capacity 100 meters
    PTA of SFA-stenosis left 12/2014
    ABI > 1.3
    Diabetes mellitus type 2, art. hypertension
    Liver-transplantation 2009, chronic renal insufficienc (GFR 35ml /min)

    PARTIALLY CO2-ANGIOGRAPHY
    Short occlusion of the poplteal artery left (P2-segment).

    DUPLEX
    Popliteal artery diameter 1.6 cm

    PROCEDURAL STEPS
    1. Antegrade access left groin
    - 7F 55 cm Ansel Sheath (COOK)

    2. Guidewire passage
    - 0.018" Victory 18gr 300 cm guidewire (BOSTON SCIENTIFIC)
    - Balloon for support: Pacific 5.0/40 mm (MEDTRONIC)

    3. Implantation of a stentgraft / stent
    - Viabahn 6.0/50 mm (GORE)
    - Supera 5.0/80 mm Interwoven Nitinol-stent (ABBOTT)
    View image
  • Thursday, January 29th: - , Technical Forum

    Case 80 – Distal 10 cm SFA occlusion left, retrograde recanalization through proximal anterior tibial access

    Center:
    Leipzig
    Case 80 – LEI 28: male 78 years (L-P)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    PAOD with rest-pain left leg, Rutherford class 4, and
    Claudicatio intermittens left calf, walking capacity 100 meters
    Failed antegrade recanalization attempt
    Diabetes mellitus type 2, former smoker

    ANGIOGRAPHY
    10 cm distal SFA-occlusion left, moderat calcification

    PROCEDURAL STEPS
    1. Right femoral retrograde and cross-over access
    - 6F 40 cm Balkin Up & Over sheath (COOK)

    2. Guidewire passage from antegrade
    - 5F Multipurpose diagnostic catheter 100 cm (CORDIS)
    - 0.035" straight stiff TERUMO glidewire, 260 cm (TERUMO)
    - in case of second failure: retrograde approach via the proximal anterior tibial artery 7 cm 21 Gauge needle (COOK)
    - 0.018" V-18 Conrol Guidewire 300 cm (BOSTON SCIENTIFIC)
    - 0.018" QuickCross 90 cm Supportcahteher (SPECTRANETICS)

    3. After snaring of the guidewire from antegrade PTA
    - Ultraverse 18 Balloon (BARD) and
    - Luminor Drug-coated balloon (iVASCULAR)

    4. Stenting on indication
    - Supera Interwoven Nitinol-Stent (ABBOTT)
    View image
  • Thursday, January 29th: - , Technical Forum

    Case 81 – Occlusion of the left tibioperoneal trunk, transpedal recanalization

    Center:
    Leipzig
    Case 81 – LEI 29: male, 71 years (M-C)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    PAOD with severe claudication and restpain during night left foot
    PTA / stenting of the popliteal artery left elsewhere and failure to recanalize the tibioperoneal trunk
    Art. hypertension, CAD with CABG 2008, Polymyalgia rheumatica

    ANGIO
    During first rezanalization attempt: perforation after attempt to pass the tibioperoneal trunk occlusion.

    PROCEDURAL STEPS
    1. Antegrade approach left groin
    - 5F 55 cm Ansel Sheath (COOK)

    2. Retrograde guidewire passage
    - 7 cm 21 Gauge needle to puncture the posterior tibial artery
    - 0.018" V-18 control guidewire 300 cm (BOSTON SCIENTIFIC)
    - 3F pedal sheath (COOK)
    - 0.018" CXI-support-catheter 90 cm (COOK)
    - potentially exchange to a 0.014" CTO-guidewire Winn 200 T (ABBOTT))

    3. PTA
    - Advance Micro 3.0/40 mm 90 cm Balloon (COOK) from retrograde

    4. Stenting
    - After guidewire-passage from antegrade after predilatation from retrogarde implanatation of a Xience Prime 3.5/38 mm drug-eluting stent (ABBOTT)
    View image
  • Thursday, January 29th: - , Main Arena 2

    Case 76 – Subacute type B dissection

    Center:
    Leipzig
    Case 76 – LEI 27: male, 61 years (J-G)
    Operators:
    • Andrej Schmidt,
    • Daniela Branzan
    CLINICAL DATA
    Acute type-B-dissection 12/2014
    Art. hypertension
    Smoker

    CT
    Enlargement of the descending thoracic aorta of 1.1 cm within 1 month.

    PROCEDURAL STEPS
    1. Percutaneous access right groin
    - Preclosing with Proglide both sides (ABBOTT)
    - 0.035" Lunderquist guidewire 260 cm (COOK)
    - Calibration-pigtail catheter left groin
    - Temporary pacemaker via right groin for rapid pacing
    - IVUS (VOLCANO)

    2. Implantation of a TAG thoracic stentgraft (GORE)
    View image
  • Thursday, January 29th: - , Technical Forum

    Case 83 – Calcified short SFA occlusion left

    Center:
    Leipzig
    Case 83 – LEI 30: male, 50 years (U-K)
    Operators:
    • Sven Bräunlich,
    • Sabine Steiner
    CLINICAL DATA
    Severe claudication left calf, walking capacity 50 meters
    Bilateral iliac artery PTA 2014
    CAD with MI and PTCA 2000
    Art. hypertension, diabetes mellitus type 2

    ABI
    Left: 0.62

    ANGIOGRAPHY
    During PTA right iliac arteries: severe calcification left SFA, short distal occlusion.

    PROCEDURAL STEPS
    1. Left antegrade approach
    - 6F 10 cm sheath (TERUMO)

    2. Guidewire passage
    - 0.018" Victory 18g guidewire 300 cm (BOSTON SCIENTIFIC)
    - QuickCross 0.018" 90 cm support-catheter (SPECTRANETICS)

    3. PTA
    - AngioSculpt 5/80 mm (SPECTRANETICS)
    - Drug-coated balloon treatment
    - Drug-coated balloon PTA

    4. Stenting on indication
    View image
  • Thursday, January 29th: - , Technical Forum

    Case 88 – CLI with complex occlusions of all BTK arteries right

    Center:
    Leipzig
    Case 88 – LEI 32: male, 81 years (G-P)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Critical limb ischemia, restpain and minor ulcerations forefoot right
    Art. hypertension, CAD with PTCA 2003
    Aortic valve replacement 2013, chronic heart failure, NYHA II-III
    Atrial fibrillation, chronic renal insufficiency GFR (62 m/min)

    ANGIOGRAPHY
    During first rezanalization attempt: occlusion of the distal SFA, popliteal artery and tibioperoneal trunk

    PROCEDURAL STEPS
    1. Antegrade approach right groin
    - 5F 55 cm Ansel Sheath (COOK)

    2. Guidewire passage
    - V-18 Control Guidewire (BOSTON SCIENTIFIC)
    - PPS Arrow Catheter (ARROW)

    3. In case of failure to pass the guidewire from antegrade
    - Retrograde approach via the dorsalis pedis artery: 7 cm 21 Gauge needle
    - 0.018 Connect Guidewire 300 cm (ABBOTT)
    - 3F pedal sheath (COOK)

    4. Guidewire passage from retrograde
    - 0.018" CXI angled support-catheter 90 cm (COOK) potentially exchange to
    - 0.014 Hydro-ST Guidewire 300 cm (COOK) and
    - Advance Micro Balloon 3.0/120 mm (COOK)
    - LegFLow Drug-Coated Balloon (CARDIONOVUM)

    5. Stenting on indication
    View image
  • Thursday, January 29th: - , Main Arena 1

    Case 69 – TAVR with cerebral protection – patient characteristics

    Center:
    Leipzig
    Case 69 – LEI 24: male, 79 years old
  • Thursday, January 29th: - , Main Arena 1

    Case 72 – Stenosis left common and profunda, occlusion of the superficial femoral artery

    Center:
    Leipzig
    Case 72 – LEI 25: male, 67 years (D-M)
    Operators:
    • Andrej Schmidt,
    • Tomohara Dohi
    CLINICAL DATA
    Critical limb ischemia with ulceration of the lower calf and forefoot
    Chronic heart failure with NYHA II-III
    Art. hypertension, diabetes mellitus type 2, former smoker

    ABI
    Left 0.45

    DUPLEX
    CFA-stenosis and SFA-occlusion

    ANGIOGRAPHY
    CFA-stenosis, PFA-stenosis and SFA-occlusion

    PROCEDURAL STEPS
    1. Right groin access and cross-over approach to left
    - 7F 40 cm Balkin Up & Over sheath (COOK)

