LINC 2016 live case guide


Find all live cases and live case centers listed below.

 

 

Leipzig, Dept of Angiology

35 livecase(s)
  • Tuesday, January 26th: - , Room 1 - Main Arena 1

    Case 01 – LEI 01: Highly calcified distal SFA / A. popliteal occlusion left – Part 1

    Center:
    Leipzig, Dept of Angiology
    Case 01 – LEI 01: male, 72 years (H-L)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Rest pain left foot, Rutherford class 4
    Severe claudication left, walking capacity 100 meters
    Angiography during PTA right iliac arteries after coronary angiography 12/2015

    ABI
    Left 0.42

    RISK FACTORS
    CAD with PTCA 12/2015
    Carotid TEA bilateral (1999 and 2000)
    Permanent atrial fibrillation
    Chronic renal insufficiency GFR 62 ml/min
    Former smoker, art. hypertension, hyperlipidaemia

    PROCEDURAL STEPS
    1. Right groin retrograde and cross-over approach
    - 0.035" SupraCore Guidewire 190 cm (ABBOTT)
    - 7F-40 cm Balkin Up&Over Sheath (COOK)

    2. Guidewire-passage and PTA of the occlusion left SFA/Apop
    - 4.0/80 mm Armada 35 Balloon (ABBOTT)
    - 0.035" Radiofocus soft angled guidewire, 260 cm (TERUMO)
    - 6.0/40 mm Armada 35 Balloon (ABBOTT)
    - Conquest High Pressure Balloon (C.R.BARD)

    In case of antegrade failure:
    3. Retrograde approach via the proximal anterior tibial artery
    - 21 Gauge 7 cm Micropuncture needle (COOK)
    - 0.018" Connect Guidewire 300 cm (ABBOTT)
    - 0.018" QuickCross Support-Catheter 90 cm (SPECTRANETICS)

    4. Stenting
    - 5.0 or 6.0/150 mm Supera Interwoven Selfexpanding Nitinolstent (ABBOTT)
    View image
  • Tuesday, January 26th: - , Room 1 - Main Arena 1

    Case 01 – LEI 01: Highly calcified distal SFA / A. popliteal occlusion left – Part 2

    Center:
    Leipzig, Dept of Angiology
    Case 01 – LEI 01: male, 72 years (H-L)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Rest pain left foot, Rutherford class 4
    Severe claudication left, walking capacity 100 meters
    Angiography during PTA right iliac arteries after coronary angiography 12/2015

    ABI
    Left 0.42

    RISK FACTORS
    CAD with PTCA 12/2015
    Carotid TEA bilateral (1999 and 2000)
    Permanent atrial fibrillation
    Chronic renal insufficiency GFR 62 ml/min
    Former smoker, art. hypertension, hyperlipidaemia

    PROCEDURAL STEPS
    1. Right groin retrograde and cross-over approach
    - 0.035" SupraCore Guidewire 190 cm (ABBOTT)
    - 7F-40 cm Balkin Up&Over Sheath (COOK)

    2. Guidewire-passage and PTA of the occlusion left SFA/Apop
    - 4.0/80 mm Armada 35 Balloon (ABBOTT)
    - 0.035" Radiofocus soft angled guidewire, 260 cm (TERUMO)
    - 6.0/40 mm Armada 35 Balloon (ABBOTT)
    - Conquest High Pressure Balloon (C.R.BARD)

    In case of antegrade failure:
    3. Retrograde approach via the proximal anterior tibial artery
    - 21 Gauge 7 cm Micropuncture needle (COOK)
    - 0.018" Connect Guidewire 300 cm (ABBOTT)
    - 0.018" QuickCross Support-Catheter 90 cm (SPECTRANETICS)

    4. Stenting
    - 5.0 or 6.0/150 mm Supera Interwoven Selfexpanding Nitinolstent (ABBOTT)
    View image
  • Tuesday, January 26th: - , Room 2 - Main Arena 2

    Case 12 – LEI 07: Acute early reocclusion left SFA after PTA/Stent

    Center:
    Leipzig, Dept of Angiology
    Case 12 – LEI 07: male, 62 years (PMC-L)
    Operators:
    • Sven Bräunlich,
    • Yvonne Bausback
    CLINICAL DATA
    Severe claudication left calf, walking capacity 120-150 meters
    ABI left 0.63
    PTA and stenting of a short distal SFA-stenosis left 11/2015 elsewhere
    Acute thrombosis of the SFA

    RISK FACTORS
    CAD, MI 2003
    Art. hypertension, diabetes mellitus type 2, former smoker

