LINC 2015 live case guide

Find all Live Cases and Live Case Centers listed below.

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