    2. Filter-protection of the deep femoral artery
    - Spider Filter 7 mm (COVIDIEN)

    3. Atherectomy of the CFA and PFA
    - TurboHawk (LX-M) (COVIDIEN)

    4. Guidewire passage of the SFA-occlusion
    - 0.035" TrailBlazer 135 cm supportcatheter (COVIDIEN)
    - 0.035" stiff angled glidewire 260 cm (TERUMO)
    - Exchange to the Spider-Filter 7 mm (COVIDIEN)

    5. Atherectomy of the SFA
    - TurboHawk (COVIDIEN)

    6. PTA with drug-coated balloons
    - Luminor 35 (iVASCULAR)
    View image
  • Friday, January 30th: - , Technical Forum

    Case 87 – Complex occlusion left popliteal artery, retrograde recanalization

    Center:
    Leipzig
    Case 87 – LEI 31: male, 79 years (M-B)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Critical limb ischemia, ulceration left plantar forefoot
    Failed antegrade recanalization attempt 1/2015
    Chronic renal failure, GFR 54 ml/min
    Hyperlipoproteinemia, art. hypertension

    ANGIOGRAPHY
    During first rezanalization attempt: occlusion of the distal SFA, poplieal artery and tibioperoneal trunk

    PROCEDURAL STEPS
    1. Antegrade approach left groin
    - 6F 40 cm Balkin Up & Over sheath (COOK)
    - retrograde access via the peroneal artery: 7 cm 21 Gauge needle
    - 0.018" V-18 Control Guidewire 300 cm (BOSTON SCIENTIFIC)
    - QuickCross 0.018" 90 cm (SPECTRANETICS)

    2. Passage of the occlusion from antegrade and retrograde with CART-technique
    - antegrade Pacific 4.0/80 mm Balloon (MEDTRONIC)
    - retrograde V-18 Control Guidewire (BOSTON SCIENTIFIC)

    3. PTA
    - GPS Arrow catheter
    - Dorado balloon 5/120mm (BARD)
    - Drug-coated balloon treatment: Luminor (iVASCULAR)

    4. Stenting on indication
    - Supera Interwoven Nitinol-Stent 5/150 mm (ABBOTT)
    View image
  • Friday, January 30th: - , Technical Forum

    Case 92 – Hybrid procedure for an occluded external iliac, common and superficial femoral artery occlusion

    Center:
    Leipzig
    Case 92 – LEI 33: male, 66 years (W-T)
    Operators:
    • Sven Bräunlich,
    • Holger Staab,
    • Daniela Branzan
    CLINICAL DATA
    PAOD with rest pain and severe claudicatio left
    Former smoker
    Art. hypertension

    ABI
    Left 0.2

    DUPLEX
    Severe PAOD with chronic occlusion externa iliac artery both sides, occlusion left common and superficial femoral artery, severely calcified.

    PROCEDURAL STEPS
    1. Thrombendartherectomy left common femoral artery

    2. Transbrachial guidewire passage through the left external iliac artery
    - 6F-90 cm Check-Flow Performer Sheath (COOK)
    - 5F Judkins Right diagnostic catheter 125 cm (CORDIS)
    - 0.035" stiff angled glidewire 260 cm (TERUMO)

    3. PTA of the iliac occlusion left after snaring of the guidewire into the left groin sheath
    - Admiral 6.0/80 mm-Balloon (MEDTRONIC)
    - 7.0/10 mm Complete stent (MEDTRONIC)

    4. Guidewire passage of the SFA occlusion from left antegrade through the CFA-patch and potentially retrograde via the distal SFA

    5. PTA and stenting of the SFA
    - Armada 5.0/120 mm Balloon (ABBOTT)
    - Supera 5.0/200 mm Interwoven Nitinol-stent (ABBOTT)
    View image
  • Friday, January 30th: - , Technical Forum

    Case 94 – Right subclavian artery occlusion

    Center:
    Leipzig
    Case 94 – LEI 35: male 68 years (G-S)
    Operators:
    • Andrej Schmidt,
    • Sven Bräunlich
    CLINICAL DATA
    Subclavian steal with right arm exercise induced dizziness
    Failed recanalization attempt due to severe iliac artery kinking
    Art. hypertension, diabetes mellitus

    RISK FACTORS
    RR-difference right to left arm: > 30 %

    ANGIOGRAPHY
    During first recanalization attempt: right vertebral retrograde flow, occlusion of the right subclavian artery.

    PROCEDURAL STEPS
    1. Access via right brachial artery and right femoral artery
    - brachial: 6F 55 cm Ansel Sheath (COOK)
    - femoral: 8F Judkins Right Guiding-Catheter (CORDIS)
    - Potentially stabilization of the guiding-catheter with a Filterwire EZ in the internal carotid artery right (BOSTON SCIENTIFIC).

    2. Bidirectional attempt to pass the occlusion
    - Judkins Right 5F diagnostic catheter 100 and 125 cm(CORDIS)
    - 0.018" Connect Flex 300 cm or Connect 250 T 300 cm guidewire (ABBOTT)

    3. PTA
    - Predilatation with Sterling 5/40 mm Balloon (BOSTON SCIENTIFIC)

    4. Stenting
    - Omnilink 8/29 mm balloon-expandable stent (ABBOTT)
    View image

Dendermonde

4 livecase(s)
  • Tuesday, January 27th: - , Main Arena 1

    Case 04 – Long SFA occlusion

    Center:
    Dendermonde
    Case 04 – DEN 01: male, 66 years (J-V)
    Operators:
    • Koen Deloose,
    • Lieven Maene
    CLINICAL DATA
    2008: CABG
    2009: Adenocarcinoma right colon (pT3N1): resection + adj. chemo smoking

    PRESENT STATE
    Claudication right > left after 100 m since 6 months
    DUS: Bilateral SFA occlusion
    CT angio

    PROCEDURAL STEPS
    1. Left CFA retrograde access

    2. Crossover procedure
    - RIM Catheter (COOK) + Roadrunner Uniglide 0.035"/260 cm stiff curved (COOK)

    3. Flexor sheath 6F, 45 cm (COOK)

    4. Roadrunner Uniglide 0.018"/260 cm (COOK) + 0.018" curved CXI Catheter 90 cm (COOK)

    5. Recanalization
    - by preference intraluminal (Plan B: subintimal)

    6. Predilatation
    - Advance 18LP balloon (COOK)

    7. Popliteal artery
    - DCB Advance PTX 0.018" balloon (COOK)

    8. SFA
    - Zilver PTX stent (COOK)
    View image
  • Tuesday, January 27th: - , Main Arena 1

    Case 07 – Long SFA occlusion right

    Center:
    Dendermonde
    Case 07 – DEN 02: male, 83 years (E-V)
    Operators:
    • Koen Deloose,
    • Lieven Maene
    CLINICAL DATA
    1992: Aortobifemoral bypass
    2003: left CAS
    severe COPD
    smoking, hypercholesterolemia, arterial hypertension

    PRESENT STATE
    claudication right leg since 6 months, 50 m
    DUS: bilateral SFA occlusions
    MR angio

    PROCEDURAL STEPS
    1. Right CFA access anterograde
    - 6F BriteTip Sheath (CORDIS) 12 cm

    2. Predilatation
    - Passeo-18 (BIOTRONIK)

    3. Dilatation
    - DCB Passeo-Lux 0.018" (BIOTRONIK)

    4. Stenting
    - Pulsar-18 (BIOTRONIK)
    View image
  • Wednesday, January 28th: - , Technical Forum

    Case 53 – Occlusion right EIA & CFA + occlusion left CFA

    Center:
    Dendermonde
    Case 53 – DEN 04: male, 80 years (A-V)
    Operators:
    • Koen Deloose,
    • Joren Callaert
    CLINICAL DATA
    PTCA in 2007
    COPD
    Hypercholesterolemia, ex-smoker

    PRESENT STATE
    Claudication in both legs with 100 m walking distance since 3 months.

    DUPLEX
    Weak monophasic signals in both groins with on the left side complete absence of flow.