    PROCEDURAL STEPS
    1. Right groin retrograde and cross-over approach
    - IMA-diagnostic 5F-catheter (CORDIS/CARDINAL HEALTH)
    - 0.035" angled soft Radiofocus glidewire, 190 cm (TERUMO)
    - 0.035" SupraCore guidewire, 190 cm (ABBOTT)
    - 8F Balkin Up&Over Sheath, 40 cm (COOK)

    2. Passage of the occlusion and percutaneous thrombectomy
    - 0.018" Connect Guidewire 300cm (ABBOTT)
    - 0.018" QuickCross Support-Catheter 135 cm (SPECTRANETICS)
    - Exchange to Rotarex guidewire (STRAUB MEDICAL)
    - 8F Rotarex Thrombectomy Catheter (STRAUB MEDICAL)

    3. PTA with DCBs
    - In.Pact Pacific 5.0/120 mm (MEDTRONIC)

    4. Stenting on indication
    - Epic Selfexpanding Nitinol-Stent (BOSTON SCIENTIFIC)
    View image
  • Tuesday, January 26th: - , Room 1 - Main Arena 1

    Case 02 – LEI 02

    Center:
    Leipzig, Dept of Angiology
    Case 02 – LEI 02
    Operators:
    • Andrej Schmidt,
    • Yvonne Bausback
    New patient! Information will follow in due time. Thank you for your understanding.
  • Tuesday, January 26th: - , Room 2 - Main Arena 2

    Case 13 – LEI 08: In-stent reocclusion left SFA

    Center:
    Leipzig, Dept of Angiology
    Case 13 – LEI 08: male, 70 years (D-K)
    Operators:
    • Matthias Ulrich,
    • Michael Moche
    CLINICAL DATA
    Severe claudication left calf, walking-capacity 150-200 meters since 9/2015
    ABI left 0,67
    Stenting left SFA 08/2014
    Stenting iliac arteries left 2003 and right 12/2015
    CAD with PTCA 2003

    RISK FACTORS
    Art. hypertension, current smoker

    ANGIOGRAPHY
    During PTA right iliac 12/2015: In-stent reocclusion left SFA

    PROCEDURAL STEPS
    1. Right groin retrograde and cross-over approach
    - IMA diagnostic catheter, 5F (CORDIS / CARDINAL HEALTH)
    - 0.035" SupraCore 190 cm Guidewire (ABBOTT)
    - 8F-40 cm Balkin Up&Over Sheath (COOK)

    2. Passage of the in-stent occlusion left SFA
    - Judkins Right 5F-catheter (CORDIS/CARDINAL HEALTH)
    - 0.035" Radiofocus angled stiff glidewire, 260 cm (TERUMO)
    - Exchange to 0.018" Guidewire (STRAUB MEDICAL)

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

    4. PTA with drug-coated balloons
    - Lutonix DCBs (C.R.BARD)
    View image
  • Tuesday, January 26th: - , Room 1 - Main Arena 1

    Case 03 – LEI 03

    Center:
    Leipzig, Dept of Angiology
    Case 03 – LEI 03
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    New patient! Information will follow in due time. Thank you for your understanding.
  • Tuesday, January 26th: - , Room 1 - Main Arena 1

    Case 06 – LEI 04: Occlusion right popliteal artery

    Center:
    Leipzig, Dept of Angiology
    Case 06 – LEI 04: female, 66 years (I-B)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication right calf and restpain during night, Rutherford class 3-4

    ABI
    Right 0.55

    PTA
    Right A.poplitea 3/2013

    DUPLEX
    Moderate stenosis right iliac artery and reocclusion right popliteal artery

    RISK FACTORS
    Art. hypertension, diabetes mellitus type II, former smoker

    PROCEDURAL STEPS
    1. Left groin retrograde and cross-over approach
    - 7F-55 cm Check-Flow-Performer Sheath (COOK)

    2. Passage of the popliteal occlusion right
    - 0.018" Victory 18 30 gr 300 cm guidewire (BOSTON SCIENTIFIC)
    - 0.018" QuickCross Support-Catheter 135 cm (SPECTRANETICS)

    3. Filter-protection placement
    - 4F-90 cm Check-Flo Performer sheath (COOK)
    - Wirion-Protection system (ALLIUM MEDICAL)

    4. Atherectomy
    - HawkOne directional atherectomy system, 6 cm tip (MEDTRONIC)

    5. PTA with Drug-coated balloons
    - In.Pact Pacific 6.0/120 mm (MEDTRONIC)

    6. Stenting on indication
    - Complete SE-Stent (MEDTRONIC)
    View image
  • Tuesday, January 26th: - , Room 5 - Global Expert Exchange

