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)
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)
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
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