    PROCEDURAL STEPS
    1. Left brachial access
    - 6F GlideWire 0.035" curved stiff (TERUMO)
    - Internal mammaria catheter 5F (CORDIS)
    - Destination 6F 90 cm (TERUMO)

    2. PLAN A: Anterograde recanalization
    - GlideWire 0.035"/280 cm curved stiff (TERUMO), alternative: Advantage GlideWire 0.018" (TERUMO)
    - supported by CXI 0.035"/0.018" 150 cm (COOK)

    3. PLAN B: Retrograde recanalization with SFA puncture(s)

    4. Predilatation
    - Armada 0.035" (ABBOTT VASCULAR)

    5. Stenting
    - Supera VMI (ABBOTT VASCULAR)
    View image
  • Wednesday, January 28th: - , Main Arena 1

    Case 38 – In-stent reocclusion right SFA and high grade stenosis left CIA

    Center:
    Dendermonde
    Case 38 – DEN 03: male, 62 years (E-V)
    Operators:
    • Koen Deloose,
    • Joren Callaert
    CLINICAL DATA
    2008: PTA+S right CIA & EIA, left SFA
    prostatic cancer, treated with radiotherapy
    8/JAN/15: PTA+S left EIA & SFA
    hypercholesterolemia, smoking

    PRESENT STATE
    Rest pain (Rutherford 4) right angiography

    PROCEDURAL STEPS
    1. Left CFA access, 6F

    2. Crossover procedure
    - RIM Catheter (COOK) + GlideWire 0.035" (TERUMO)
    - Destination 7F 45 cm sheath (TERUMO)

    3. In-stent recanalization
    - GlideWire 0.035"/0.018" (TERUMO)
    - Berenstein 4F 100 cm (CORDIS) CXI 0.035"/0.018" catheter (COOK)

    4. Predilatation
    - Armada 0.035" (ABBOTT VASCULAR)

    5. Stenting
    - Viabahn Endoprosthesis (GORE)

    6. Left CIA stenosis stenting
    - BeGraft balloon-expandable stent-graft (BENTLEY INNOMED)
    View image

Cotignola

4 livecase(s)
  • Tuesday, January 27th: - , Technical Forum

    Case 25 – Severe bilateral internal carotid artery stenosis

    Center:
    Cotignola
    Case 25 – COT 03: male, 80 years old (Q. F.)
    Operators:
    • Antonio Micari
  • Tuesday, January 27th: - , Main Arena 1

    Case 06 – Right superficial femoral artery chronic total occlusion

    Center:
    Cotignola
    Case 06 – COT 01: male, 63 years old (I. E.)
    Operators:
    • Antonio Micari,
    • Alberto Cremonesi,
    • Giuseppe Vadalà
  • Tuesday, January 27th: - , Main Arena 2

    Case 22 – Right common and superficial femoral artery severe stenosis

    Center:
    Cotignola
    Case 22 – COT 02: male, 78 years old (M. A.)
    Operators:
    • Giuseppe Roscitano,
    • Antonio Micari,
    • Chiara Grattoni
  • Tuesday, January 27th: - , Technical Forum

    Case 29 – Right symtomatic internal carotid artery critcal stenosis

    Center:
    Cotignola
    Case 29 – COT 04: female, 73 years old (C. E.)
    Operators:
    • Alberto Cremonesi,
    • Giuseppe Vadalà

Berne

3 livecase(s)
  • Tuesday, January 27th: - , Main Arena 2

    Case 11 – Iliofemoral venous intervention

    Center:
    Berne
    Case 11 – BER 01: female, 71 years (B-M)
    Operators:
    • Nils Kucher,
    • Torsten Fuß
    CLINICAL DATA
    Past Medical History:
    Iliac vein thrombosis left side in 2012 (May Thurner) treated with CDT (EKOS) and 2 overlapping stents in common and external iliac veins

    VTE-RISK FACTORS
    Chronic venous insufficiency (ulcer, varicose veins), smoking
    Currently no anticoagulation therapy

    PRESENT COMPLAINT
    Chronic venous insufficiency left leg with:
    Mild leg swelling (2 cm plus in thigh circumference) / No venous claudication
    Hyperpigmentation, varicose veins

    DUPLEX
    Popliteal & femoral veins: patent / Common femoral vein: patent
    External and common iliac veins: instent restenosis

    PROCEDURAL STEPS
    1. Local anaesthesia with standby

    2. Venous access with ultrasound guidance in left popliteal (10F sheath)

    3. Wire crossage
    - 0.035" stiff angled (TERUMO)

    4. Phlebography, IVUS

    5. Predilatation
    - Atlas Balloon 12–14 mm (BARD), Aspirex 10F (STRAUB MEDICAL) thrombectomy depending on thrombus load

    6. Implantation of dedicated Iliac vein stents over TERUMO stiff angled wire 0.035"
    - Sinus-Obliquus 14–16 mm (OPTIMED),
    - Sinus-XL Flex 14–16 mm (OPTIMED)
    - Vici 14–16 mm (Veniti)

    7. High-pressure postdilation of stents
    - Atlas Balloon 14–16 mm (BARD)
    View image
  • Tuesday, January 27th: - , Main Arena 2

    Case 13 – Iliofemoral venous intervention

    Center:
    Berne
    Case 13 – BER 02: female, 28 years (C-J)
    Operators:
    • Nils Kucher,
    • Torsten Fuß,
    • Frédéric Glause
    CLINICAL DATA
    Past medical history:
    Iliofemoral DVT left side in April 2014 treated conservatively
    VTE-Risk factors: history of distal DVT right leg 2007
    while on oral contraception and smoking
    Currently on anticoagulation therapy, compression stockings

    PRESENT COMPLAINT
    Chronic venous insufficiency left leg with:
    Moderate leg swelling despite compression therapy
    Severe venous claudication

    CT
    No clear signs of May Thurner present / external iliac vein occlusion
    Popliteal and femoral veins postthrombotic, common femoral and iliac veins occluded

    PROCEDURAL STEPS
    1. General anaesthesia, prone position, urinary catheter

    2. Venous access with ultrasound guidance in left popliteal
    - 7F destination sheath

    3. Wire crossage
    - TERUMO 0.035" stiff angled, 4F Berenstein catheter, torque device

    4. Phlebography, IVUS

    5. Predilation
    - Atlas Balloon 12–14 mm (BARD)

    6. Implantation of dedicated Iliac vein stents over TERUMO stiff angled wire 0.035"
    - Sinus-Obliquus 14–16 mm (OPTIMED),
    - Sinus-XL Flex 14–16 mm (OPTIMED)

    7. High-pressure post-dilation of stents
    - Atlas Balloon 14–16 mm (BARD)
    View image
  • Tuesday, January 27th: - , Main Arena 2

    Case 19 – Ilio-caval venous intervention and ovarian vein ablation

    Center:
    Berne
    Case 19 – BER 04: female 39 years, (C-M)
    Operators:
    • Nils Kucher,
    • Torsten Fuß
    CLINICAL DATA
    Past medical history:
    Bilateral iliofemoral DVT involving infrarenal VCI 2001 treated conservatively
    VTE-Risk factors: oral contraception, Faktor V Leiden
    Currently no anticoagulation therapy, compression stockings
    Endometriosis, WPW syndrome

    PRESENT COMPLAINT
    Chronic venous insufficiency both legs with:
    Mild leg swelling, Moderate venous claudication, cramps
    Severe pelvic congestions syndrome with abdominal and back pain, depending on menstrual cycle.

    DUPLEX
    Popliteal & femoral veins & external iliac veins: patent
    Iliac veins and IVC: postthrombotic high velocity flow without modulation
    MR venography: postthrombotic changes of IVC and left common iliac vein, right ovarian vein ectasia.

    CT
    Right ovarian vein (10 mm), postthrombotic infrarenal IVC

    PROCEDURAL STEPS
    1. General anaesthesia, supine position, urinary catheter

    2. Venous access in both common femoral (10F) and right jugular veins (6F)

    3. Wire crossage IVC from both femoral veins
    - TERUMO 0.035" stiff angled, 4F Berenstein catheter, torque device

    4. Phlebography, IVUS

    5. Right ovarian vein venography & embolization from jugular access
    - pushable Nester coils (COOK)

    6. Predilation IVC
    - Atlas Balloon 14–18 mm (BARD)

    7. Implantation of dedicated vein stents over TERUMO stiff angled wire 0.035" in IVC and kissing stents iliac veins
    - Sinus-XL 18–22 mm (OPTIMED) for IVC,
    - Sinus-XL Flex 14–16 mm (OPTIMED) for iliac veins

    8. High-pressure postdilation of stents
    - Atlas Balloon 14–18 mm (BARD)
    View image

Galway

3 livecase(s)
  • Tuesday, January 27th: - , Main Arena 2

    Case 12 – Acute ilio-femoral deep vein thrombosis

    Center:
    Galway
    Case 12 – GAL 01: male, 56 years old - carpenter
    Operators:
    • Gerard O'Sullivan,
    • Jean Marc Pernes,
    • Tony Lopez
  • Tuesday, January 27th: - , Main Arena 2