    Case 32 – LEI 10

    Center:
    Leipzig, Dept of Angiology
    Case 32 – LEI 10
    Operators:
    • Andrej Schmidt,
    • Yvonne Bausback
    New patient! Information will follow in due time. Thank you for your understanding.
  • Tuesday, January 26th: - , Room 1 - Main Arena 1

    Case 07 – LEI 05: BTK-occlusion right with critical limb ischemia

    Center:
    Leipzig, Dept of Angiology
    Case 07 – LEI 05: male, 81 years (G-P)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Restpain right forefoot and minor gangrene Dig I, Rutherford 5
    Recurrent infrainguinal disease right with
    PTA right SFA and BTK-arteries 4/2014 and 2/2015
    Ischaemic cardiomyopathy, NYHA II-III
    CAD with PTCA left main 2/2015
    TAVI 2/2015
    Permanent atrial fibrillation
    PTA right vertebral artery 12/2015

    ABI
    Right: 0.37

    ANGIOGRAPHY
    During vertebral artery PTA 12/2015: occlusion of all 3 BTK-arteries right

    RISK FACTORS
    Arterial hypertension, former smoker, hyperlipidaemia

    PROCEDURAL STEPS
    1. Right antegrade approach
    - 6F 55 cm Flexor Check-Flo Introducer, Raabe Modification (COOK)

    2. Passage of the anterior tibial artery occlusion
    - CXC 0.018” 90 cm Support-Catheter (COOK)
    - 0.018” V-18 Control Guidewire, 300 cm (BOSTON SCIENTIFIC)
    Exchange to:
    - 0.014" Floppy ES 300 cm guidewire (ABBOTT)

    3. PTA and arterial wall-injection of dexamethason
    - Armada 14 3.0/120 mm balloon (ABBOTT)
    - BullFrog Micro-Infusion-Device (MERCATOR MEDSYSTEMS)
    View image
  • Tuesday, January 26th: - , Room 3 - Technical Forum

    Case 30 – LEI 09: Recurrent stenosis left common carotid artery

    Center:
    Leipzig, Dept of Angiology
    Case 30 – LEI 09: male, 56 years (L-F)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Recurrent stenosis left common carotid artery at the proximal anastomosis
    of a prosthesis-interposition left CCA after radical neck dissection
    of a parotid cancer left with infiltration of the CCA and radiation therapy 2010
    Fogarty-thrombectomy left CCA and stenting left CCA/ICA 2015
    Minor stroke 2015

    RISK FACTORS
    Facial nerve paresis left since 2015
    Minor paresis right arm since 2015
    Dysarthria
    Former smoker, arterial hypertention, diabetes mellitus type II

    DUPLEX
    High grade recurrent stenosis left proximal common carotid artery

    ANGIOGRAPHY
    90% proximal CCA-stenosis and 70% recurrent stenosis distal to the ICA-stent

    PROCEDURAL STEPS
    1. Right groin retrograde approach
    - Judkins-Right 8F-guiding-catheter (CORDIS)

    2. Placement of a filter
    - Wirion protection device (ALLIUM MEDICAL)

    3. Predilatation, stenting and postdilatation
    - 3.5/20 mm AngioSculpt RX scoring-balloon (SPECTRANETICS)
    - 9.0 or 10/30 mm CGuard carotid embolic prevention system (InspireMD/PENUMBRA)
    - 7.0/20 mm Sterling RX-balloon (BOSTON SCIENTIFIC)
    View image
  • Tuesday, January 26th: - , Room 1 - Main Arena 1

    Case 09 – LEI 06: Calcified popliteal artery occlusion

    Center:
    Leipzig, Dept of Angiology
    Case 09 – LEI 06: male, 73 years, (S-W)
    Operators:
    • Sven Bräunlich,
    • Yvonne Bausback
    CLINICAL DATA
    Critical limb ischemia with ulceration lateral foot right
    Severe claudication right since years
    ABI right 0.34, Rutherford class 5
    Thrombendartherectomy right groin 2013

    RISK FACTORS
    Diabetes mellitus type 2, art. hypertension, former smoker

    ANGIOGRAPHY
    Severely calcified distal SFA and Apop – occlusion right

    PROCEDURAL STEPS
    1. Right antegrade approach
    - 6F 55 cm sheath (COOK)

    2. Passage of the occlusion
    - Stiff angled Radiofocus guidewire 0.035”, 260cm (TERUMO)
    - Armada 35 balloon 4.0/120mm (ABBOTT)
    In case of failure form antegrade:
    - Retrograde approach vie peroneal or posterior tibial artery

    3. PTA
    - Armada 5/40 and 6/40 mm balloon (ABBOTT)
    - Conquest High Pressure Balloon (C.R.BARD)

    4. Stenting
    - Supera Interwoven Nitinol Stent (ABBOTT)
    View image
  • Wednesday, January 27th: - , Room 5 - Global Expert Exchange

    Case 58 – LEI 21

    Center:
    Leipzig, Dept of Angiology
    Case 58 – LEI 21
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    New patient! Information will follow in due time. Thank you for your understanding.
  • Wednesday, January 27th: - , Room 2 - Main Arena 2

    Case 44 – LEI 15: Abdominal aortic aneurysm – Part 1

    Center:
    Leipzig, Dept of Angiology
    Case 44 – LEI 15: male, (R-E)
    Operators:
    • Andrej Schmidt,
    • Daniela Branzan
    CLINICAL DATA
    Incidental finding of an eccentric AAA, 5.3 cm diameter

    RISK FACTORS
    CAD with NSTEMI 10/2015, PTCA LAD
    Chronic renal insufficiency (GFR 72 ml/min)
    Art. hypertention, former smoker

    PROCEDURAL STEPS
    1. Percutaneous access both groins in local anaesthesia
    - 5F-10 cm Radifocus-sheaths (TERUMO)
    - 0.035" SupraCore guidewire 190 m (ABBOTT)
    - Preloading of 2 Proglide-systems per groin (ABBOTT)
    - 0.035" Lunderquist 260 cm guidewires bilateral (COOK)

    2. Graft implantation
    - Implantation of the Altura Stentgraft system and extension to the hypogastric artery bilateral (LOMBARD MEDICAL)

    3. Postdilatation of the whole graft
    - Exchange to 12F-12 cm sheath bilateral (COOK)
    - Reliant balloons both sides (MEDTRONIC)
    View image
  • Wednesday, January 27th: - , Room 5 - Global Expert Exchange

    Case 60 – LEI 22

    Center:
    Leipzig, Dept of Angiology
    Case 60 – LEI 22
    Operators:
    • Sven Bräunlich,
    • Matthias Ulrich
    New patient! Information will follow in due time. Thank you for your understanding.
  • Wednesday, January 27th: - , Room 2 - Main Arena 2

    Case 44 – LEI 15: Abdominal aortic aneurysm – Part 2

    Center:
    Leipzig, Dept of Angiology
    Case 44 – LEI 15: male, (R-E)
    Operators:
    • Andrej Schmidt,
    • Daniela Branzan
    CLINICAL DATA
    Incidental finding of an eccentric AAA, 5.3 cm diameter

    RISK FACTORS
    CAD with NSTEMI 10/2015, PTCA LAD
    Chronic renal insufficiency (GFR 72 ml/min)
    Art. hypertention, former smoker

    PROCEDURAL STEPS
    1. Percutaneous access both groins in local anaesthesia
    - 5F-10 cm Radifocus-sheaths (TERUMO)
    - 0.035" SupraCore guidewire 190 m (ABBOTT)
    - Preloading of 2 Proglide-systems per groin (ABBOTT)
    - 0.035" Lunderquist 260 cm guidewires bilateral (COOK)

    2. Graft implantation
    - Implantation of the Altura Stentgraft system and extension to the hypogastric artery bilateral (LOMBARD MEDICAL)

    3. Postdilatation of the whole graft
    - Exchange to 12F-12 cm sheath bilateral (COOK)
    - Reliant balloons both sides (MEDTRONIC)
    View image
  • Wednesday, January 27th: - , Room 1 - Main Arena 1

    Case 35 – LEI 11: Reocclusion right SFA

    Center:
    Leipzig, Dept of Angiology
    Case 35 – LEI 11: male, 50 years (R-D)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication right calf, painfree walking capacity 50 meters
    Rutherford class 3
    ABI right 0.63
    PTA left SFA 12/2015, PTA right SFA with DCBs 12/2012

    RISK FACTORS
    Art. hypertension, current smoker

    PROCEDURAL STEPS
    1. Left groin retrograde and cross-over approach
    - 7F–40 cm Balkin Up&Over Sheath

    2. Guidewire passage
    - 0.035" stiff angled Radiofocus guidewire, 260 cm (TERUMO)
    - 0.035" Seeker Support-catheter, 135 cm (BARD)
    In case of failure to redirect the guidewire back into the true lumen retrograde approach via the distal SFA:
    - 21 Gauge 9 cm puncture needle (COOK)
    - 0.018" V-18 Control guidewire 90 cm (BOSTON SCIENTIFIC)

    3. PTA and stenting
    - Armada 35 5.0/120mm (ABBOTT)
    - 6.0/250 mm Viabahn (W.L.GORE)
    - 7.0/80 mm GORE Tigris Stent across the collateral distal to the occlusion (W.L.GORE)
    View image
  • Wednesday, January 27th: - , Room 1 - Main Arena 1