    Case 14 – Endovascular treatment of a complex recurrent thrombosis

    Center:
    Galway
    Case 14 – GAL 02: female, 41 years
    Operators:
    • Gerard O'Sullivan,
    • Jean Marc Pernes,
    • Tony Lopez
    CLINICAL DATA
    Unusual presentation in 2008 with supra-renal IVC thrombosis and extensive right lower extremity DVT
    Suprarenal IVC filter placed
    Successfully treated by catheter directed thrombolysis and placement of tandem 12mm diameter, 90mm long Wallstent
    Patient could not tolerate balloon dilatation beyond 10 mm
    Fully anticoagulated
    Lost to follow up; represented in 2013 with varicose veins RLE. CEAP 4

    PROCEDURAL STEPS
    1. General anaesthetic, urethral catheter, supine position

    2. Mid thigh femoral venous access
    - 5F sheath; ascending venography
    - R IJV access; 55cm long sheath; 8F
    - 5000u IV Heparin
    - Upsize to 10F sheath R FV

    3. Attempt to cross occluded stent in R EIV from below and if necessary above
    - Stif glidewire; back end stiff glidewire; centring balloon technique CTO wire (Asahi Astata 30g with 2.5 mm balloon to back it up).
    - IF we get across; attempt to clear out stent with Rotarex (STRAUB MEDICAL).

    4. Exchange for a 180cm Amplatz wire
    - Pre dilate lesion with a high pressure balloon (BARD Atlas).
    - Stent lesion with a dedicated venous stent
    Veniti Vici 16 mm diameter, 120 mm long

    5. Repeat balloon dilatation to nominal diameter of stent
    - Confirm full stent expansion by IVUS (VOLCANO) and cone beam CT (SIEMENS).
    - Completion venography

    6. Radiofrequency ablation
    - IF ALL ABOVE SUCCESSFUL then; radiofrequency ablation to R GSV throughout its length (ClosureFast, COVIDIEN).

    7. Remove sheaths
    - Class 2 thigh high compression stockings (Jobst) for 6 weeks.
    - Full anticoagulation
    - Overnight thigh high sequential compression device (COVIDIEN).
    - Colour Doppler US day 1; CTV at 6/52
    View image
  • Tuesday, January 27th: - , Main Arena 2

    Case 23 – Ovarian and internal iliac vein embolization

    Center:
    Galway
    Case 23 – GAL 04: female, 36 years
    Operators:
    • Tony Lopez,
    • Gerard O'Sullivan,
    • Jean Marc Pernes
    CLINICAL DATA
    Noticed development of vulval varices after birth 2nd child and became much worse after third. Uncomfortable. Unpleasant.

    PROCEDURAL STEPS
    1. Local anaesthetic, no sedation

    2. S upine position

    3. R IJV access

    4. S elective catheterisation right ovarian, left ovarian and bilateral internal iliac veins

    5. Combination of foam sclerosant and coil (COOK) embolisation

    6. Deliberate dissection orifice right ovarian vein!!
    View image

Berlin

3 livecase(s)
  • Tuesday, January 27th: - , Technical Forum

    Case 24 – Right ICA postoperative re-stenosis CEA 1997

    Center:
    Berlin
    Case 24 – BLN 03: male, 60 years old (G. F.)
    Operators:
    • Ralf Langhoff,
    • Andrea Behne
  • Tuesday, January 27th: - , Global Expert Exchange

    Case 32 – Occlusion of the right tibioperoneal trunc

    Center:
    Berlin
    Case 32 – BLN 04: male, 60 years (W-P)
    Operators:
    • Ralf Langhoff,
    • Andrea Behne
    CLINICAL DATA
    CLI patient , wound right dig ped I, CTO of the tibioperoneal trunc, recanalisation of the SFA in cross-over technique 12/2014 with stenting, but still not complete healing

    RISK FACTORS
    Abdominal aortic aneurysm 4,0 cm, CAD, CABG in 1999, art. hypertension, hyperlipidaemia, IDDM.

    PROCEDURAL STEPS
    1. Antegrade punctering of the right CFA, insertion of a 4F Fortress 45 cm sheath

    2. Recanalisation of the tibioperoneal trunc
    - 0.018" Advantage wire (TERUMO)

    3. Predilatation
    - Arrow GPS 3 x 40 mm balloon catheter (TELEFLEX)

    4. Angiocontrol of the PTA result via balloon sideport

    5. Secondary stenting
    - 3.5 mm x 31 mm Cre8 BTK drug-eluting stent (ALVIMEDICA)

    6. Manual compression
    View image
  • Tuesday, January 27th: - , Main Arena 2

    Case 21 – CTO right distal SFA

    Center:
    Berlin
    Case 21 – BLN 04: male, 59 years old (F. G.)
    Operators:
    • Ralf Langhoff,
    • Normund Jabs

Sapporo

3 livecase(s)
  • Tuesday, January 27th: - , Global Expert Exchange

    Case 31 – Long CTO of left SFA

    Center:
    Sapporo
    Case 31 – SAP 02: male, 64 years (Y-S)
    Operators:
    • Kazushi Urasawa,
    • M. Tan
    CLINICAL DATA
    PAOD Rutherford 3, claudication both legs
    PTA and stenting at bi-lateral iliac arteries at 2009
    Claudication appeared again early last year
    Stenting for bi-lateral EIA and right SFA at 12/2014

    RISK FACTORS
    Ischemic heart disease, hypertension,
    diabetes mellitus type 2, dyslipidemia,
    CKD (hemodialysis dependent)

    ABI
    Right 1.15, left 0.87 (after EVT)

    PROCEDURAL STEPS
    1. Left common femoral access and ipsi-lateral antegrade approach
    - 6F Guiding sheath, Parent-Plus 23 cm (MEDIKIT)

    2. Retrograde puncture of the left distal SFA
    - 20G Introducer Needle (MEDIKIT)
    - Cruise 0.014" 225 cm (NEOS)
    - Promenent-NEO2 60 cm (TOKAI MEDICAL PRODUCTS)

    3. Antegrade wiring
    - 0.014" Harberd (Asahi Intec) supported by Prominent-NEO 135 cm

    4. Retrograde wiring
    - 0.014" Chevalier floppy (CORDIS Endovascular)
    - Wire rendez-vous technique within SFA-CTO

    5. PTA / stenting from antegrade
    - Coyote 3.0 x 220 mm (BOSTON SCIENTIFIC)
    - Sterling 5.0 x 220 mm (BOSTON SCIENTIFIC)
    - Smart Control (CORDIS)
    View image
  • Tuesday, January 27th: - , Technical Forum

    Case 26 – Re-occlusion of left distal SFA and popliteal artery (POP)

    Center:
    Sapporo
    Case 26 – SAP 01: male, 53 years (M-T)
    Operators:
    • Kazushi Urasawa,
    • T. Haraguchi
    CLINICAL DATA
    POAD Rutherford 3, claudication left carf at less than 100 meters
    Stenting for left SFA and PTA for left POP 1/2014
    Claudication appeared again at 12/2014

    DUPLEX
    Dyslipidemia, diabetes mellitus type 2
    ABI: right 1.15, left unmeasureable
    CT images of left femoral artery

    PROCEDURAL STEPS
    1. Left common femoral access and ipsi-lateral antegrade approach
    - 6F Guiding sheath, Parent-Plus 23 cm (MEDIKIT)

    2. Retrograde puncture of the left distal PTA
    - 20G Introducer Needle (MEDIKIT)
    - Cruise 0.014" 225 cm (NEOS)
    - Promenent-NEO2 60 cm (TOKAI MEDICAL PRODUCTS)

    3. Antegrade wiring
    - 0.035" Redifocus small-J (TERUMO) supported by 4F angiographic catheter (CORDIS)
    - 0.014" Astatto XS9-12 (Asahi Intec) supported by Prominent-NEO 135cm (TOKAI MEDICAL PRODUCTS)

    4. Retrograde wiring
    - 0.014" Chevalier floppy (CORDIS Endovascular)
    - Wire rendez-vous technique within CTO lesion

    5. Thrombus aspiration
    - TVAC aspiration catheter (NIPRO)
    - Distal protection by external pressure cuff

    6. PTA/stenting from antegrade
    - Coyote 3.0 x 220 mm (BOSTON SCIENTIFIC)
    - Sterling 5.0 x 220 mm (BOSTON SCIENTIFIC)
    - Smart Control, if necessary (CORDIS)
    View image
  • Tuesday, January 27th: - , Technical Forum