    Case 37 – LEI 12: Chronic SFA-Occlusion right

    Center:
    Leipzig, Dept of Angiology
    Case 37 – LEI 12: male, 74 years (G-W)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication right calf, Rutherford class 3
    ABI right 0.62
    Angiography during PTCA 11/2015:
    Long SFA-occlusion right and popliteal artery stenosis right

    RISK FACTORS
    CAD with NSTEMI 11/2015 and PTCA RCX
    Moderate aortic valve stenosis
    Former smoker, art. hypertension, diabetes mellitus Type 2

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

    2. Passage of the CTO
    - 0.035" Radiofocus glidewire, stiff, angled, 260 cm (TERUMO)
    - 0.035" Seeker support-catheter, 135 cm (BARD)
    - Exchange to a 0.018" SteelCore guidewire 300 cm (ABBOTT)

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

    4. Stenting on indication
    - LifeStent (BARD)
    View image
  • Wednesday, January 27th: - , Room 1 - Main Arena 1

    Case 38 – LEI 13

    Center:
    Leipzig, Dept of Angiology
    Case 38 – LEI 13
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    New patient! Information will follow in due time. Thank you for your understanding.
  • Wednesday, January 27th: - , Room 2 - Main Arena 2

    Case 48 – LEI 16: Abdominal aortic aneurysm – Part 1

    Center:
    Leipzig, Dept of Angiology
    Case 48 – LEI 16: male, 67 years (M-F)
    Operators:
    • Andrej Schmidt,
    • Daniela Branzan,
    • Michael Moche
    CLINICAL DATA
    Progressive abdominal aortic aneurysm, diameter 5.1 cm
    CAD, PTCA 2014
    PAOD
    Renal insufficiency (GFR 52 ml/min)

    RISK FACTORS
    Pulmonary thromboembolism 10/2015
    Arterial hypertension, hyperlipidemia, diabetes mellitus

    PROCEDURAL STEPS
    1. Bifemoral percutaneous approach in local anaesthesia
    - Preclosing with 2 Proglide closure devices both sides (ABBOTT)

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

    3. Implantation of a bifurcational stentgraft
    - Ovation Stentgraft (TRIVASCULAR / LOMBARD MEDICAL)
    Cannulation of the contralateral limb:
    - 5F Amplatz Left diagnostic catheter (CORDIS / CARDINAL HEALTH)
    - 0.035" soft angled short Radiofocus glidewire (TERUMO)

    4. PTA
    - proximal seal: Reliant-balloon (MEDTRONIC)
    - Graft-bifurcation: 12/40 mm Admiral balloon (MEDTRONIC)
    View image
  • Wednesday, January 27th: - , Room 2 - Main Arena 2

    Case 48 – LEI 16: Abdominal aortic aneurysm – Part 2

    Center:
    Leipzig, Dept of Angiology
    Case 48 – LEI 16: male, 67 years (M-F)
    Operators:
    • Andrej Schmidt,
    • Daniela Branzan,
    • Michael Moche
    CLINICAL DATA
    Progressive abdominal aortic aneurysm, diameter 5.1 cm
    CAD, PTCA 2014
    PAOD
    Renal insufficiency (GFR 52 ml/min)

    RISK FACTORS
    Pulmonary thromboembolism 10/2015
    Arterial hypertension, hyperlipidemia, diabetes mellitus

    PROCEDURAL STEPS
    1. Bifemoral percutaneous approach in local anaesthesia
    - Preclosing with 2 Proglide closure devices both sides (ABBOTT)

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

    3. Implantation of a bifurcational stentgraft
    - Ovation Stentgraft (TRIVASCULAR / LOMBARD MEDICAL)
    Cannulation of the contralateral limb:
    - 5F Amplatz Left diagnostic catheter (CORDIS / CARDINAL HEALTH)
    - 0.035" soft angled short Radiofocus glidewire (TERUMO)

    4. PTA
    - proximal seal: Reliant-balloon (MEDTRONIC)
    - Graft-bifurcation: 12/40 mm Admiral balloon (MEDTRONIC)
    View image
  • Wednesday, January 27th: - , Room 3 - Technical Forum

    Case 57 – LEI 20: Infrarenal aortic stenosis and bilateral iliac occlusions, Leriche-Syndrome

    Center:
    Leipzig, Dept of Angiology
    Case 57 – LEI 20: male, 68 years (K-A)
    Operators:
    • Andrej Schmidt,
    • Holger Staab,
    • Daniela Branzan
    CLINICAL DATA
    Claudication intermittens, walking capacity 50 meters
    Weakness and pain buttock, thigh and calf bilateral
    ABI bilateral 0.67
    CAD, PTCA 2012 and 2013, cardiomyopathy, EF 45%
    Adipositas
    Gastric surgery due to perforation 2001

    RISK FACTORS
    Art. hypertension, hyperlipidemia

    PROCEDURAL STEPS
    1. Transbrachial approach
    - 6F 90 cm Check-Flo performer sheath (COOK)
    - 5F 125 cm diagnostic Judkins Right catheter (CORDIS / CARDINAL HEALTH)
    - SupraCore 300 cm 0.035" guidewire (ABBOTT)

    2. Passage of the occlusions
    - Stiff angled 0,035" guidewire, 260 cm (TERUMO)
    - Together with 5F-125 cm Judkins Right Catheter

    3. Bilateral groin access
    - 7F 10 cm Radiofocus sheath (TERUMO)
    - Snaring of the antegrade guidewire form above into the groin-sheath or
    - Into 6F-Judkins-Right guiding catheter (CORDIS), inserted form below

    4. PTA via the groin access bilateral
    - SupraCore 300 cm 0,035" guidewire (ABBOTT)
    - Admiral balloon 6.0/120 mm bilateral (MEDTRONIC)

    5. Stenting
    - Aorta: Sinus XL Aortic Stent (OPTIMED)
    - Common iliac arteries: 8.0/59 mm LifeStream covered Stentgrafts in Kissing technique (C.R.BARD)
    - External iliac artery bilateral: 8.0/120 mm Absolute Pro Stent bilateral (ABBOTT)
    View image
  • Wednesday, January 27th: - , Room 1 - Main Arena 1

    Case 41 – LEI 14: Diffuse restenosis left SFA

    Center:
    Leipzig, Dept of Angiology
    Case 41 – LEI 14: male, 73 years (P-S)
    Operators:
    • Sven Bräunlich,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication left calf, walking capacity 200-300 meters
    Rutherford class 3, ABI left 0.68
    PTA with plane balloon angioplasty left 7/2015
    (POBA-arm of a DCB randomized controlled trial)
    PTA right SFA 1/2016
    CAD
    Minor stroke without residual symptoms 2012

    RISK FACTORS
    Art. hypertension, former smoker
    Angiography during PTA right SFA: diffuse restenosis left SFA

    PROCEDURAL STEPS
    1. Right groin retrograde and cross-over approach
    - IMA 5F diagnostic catheter (CORDIS / CARDINAL HEALTH)
    - 0.035" soft angled Radiofocus guidewire, 190 cm (TERUMO)
    - 0.035" SupraCore Guidewire 190 cm (ABBOTT)
    - 6F-40 cm Balkin Up&Over Sheath (COOK)

    2. Guidewire-passage and preparation of the lesion
    - 0.018" SteelCore Guidewire, 300 cm (ABBOTT)
    - FLEX Plaque Modification Catheter (VENTURE MED GROUP)

    3. PTA and stenting on indication
    - Luminor DCB 5.0/120 mm (iVASCULAR)
    - VascuFlex Multi-LOC (B.BRAUN)
    View image
  • Wednesday, January 27th: - , Room 2 - Main Arena 2

    Case 49b – LEI 17: Amplatzer Plug implantation for an Endoleak via subclavian artery

    Center:
    Leipzig, Dept of Angiology
    Case 49b – LEI 17: female 73 years (M-K)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Type II Endoleak after thoracoabdominal Stentgraft via left subclavian artery
    Surgical repair of an aneurysm of the ascending aorta 2015
    Bypass surgery from right to left common carotid and from left common carotid to left subclavian artery to prepare a landing-zone for a thoracoabdominal stentgraft
    No proximal bending / clipping to occlude the left subclavian artery

    RISK FACTORS
    Art. Hypertension

    ANGIOGRAPHY LEFT
    Via left brachial artery: large endoleak into the descending thoracic aorta

    PROCEDURAL STEPS
    1. Left brachial approach
    - 6F 55 cm sheath (COOK)

    2. Implantation of an Amplatzer Plug 16 mm (ST JUDE MEDICAL) into the proximal left subclavian artery
    View image
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 62 – LEI 22

    Center:
    Leipzig, Dept of Angiology
    Case 62 – LEI 22
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    New patient! Information will follow in due time. Thank you for your understanding.
  • Thursday, January 28th: - , Room 2 - Main Arena 2

    Case 77 – LEI 26: EVAR with a NELLIX endovascular aneurysm sealing system – Part 1