    Case 27 – SFA CTO

    Center:
    Sapporo
    Case 27 – SAP 01A: male, 91 years (H-Y)
    Operators:
    • Kazushi Urasawa,
    • Ryoji Koshida
    CLINICAL DATA
    PAOD Rutherford 2, claudication right calf at 300 meters

    RISK FACTORS
    Old cerebral infarction

    ABI
    Right 0.69, left 0.92

    PROCEDURAL STEPS
    1. Right common femoral access and ipsi-lateral antegrade approach
    - 6F guiding sheath, Parent-Plus 23 cm (MEDIKIT)

    2. Antegrade wiring
    - 0.014" Halberd (ASAHI INTEC) supported by Prominent-NEO 135 cm (TOKAI MEDICAL PRODUCTS)
    - 0.014" Astato XS9-12 (ASAHI INTEC)

    3. Retrograde wiring
    - 0.014" Cruise (Neos) supported by Prominent 135 cm (TOKAI MEDICAL PRODUCTS)
    - Guidewire rendez-vous technique within SFA-CTO

    4. PTA/Stenting from antegrade
    - Coyote 3.0 x 220 mm (BOSTON SCIENTIFIC)
    - Sterling 5.0 x 220 mm (BOSTON SCIENTIFIC)
    - Smart control, if necessary (CORDIS)
    View image

Teaneck

4 livecase(s)
  • Wednesday, January 28th: - , Technical Forum

    Case 58 – Iliac vein compression prior EVLT

    Center:
    Teaneck
    Case 58 – TEA 03: male, 71 years old
    Operators:
    • Kevin Herman,
    • John Rundback,
    • Amish Patel
  • Wednesday, January 28th: - , Technical Forum

    Case 59 – Chronic femoral DVT initial therapy

    Center:
    Teaneck
    Case 59 – TEA 04: male, 46 years
    Operators:
    • John Rundback,
    • Amish Patel
    CLINICAL DATA
    46-year-old gentleman with a history of chronic DVT for several years, first seen in June 2013. He has persistent progressive symptoms with left leg swelling and ankle pain, despite reliable use of graded compression stockings and other conservative measures. This is interfering with his work as an electrician. His medications are aspirin 81 mg only.

    PROCEDURAL STEPS
    1. US guided popliteal puncture
    - Sono-site ultrasound, Micropuncture set (COOK)
    - Upsize to 7F sheath (TERUMO)

    2. Lesion crossing
    - 0.035" Glidewire advantage (TERUMO)
    - Glidecatheter

    3. Balloon venoplasty
    - Charger (BOSTON SCIENTIFIC) or Admiral (MEDTRONIC)

    4. Positioning of EKOS thrombolytic infusion catheter (per chronic DVT trial)
    View image
  • Wednesday, January 28th: - , Main Arena 1

    Case 43 – Left renal artery stenosis

    Center:
    Teaneck
    Case 43 – TEA 01: female, 73 years
    Operators:
    • John Rundback,
    • Joseph Manno
    CLINICAL DATA
    73-year-old woman with known bilateral severe renal artery stenosis
    from a CTA on 10/16/2013 with atrophy in the left kidney.
    She has not had congestive heart failure.
    She was a former smoker; stopped approximately two years ago.
    She has a history of coronary artery disease with myocardial infarction
    and coronary stents in 2012. She does not have dyslipidemia or diabetes.

    Current blood pressure medications are clonidine 0.1 b.i.d., Toprol 12.5 daily,
    and losartan/hydrochlorothiazide 50/12.5 daily. She also takes Zocor 40,
    Plavix 75, and aspirin 81.

    VITAL SIGNS
    Blood pressure, was 178/67 mmHg in the right arm and 161/70 mm Hg in the left arm.

    LABS
    GFR 66 ml/min.1.73m2

    PROCEDURAL STEPS
    1. Right femoral puncture and insertion of 7F RDC guide sheath (CORDIS)

    2. Selective catheterization of left renal artery
    - Spartacore wire (ABBOTT)

    3. Possible Buddy Wire and pressures
    - Radi wire (VOLCANO)

    4. Renal artery stenting
    - Formula 414 stents (COOK)
    View image
  • Wednesday, January 28th: - , Main Arena 1

    Case 44 – Celiac artery aneurysm

    Center:
    Teaneck
    Case 44 – TEA 02: male, 57 years
    Operators:
    • Kevin Herman,
    • John Rundback,
    • Joseph Manno
    CLINICAL DATA
    Patient is a 57-year-old gentleman with history of hypertension sleep apnea and obesity who presented to emergency room for 3 days history of sudden onset severe left abdominal pain and worse during inspiration and sometimes radiating to his left shoulder. An abdominal CT scan showed a splenic infarct 2.5 cm celiac artery aneurysm.

    RISK FACTORS
    History of a cardiomyopathy with negative cardiac catheterization, nonischemic left bundle branch block, renal insufficiency Echocardiogram showed LVEF 40% without atrial or ventricular thrombus.

    PROCEDURAL STEPS
    1. US guided radial puncture
    - Sono-site ultrasound, Micropuncture set (COOK)
    - Adminstration of NTG and Verapamil
    - Insertion of 6F Slender Sheath (TERUMO)
    - Traverse arch, wire descending thoracic aorta and exchange for 5F Shuttle Sheath (COOK)

    2. Select celiac access, subselect and coil proximal splenic artery
    - Interlock coils (BOSTON SCIENTIFIC)

    3. Possible subselect and coil embolize left gastric artery

    4. Advance 0.018" Platinum plus wire into hepatic artery

    5. Exclude celiac aneurysm with ICast stent grafts (Atrium) or Viabahn stent grafts (GORE)
    View image

Münster

12 livecase(s)
  • Wednesday, January 28th: - , Main Arena 2

    Case 47 – Infrarenal abdominal aneurysm 61 mm / Severe calcified and stenosed iliac arteries

    Center:
    Münster
    Case 47 – MUN 02: male, 82 years (F-F)
    Operators:
    • Bernd Gehringhoff,
    • Martin Austermann,
    • Arne Schwindt
    CLINICAL DATA
    CAD
    Art. Hypertension
    Nephrectomy left side

    PROCEDURAL STEPS
    1. Percutaneous approach both groins
    - Prostar XL (ABBOTT)
    - 14F sheath (COOK)

    2. Possibly predilatation of the iliacs

    3. Placement of the "ultra low profile" Incraft bifurcated endograft (14F CORDIS) below the renal arteries
    View image
  • Wednesday, January 28th: - , Main Arena 2

    Case 48 – Juxtarenal aortic aneurysm 73 mm

    Center:
    Münster
    Case 48 – MUN 03: male, 73 years old (W.W.)
    Operators:
    • Bernd Gehringhoff,
    • Martin Austermann
  • Wednesday, January 28th: - , Main Arena 2

    Case 48 – Juxtarenal aortic aneurysm 73 mm

    Center:
    Münster
    Case 48 – MUN 03: male, 73 years old (W.W.)
    Operators:
    • Bernd Gehringhoff,
    • Martin Austermann
  • Wednesday, January 28th: - , Technical Forum

    Case 56 – Persistent type II endoleak after EVAR

    Center:
    Münster
    Case 56 – MUN 04: male, 78 years old (O. H. J.)
    Operators:
    • Arne Schwindt,
    • N. Abu-Bakr
  • Wednesday, January 28th: - , Technical Forum

    Case 57 – Type II endoleak with aneurysm growth

    Center:
    Münster
    Case 57 – MUN 05: female, 79 years
    Operators:
    • Arne Schwindt,
    • Konstantinos Stavroulakis
    CLINICAL DATA
    EVAR 2009 with Talent prothesis, in followup visits perstent Type II endoleak via lumbar arteries, axial aneurysm growth of 8 mm

    RISK FACTORS
    Hypertension, hyperlipidemia

    PROCEDURAL STEPS
    1. Left transbrachial approach
    - 5F 90 cm shuttle sheath (COOK) to left common iliac artery

    2. Cannulation of left hypogastric
    - 0.035" Glidewire and 4F 120 cm Glidecath (TERUMO)

    3. Cannulation of left ileolumbar artery
    - 0.014" Choice PTII wire (BOSTON SCIENTIFIC)

    4. Cannulation of endoleak
    - 0.014" Echelon or 0.010 Marathon microcatheter (COVIDIEN)

    5. Embolisation of Endoleak with alcohol-copolymer
    - Onyx (COVIDIEN)
    View image
  • Wednesday, January 28th: - , Main Arena 1