    Center:
    Leipzig, Dept of Angiology
    Case 77 – LEI 26: male, 74 years, (W-F)
    Operators:
    • Andrej Schmidt,
    • Daniela Branzan,
    • Andrew Winterbottom,
    • Michael Moche
    CLINICAL DATA
    Progressive abdominal aortic aneurysm, max. diameter 55mm
    CAD, PTCA 2012
    Art. hypertension
    Pulmonary embolism, mild dyspnoe 11/2015

    DUPLEX
    Duplex-sonographic surveillance for a few years
    Progression from < 5.0 cm to 5.5 cm within a year

    PROCEDURAL STEPS
    1. Percutaneous approach with local anaesthesia both groins
    - Preloading of 2 Proglide-Systems per groin (ABBOTT)
    - 0.035" LunderQuist 200 cm guidwires via both groins (COOK)
    - Calibration angiography to estimate the graft-length

    2. Bilateral insertion of the Nellix-systems (ENDOLOGIX)
    - Implantation of the 10 mm-diameter stentgrafts with integrated balloons
    - Pre-filling of Nellix Endobags with pressure-monitoring (ENDOLOGIX)
    - After aspiration of the pre-fill injection of the Polymer-filling
    - Postdilatation with integrated 10 mm balloons

    3. Groin-closure after final angiography
    View image
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 65 – LEI 23

    Center:
    Leipzig, Dept of Angiology
    Case 65 – LEI 23
    Operators:
    • Sven Bräunlich,
    • Matthias Ulrich
    New patient! Information will follow in due time. Thank you for your understanding.
  • Thursday, January 28th: - , Room 2 - Main Arena 2

    Case 77 – LEI 26: EVAR with a NELLIX endovascular aneurysm sealing system – Part 2

    Center:
    Leipzig, Dept of Angiology
    Case 77 – LEI 26: male, 74 years, (W-F)
    Operators:
    • Andrej Schmidt,
    • Daniela Branzan,
    • Andrew Winterbottom,
    • Michael Moche
    CLINICAL DATA
    Progressive abdominal aortic aneurysm, max. diameter 55mm
    CAD, PTCA 2012
    Art. hypertension
    Pulmonary embolism, mild dyspnoe 11/2015

    DUPLEX
    Duplex-sonographic surveillance for a few years
    Progression from < 5.0 cm to 5.5 cm within a year

    PROCEDURAL STEPS
    1. Percutaneous approach with local anaesthesia both groins
    - Preloading of 2 Proglide-Systems per groin (ABBOTT)
    - 0.035" LunderQuist 200 cm guidwires via both groins (COOK)
    - Calibration angiography to estimate the graft-length

    2. Bilateral insertion of the Nellix-systems (ENDOLOGIX)
    - Implantation of the 10 mm-diameter stentgrafts with integrated balloons
    - Pre-filling of Nellix Endobags with pressure-monitoring (ENDOLOGIX)
    - After aspiration of the pre-fill injection of the Polymer-filling
    - Postdilatation with integrated 10 mm balloons

    3. Groin-closure after final angiography
    View image
  • Thursday, January 28th: - , Room 2 - Main Arena 2

    Case 78 – LEI 27

    Center:
    Leipzig, Dept of Angiology
    Case 78 – LEI 27
    Operators:
    • Andrej Schmidt,
    • Daniela Branzan,
    • Holger Staab,
    • Fabio Verzini
    New patient! Information will follow in due time. Thank you for your understanding.
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 68 – LEI 24: Retrograde approach using a 2.9F pedal sheath in CLI

    Center:
    Leipzig, Dept of Angiology
    Case 68 – LEI 24: male 76 years (H-H)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Critical limb ischemia with forefoot gangrene left
    Rutherford class 5, ABI > 1.3
    Failed recanalization attempt 01/2016 of an occluded anterior tibal artery

    RISK FACTORS
    Diabetes mellitus type 2, art. Hypertension

    ANGIOGRAPHY
    During recanalization attempt:
    Left: SFA, Apop and peroneal artery patent, posterior and anterior tibial artery occluded
    Guidewire-perforation in the mid segment of the anterio tibial artery

    PROCEDURAL STEPS
    1. Antegrade left access
    - 5F-55 cm sheath (COOK)

    2. Retrograde approach via the dorsalis pedis artery
    - Pedal puncture kit (COOK)
    - 21 Gauge 4 cm needle (COOK)
    - 2.9F ID pedal sheath (COOK)

    3. Retrograde passage of the ATA-occlusion left
    - 0.018" straight CXI support-catheter, 90 cm (COOK)
    - 0.014" Hydro-ST guidewire, 300 cm (COOK)
    - 0.014" CTO-Approach 25 gramm 300 cm guidewire (COOK)