    Case 46 – In-stent occlusion right A. poplitea

    Center:
    Münster
    Case 46 – MUN 01: female, 55 years (N-K)
    Operators:
    • Arne Schwindt,
    • Konstantinos Stavroulakis
    CLINICAL DATA
    PAOD Rutherford 4, intermittend rest pain,claudication right calf at 20 meters
    PTA and Stent right popliteal 2009, Stent left CIA 2/2011

    RISK FACTORS
    NIDDM, hypertension, hyperlipidemia

    PROCEDURAL STEPS
    1. Left femoral approach
    - 5F 10 cm sheath (TERUMO)

    2. Cross-over manoeuvre
    - Insertion 6F 45 cm Destination sheath (TERUMO) via 0.035 Advantage wire (TERUMO)

    3. True lumen recanalization right A. pop.
    - Ocelot PIXL (AVINGER)

    4. Directional atherectomy popliteal artery
    - Turbohawk LSM (COVIDIEN)

    5. Postdilation
    - In.Pact paclitaxel eluting balloon (MEDTRONIC)
    View image
  • Thursday, January 29th: - , Main Arena 1

    Case 63 - SFA occlusion left SFA TASC II D

    Center:
    Münster
    Case 63 – MUN 06: female - 73 years
    Operators:
    • Arne Schwindt,
    • N. Abu-Bakr
    CLINICAL DATA
    - Claudication left leg with pain free walking distance of 150m (Rutherford III)
    - CVRF: hypertension, former smoker
    - high grade stenosis promixal SFA
    - 12 cm CTO distal SFA
    - Mild Ca+

    ABI LEFT
    - 0.6

    PROCEDURAL STEPS
    - Crossed using the Ocelot Catheter (AVINGER, Redwood City, CA)
    - Real time confirmation of true lumen crossing (avoided disruption of medial/adventitial border)
    - Reduced fluoroscopy using only OCT for crossing)
    - Cap to cap standalone crossing
    - OCT guided Atherectomy using the Pantheris Catheter (not approved for sale, currently under FDA IDE Clinical Trials) (AVINGER, Redwood City, CA)
    - Real time directional cutting targeting plaque
    - Histology of plaque sample reveals 0% adventitia
    - Reduced fluoroscopy using OCT for atherectomy
    - Post Atherectomy DEB using In.Pact Admiral Balloon (MEDTRONIC, Minneapolis, MN)

    POST PROCEDURAL ABI LEFT
    - 1.2
    View image
  • Thursday, January 29th: - , Main Arena 2

    Case 74 – Thoraco-abdominal aortic aneurysm 84 mm

    Center:
    Münster
    Case 74 – MUN 08: female, 76 years old (P. I.)
    Operators:
    • Martin Austermann,
    • Bernd Gehringhoff
  • Thursday, January 29th: - , Main Arena 2

    Case 77 – Juxtarenal aortic aneurysm 83 mm

    Center:
    Münster
    Case 77 – MUN 09: male, 70 years old (N. H.)
    Operators:
    • Martin Austermann,
    • Bernd Gehringhoff,
    • Konstantinos Donas
  • Thursday, January 29th: - , Main Arena 1

    Case 70 – High grade left internal carotid artery stenosis

    Center:
    Münster
    Case 70 – MUN 07: female, 72 years
    Operators:
    • Arne Schwindt,
    • Simone Hartmann
    CLINICAL DATA
    Asymptomatic, 90% ICA stenosis, vmax in CCD 280cm/sec
    Type III aortic arch

    RISK FACTORS
    Hypertension

    PROCEDURAL STEPS
    1. Femoral approach
    - Cannulation of left common carotid artery with 6F 90 cm Shuttle sheath (COOK) in telescope technique with 5,4 VTEK Slipcath (COOK).

    2. Passage of lesion
    - Epifilterwire (BOSTON SCIENTIFIC)

    3. Implantation of Roadsaver dual layer carotid stent (TERUMO)

    4. Postdilation
    - Sterling RX balloon (BOSTON SCIENTIFIC)
    View image
  • Thursday, January 29th: - , Main Arena 2

    Case 78 – Thoraco-abdominal aortic nbeurysm 62 mm

    Center:
    Münster
    Case 78 – MUN 10: male, 74 years old (S. C.)
    Operators:
    • Martin Austermann,
    • Bernd Gehringhoff
  • Friday, January 30th: - , Main Arena 1

    Case 89 – Thoracoabdominal aortic aneurysm type IV

    Center:
    Münster
    Case 89 – MUN 11: male, 75 years (S-H)
    Operators:
    • Martin Austermann,
    • Bernd Gehringhoff
    CLINICAL DATA
    CAD 3VD
    Art. Hypertension
    Impaired renal function
    DM 2

    DUPLEX
    Thoraco-abdominal aortic aneurysm 62mm
    - Crawford Type IV with aneurysms of both common iliac arteries
    - occlusion of the left hypogastric artery
    - replaced infrarenal aorta

    PROCEDURAL STEPS
    1. Percutaneous approach both groins
    - Prostar XL (ABBOTT)
    - 14F (COOK) both groins

    2. Left axillary access
    - 5F TERUMO sheath,later 12/8F sheath

    3. Placement of a CMD
    - Zenith-endograft (COOK) with three branches

    4. Implantation of the distal bifurcated endograft and a IBD on the right side

    5. Closure of the groins

    6. Cannulation of the SMA, renal arteries and the right hypogastric artery through the branches and implantation of the bridging stentgafts
    View image

Heidelberg

6 livecase(s)
  • Wednesday, January 28th: - , Technical Forum

    Case 54 – Hepatocellular carcinoma (HCC)

    Center:
    Heidelberg
    Case 54 – HEI 02: male, 83 years
    Operators:
    • Boris Radeleff,
    • Nikolas Kortes,
    • Natalie Tessendorf,
    • Björn Bliesener
    CLINICAL DATA
    Multifocal hepatocellular carcinoma ED: 07/14
    Child A liver cirrhosis
    After 1. DEB-TACE (3 ml 75 μm Tandem loaded with 150 mg doxorubicin
    plus 11 μml unloaded Embozene 250 μm; CELONOVA, USA) 11.12.2014
    Today: 2. DEB-TACE of the first cycle

    PROCEDURAL STEPS
    1. Transfemoral approach right groin

    2. Short 4F sheath Radifocus (TERUMO)

    3. 0.035" 180 cm J-wire

    4. 4F 110 cm 4F Sidewinder Typ I (CORDIS)

    5. 2,8F Microcatheter Progreat (TERUMO)

    6. Embolisation
    - 75μm Tandem DEB-particles (CELONOVA); loaded with 150 mg of doxorubicin
    View image
  • Wednesday, January 28th: - , Main Arena 2

    Case 50 – Asymptomatic AAA 5.3 cm

    Center:
    Heidelberg
    Case 50 – HEI 01: male, 76 years (G-Z)
    Operators:
    • Alexander Hyhlik-Dürr,
    • Dittmar Böckler,
    • Drosos Kotelis
    CLINICAL DATA
    Asymptomatic progressive AAA 53 mm

    RISK FACTORS
    Art. hypertension, history of smoking

    PROCEDURAL STEPS
    1. Fusion imaging (2D-3D registration)
    - Artis Zeego/Leonardo (SIEMENS)

    2. Bifemoral cut-down

    3. Guidewire positioning
    - Lunderquist GW 180 cm (COOK)

    4. Implantation of a bifurcated stentgraft
    - Endurant II (MEDTRONIC)

    5. Postdilation
    - Reliant balloon (MEDTRONIC)

    6. Contrast enhanced Dyna-CT
    - Artis Zeego/Leonardo (SIEMENS)
    View image
  • Wednesday, January 28th: - , Main Arena 2

    Case 50 – Asymptomatic AAA 5.3 cm

    Center:
    Heidelberg
    Case 50 – HEI 01: male, 76 years (G-Z)
    Operators:
    • Alexander Hyhlik-Dürr,
    • Dittmar Böckler,
    • Drosos Kotelis
    CLINICAL DATA
    Asymptomatic progressive AAA 53 mm

    RISK FACTORS
    Art. hypertension, history of smoking

    PROCEDURAL STEPS
    1. Fusion imaging (2D-3D registration)
    - Artis Zeego/Leonardo (SIEMENS)

    2. Bifemoral cut-down

    3. Guidewire positioning
    - Lunderquist GW 180 cm (COOK)

    4. Implantation of a bifurcated stentgraft
    - Endurant II (MEDTRONIC)

    5. Postdilation
    - Reliant balloon (MEDTRONIC)

    6. Contrast enhanced Dyna-CT
    - Artis Zeego/Leonardo (SIEMENS)
    View image
  • Wednesday, January 28th: - , Technical Forum

    Case 60 – TIPS

    Center:
    Heidelberg
    Case 60 – HEI 03: male, 52 years
    Operators:
    • Boris Radeleff,
    • Ulrike Stampfl,
    • Karl-Heinz Weiss,
    • Nikolas Kortes,
    • Natalie Tessendorf,
    • Björn Bliesener
    CLINICAL DATA
    Pat. on waiting list for LTx
    Cryptogenic liver cirrhosis, child A
    Refractory ascites
    Previous episode of hep. encephalopathy

    PROCEDURAL STEPS
    1. Transjugular venous access right side
    - 9F 20 cm sheath (Arrows)

    2. Puncture attempt: right liver vein --> right PV
    - TIPS-set (OPTIMED) 30Æ or 60Æ angled

    3. 0.035" superstiff wire (BOSTON SCIENTIFIC)

    4. Predilatation
    - 8 x 80 mm MARS® balloon (OPTIMED)

    5. 10F Sheath (Checkflow, COOK) 38-45 cm, straight / angled

    6. Stentgraft implantation
    - Viatorr®-Stentgraft (GORE)

    7. Planning
    - Puncture: right LV right PV
    - Needle type: 30Æ angled
    - Shunt: 10 mm Viatorr (GORE) 10/6/2 or 10/7/2
    View image
  • Thursday, January 29th: - , Main Arena 2

    Case 75 – Asymptomatic AAA 5.4 cm

    Center:
    Heidelberg
    Case 75 – HEI 04: male, 79 years (G-K)
    Operators:
    • Dittmar Böckler,
    • Alexander Hyhlik-Dürr,
    • Drosos Kotelis
    CLINICAL DATA
    Asymptomatic AAA 54 mm!
    Asymptomatic aneurysm of the left common iliac artery 26 mm
    Left SFA occlusion

    RISK FACTORS
    Art. hypertension, history of smoking

    PROCEDURAL STEPS
    1. Bifemoral cut-down

    2. 8F sheath placement (TERUMO)

    3. Fusion imaging for endograft navigation using 2-D – 3-D registration

    4. Guidewire insertion (TERUMO)
    - Lunderquist GW 180 cm (COOK)

    5. Stentgraft positioning and deployment
    - 2 Nellix systems (ENDOLOGIX)

    6. Endobag prefilling with saline, angiography

    7. Endobag filling with polymer

    8. Optional secondary fill
    View image
  • Thursday, January 29th: - , Main Arena 2

    Case 75 – Asymptomatic AAA 5.4 cm

    Center:
    Heidelberg
    Case 75 – HEI 04: male, 79 years (G-K)
    Operators:
    • Dittmar Böckler,
    • Alexander Hyhlik-Dürr,
    • Drosos Kotelis
    CLINICAL DATA
    Asymptomatic AAA 54 mm!
    Asymptomatic aneurysm of the left common iliac artery 26 mm
    Left SFA occlusion

    RISK FACTORS
    Art. hypertension, history of smoking

    PROCEDURAL STEPS
    1. Bifemoral cut-down

    2. 8F sheath placement (TERUMO)

    3. Fusion imaging for endograft navigation using 2-D – 3-D registration

    4. Guidewire insertion (TERUMO)
    - Lunderquist GW 180 cm (COOK)

    5. Stentgraft positioning and deployment
    - 2 Nellix systems (ENDOLOGIX)

    6. Endobag prefilling with saline, angiography

    7. Endobag filling with polymer

    8. Optional secondary fill
    View image

São Paulo

2 livecase(s)
  • Wednesday, January 28th: - , Global Expert Exchange

    Case 62 – Symptomatic severe stenosis of ostial right CCA, left ICA & SCA

    Center:
    São Paulo
    Case 62 – SAO 02: female, 69 years (E-C)
    Operators:
    • Armando Lobato,
    • Dino Felli Colli,
    • Robert Guimaraes,
    • Salomao Goldman
    CLINICAL DATA
    04/12 TIA (Dysarthria and right arm paresis)

    RISK FACTORS
    Hypertension, former smoker, hyperlipidaemia, diabetes mellitus

    PROCEDURAL STEPS
    1. Femoral access: Navigation of a diagnostic catheter into the left ECA
    - 5F JB1 diagnostic catheter, 100 cm (CORDIS)
    - 0.035" TERUMO angled guide-wire, 260 cm (TERUMO)

    2. Introduction of the cerebral protection device and endovascular clamping
    - 8F - 11 cm introducer (CORDIS)
    - 0.035" E-Wire guide-wire, 260 cm (JOTEC)
    - Endovascular Clamping Device – MoMa 8F (MEDTRONIC)

    3. Passing of the left ICA lesion and stenting
    - 0.014" Choice Pt Extra stiff guide-wire, 190 cm (BOSTON SCIENTIFIC)
    - 3.5/20 mm Falcon Bravo RX PTA Balloon Catheter (MEDTRONIC)
    - 40 mm Adapt RX Carotid Stent (BOSTON SCIENTIFIC)

    4. Postdilatation
    - 5.0/20 mm Falcon Bravo RX PTA Balloon Catheter (MEDTRONIC)

    5. Left brachial access: Navigation of a diagnostic catheter into the left ECA
    - 7F – 45 cm introducer (CORDIS)
    - 7F VERT diagnostic catheter, 100 cm (TERUMO)
    - 0.035" Teruma angled guide-wire, 260 cm (TERUMO)

    6. Passing of the left subclavian artery lesion and stenting
    - 70/20 mm Powerflex Pro OTW PTA ballon catheter (CORDIS)
    - Stent Genesis 90 x 29 7F OTW (CORDIS)
    View image
  • Wednesday, January 28th: - , Main Arena 2

    Case 52 – Sac hygroma after EVAR: endograft relining

    Center:
    São Paulo
    Case 52 – SAO 01: male, 81 years (N-T)
    Operators:
    • Armando Lobato,
    • Dino Felli Colli,
    • Robert Guimaraes,
    • Marcelo Cury
    CLINICAL DATA
    Asymptomatic expanding aneurysm sac after EVAR without apparent endoleak secondary to sac hygroma

    RISK FACTORS
    Hypertension, COPD, hyperlipidaemia, former smoker

    PROCEDURAL STEPS
    1. Cut down bilateral common femoral arteries
    - DrySeal Introducer 18F (WL GORE)
    - DrySeal Introducer 20F (WL GORE)
    - 0.035" E-Wire guide-wire, 260 cm (JOTEC)

    2. Endograft relining
    - Endurant proximal cuff 28 x 45 mm (MEDTRONIC)
    - Endurant iliac limb externsion 16 x 16 x 120 mm 14F (MEDTRONIC)
    - Endurant iliac limb externsion 16 x 20 x 120 mm 16F (MEDTRONIC)

    3. Latex balloon accomodation
    - Reliant balloon (MEDTRONIC)
    View image

Abano Terme

3 livecase(s)
  • Wednesday, January 28th: - , Technical Forum

    Case 61 – AT/PT and lateral plantar recanalization

    Center:
    Abano Terme
    Case 61 – ABT 01: male, 60 years (Z-M)
    Operators:
    • Marco Manzi,
    • Luis Mariano Palena
    CLINICAL DATA
    DM, neurovasculopathy

    RISK FACTORS
    Right pre-tibial II-III D lesion, right foot rest pain. TcPO2: 17 mmHg
    Hypertension
    Ischemic heart disease (previous PTcA)

    PROCEDURAL STEPS
    1. Right Groin antegrade US guided approach
    - 6F 11 cm sheath (TERUMO)

    2. Antegrade wiring of AT and arch
    - 4F BER 2, 100 cm (CORDIS)
    - 0.014" Pilot 200, 300 cm (ABBOTT)

    3. Antegrade passage of the PT/lateral plantar occlusion
    - 4F BER 2 100 cm (CORDIS), V18 CW (BOSTON SCIENTIFIC)

    4. Wires rendez-vous through arch and lateral plantar artery

    5. Predilatation
    - Armada XT, 1,5 mm x 20 mm (ABBOTT)

    6. Definitive dilatation
    - Armada 14, 2,5 mm x 200 mm (ABBOTT)
    View image
  • Thursday, January 29th: - , Technical Forum

    Case 79 – PT and lateral plantar/dorsalis paedis/arch revascularization

    Center:
    Abano Terme
    Case 79 – ABT 02: male, 65 years (S-G)
    Operators:
    • Marco Manzi,
    • Luis Mariano Palena
    CLINICAL DATA
    DM, neurovasculopathy

    RISK FACTORS
    I° toe gangrene and calcanear Tuc 1 c lesion; TcPO2: 8 mmHg.
    Hypertension, dyslipidemia
    Ischemic heart disease (previous PTcA)

    PROCEDURAL STEPS
    1. Antegrade US guided left groin approach
    - 6F 11 cm sheath (TERUMO)
    - 4F 110 cm Flexor sheath (COOK) option

    2. Antegrade/retrograde trans tarsal loop passage of the PT occlusion
    - 0.018" V18 300 cm (BOSTON SCIENTIFIC)
    - Pilot 200, 300 cm (ABBOTT)

    3. Wires rendez-vous

    4. Predilatation
    - Ultraverse 1.5 mm x 20 mm (BARD)
    - Ultraverse 2.0 mm x 300 mm (BARD)

    5. Definitive dilatation
    - Lutonix 2.5 mm x 150 mm (BARD)
    View image
  • Thursday, January 29th: - , Technical Forum

    Case 85 – Distal AT, dorsalis paedis, arch and lateral plantar revascularization

    Center:
    Abano Terme
    Case 85 – ABT 03: male, 83 years (T-D)
    Operators:
    • Marco Manzi,
    • Luis Mariano Palena
    CLINICAL DATA
    DM, neurovasculopathy

    RISK FACTORS
    Right CLI, diffuse onycodisthrophia, I° and II° TUC 1c, TcPO2=22 mmHg
    Hypertension, dyslipidemia, ischemic heart disease, CAF, previous left CFA surgical endoatherectomy

    PROCEDURAL STEPS
    1. Right groin US guided antegrade approach
    - 6F 11 cm sheath (TERUMO)

    2. Antegrade passage of the distal AT/dorsalis paedis occlusion
    - 4F Ber 2, 100 cm (CORDIS),
    - 0.018" 300 cm V18 CW (BOSTON SCIENTIFIC)
    - 0.014" 300 cm V14 (BOSTON SCIENTIFIC)
    - retrograde distal I° digital puncture after failure
    - arch evaluation and possible trans-loop retrograde lateral plantar recanalization

    3. Predilatation
    - Coyote ES 1.5 mm/2 mm x 20 mm

    4. Definitive dilatation
    - Coyote 2.5 mm x 200 mm
    View image

Bad Krozingen

7 livecase(s)
  • Thursday, January 29th: - , Main Arena 1

    Case 64 – Occlusion of the posterior tibial artery

    Center:
    Bad Krozingen
    Case 64 – BK 01: male, 82 years (R-S)
    Operators:
    • Aljoscha Rastan,
    • Elias Noory
    CLINICAL DATA
    Claudication (foot) Rutherford-Becker class 3
    Recanalisation of the femoro-popliteal bypass (P I) 12/2014
    Femoro-popliteal bypass (PTFE) 2008

    RISK FACTORS
    Hypertension, tobacco use

    ABI AT REST
    0.6/1.0

    DUPLEX
    Occlusion of the PTA/ATA

    PROCEDURAL STEPS
    1. Antegrade femoral access right groin
    - 6F 11cm sheath (CORDIS)
    - 5F STR guiding catheter (CORDIS)

    2. Recanalisation of the posterior tibial artery
    - 0.014" Pilot 150 wire (ABBOTT), 0.014" Extra-Support wire (ABBOTT)
    - 0.014" Advantage (TERUMO), 2.0x120mm OTW Amphirion balloon (MEDTRONIC)

    3. Atherectomy
    - Phoenix 1.8 mm (VOLCANO)

    4. (DE-) Postdilatation and stenting on indication
    - 2.5x120 mm Lutonix 14 (BARD)

    5. Optional: tibial access
    View image
  • Thursday, January 29th: - , Main Arena 1

    Case 65 – Occlusion of the right SFA

    Center:
    Bad Krozingen
    Case 65 – BK 02: male, 76 years old (P. W.)
    Operators:
    • Thomas Zeller
  • Thursday, January 29th: - , Main Arena 1

    Case 66 – Occlusion of the left SFA

    Center:
    Bad Krozingen
    Case 66 – BK 03 b: male, 67 years old
  • Thursday, January 29th: - , Technical Forum

    Case 82 – Occlusion (in-stent) of the left SFA

    Center:
    Bad Krozingen
    Case 82 – BK 05: male, 65 years (E-G)
    Operators:
    • Aljoscha Rastan,
    • Elias Noory
    CLINICAL DATA
    Claudication Rutherford-Becker class 3
    Recanalization and stenting of the left EIA and SFA 06/2013
    Stenting of the right SFA 09/2013

    RISK FACTORS
    Tobacco use, hypertension, hypercholesterolemia

    ABI AT REST
    Right/left: 0.6/0.3

    DUPLEX
    Left leg: CIA, EIA, CFA, DFA without stenosis.
    Origin of the SFA occluded. Detectable blood flow in the PA (I).

    PROCEDURAL STEPS
    1. Retrograde femoral access (cross-over)
    - 6F and 8F Cross-over sheath Balkin (CORDIS)
    - 0.035" stiff wire (TERUMO)

    2. Recanalization of the SFA
    - 0.018" Advantage (TERUMO), Quick-Cross support-catheter (SPECTRANETICS)

    3. Laser procedure
    - 2.0mm Elite Laser, Turbo-Tandem (SPECTRANETICS)
    - Wirion filter (GARDIA MEDICAL)

    4. DEB postdilatation
    - 5 mm and 6 mm x 120 mm PacificInpact balloon

    5. Stenting on indication
    View image
  • Thursday, January 29th: - , Main Arena 1

    Case 67 – Occlusion of the left SFA/PA

    Center:
    Bad Krozingen
    Case 67 – BK 03: male, 81 years (G-S)
    Operators:
    • Thomas Zeller
    CLINICAL DATA
    Claudication (left calf) Rutherford-Becker class 3
    Coronary heart disease: DES RCX 02/2005; PCI RCA 09/2001

    RISK FACTORS
    Tobacco, hypertension, diabetes hypercholesterolemia

    ABI AT REST
    Right/left: 0.9/0.4

    DUPLEX
    Left leg: CIA, EIA, DFA without stenosis, distal part of the SFA incl. PA occluded
    Detectable blood flow in the middle part of the PA and the tibio-peroneal trunc

    PROCEDURAL STEPS
    1. Antegrade femoral access
    - 7F sheath (CORDIS)

    2. Recanalization of the SFA/PA
    - 4F vertebralis catheter (CORDIS)
    - 0.035" wire (TERUMO)

    3. Atherectomy
    - Jetstream (BOSTON SCIENTIFIC)

    4. Postdilatation
    - 4/5 mm 120 mm DE-balloon angioplasty, Ranger (BOSTON SCIENTIFIC)

    5. Stenting on indication
  • Thursday, January 29th: - , Technical Forum

    Case 86A – Occlusion of the right PTA

    Center:
    Bad Krozingen
    Case 86A – BK 07A: male, 54 years (F-D)
    Operators:
    • Thomas Zeller
    CLINICAL DATA
    Claudication Rutherford-Becker class 3
    Femoro-popliteal Bypass surgery 2005, re-occlusion of the Bypass 2006+2014
    Recanalization+DEB+Stent of the SFA/PA 12/2014

    RISK FACTORS
    Tobacco use

    ABI AT REST
    Right/left: 0.5/1.1

    DUPLEX
    Bypass and PA without stenosis, occlusion of the PTA and ATA.

    PROCEDURAL STEPS
    1. Antegrade femoral access (cross-over)
    - 6F sheath (TERUMO)

    2. Recanalization of PTA
    - 5F STR-catheter (CORDIS), 0.014" Pilot 50/150 wire (ABBOTT), 0.014" Advantage (TERUMO)
    - 2.0 x 120 mm Amphirion-OTW (MEDTRONIC)

    3. Predilatation
    - 2.0 x 120 mm Amphirion-RX (MEDTRONIC)

    4. Dilatation
    - 2.5/3 x 120 mm Lutonix (DE-) balloon (BARD)

    5. Optional
    - DES, retrograde access, re-entry device
    View image
  • Thursday, January 29th: - , Main Arena 1

    Case 71 – Calcified stenosis of the left CFA

    Center:
    Bad Krozingen
    Case 71 – BK 04: male, 70 years old (E. S.)
    Operators:
    • Elias Noory,
    • Aljoscha Rastan