    4. PTA from retrograde
    - Advance Micro balloon 2.5/120 mm (COOK)
    View image
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 71 – LEI 25: Popliteal occusion right, previous unsuccessful recanalization attempt

    Center:
    Leipzig, Dept of Angiology
    Case 71 – LEI 25: male, 76 years (W-K)
    Operators:
    • Andrej Schmidt,
    • Sven Bräunlich
    CLINICAL DATA
    Restpain and severe claudication right foot and calf
    11/2015 unsuccessful recanalization attempt elsewhere with
    inability to redirect the guidewire into the true lumen distally

    ABI
    Right 0.47

    RISK FACTORS
    Art. hypertension, former smoker, hyperlipidaemia

    PROCEDURAL STEPS
    1. Right antegrade approach
    - 6F-55 cm Check-Flo Performer sheath (COOK)

    2. Second attempt to pass the occlusion from antegrade
    - 0.018" Connect 250 T guidewire, 300 cm (ABBOTT)
    - Pacific balloon 3.0/80 mm (MEDTRONIC)

    3. In case of failure retrograde approach via the peroneal artery
    - 21 gauge 7 cm puncture needle (COOK)
    - 0.018" V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
    - 0.018" TrailBlazer support-catheter, 90 cm (MEDTRONIC / COVIDIEN)
    - Snaring of the guidewire from antegrade after passage of the CTO

    4. Vessel preparation and PTA from antegrade
    - FLEX Plaque-Modification catheter (VENTUREMEDGROUP)
    - Lutonix DCB (C.R.BARD)

    5. Stenting on indication
    - Multi-LOC Multiple-Stent-Delivery-System (B.BRAUN) or
    - Supera Interwoven Nitinol-Stent (ABBOTT)
    View image
  • Thursday, January 28th: - , Room 2 - Main Arena 2

    Case 81 – LEI 28: Fenestrated EVAR for a juxtarenal aortic aneurysm

    Center:
    Leipzig, Dept of Angiology
    Case 81 – LEI 28: male
    Operators:
    • Andrej Schmidt,
    • Daniela Branzan,
    • Holger Staab
    CLINICAL DATA
    Progressive juxtarenal aneurysm
    Incidental finding during an episode of abdominal pain
    CAD, PTCA 20120

    RISK FACTORS
    Art. hypertension, former smoker

    PROCEDURAL STEPS
    1. General anaesthesia
    Percutaneous approach via both groins and left axillary artery

    - Preloading of 2 Proglide-systems per groin and left axillary artery (ABBOTT)
    - 12F-45 cm Sheath via left brachial artery (COOK)
    - 0.035" Lunderquist 300 cm (COOK) pullthrough left groin to axillary artery using a
    - Snare-kit 10 mm (COVIDIEN / MEDTRONIC)

    2. Precannulation of the visceral arteries before stentgraft implantation
    - 16F-30 cm sheath via right groin (COOK)
    - SOS Omni-Selective 5F-catheter (ANGIODYNAMICS)
    - Stabilization with guidewires: Galeo Pro (BIOTRONIK)

    3. Stentgraft implantation
    - Implantation of the 4-vessl branched CMD-stentgraft (JOTEC) via left groin
    - Removal of the stentgraft delivery system and partiall closure left groin

    4. Cannulation of the visveral arteries
    - Puncture of the valve of the 12F-45 cm sheath axillary artery and insertion of a 7F-55 cm sheath (COOK)
    - Judkins Right Diagnostic Catheter (CORDIS)
    - 0.018" V-18-Control Guidewire 300 cm (BOSTON SCIENTIFIC)

    5. Implantation of covered stents to the visceral arteries
    - E-ventus BX stentgrafts (JOTEC)
  • Friday, January 29th: - , Room 3 - Technical Forum

    Case 89 – LEI 30: Complex SFA-occlusion right

    Center:
    Leipzig, Dept of Angiology
    Case 89 – LEI 30: male, 54 years (G-M)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication bilateral, right > left, restpain right foot, Rutherford 4
    walking capacity 60 meters
    ABI right 0.55
    PTA of iliac stenosis bilateral 11/2015
    Persistent symptoms

    CLINICAL DATA
    Art. hypertension, current smoker

    PROCEDURAL STEPS
    1. Left groin retrograde and cross-over approach
    - 7F 55 cm Check-Flow-Performer sheath (COOK)

    2. Atherectomy of the profunda femoris stenosis right
    - HawkOne directional atherectomy system, 9 cm tip (MEDTRONIC)

    3. Passage of the SFA-occlusion and filter placement
    - 0.018" Connect guidewire 300 cm (ABBOTT)
    - 0,018" QuickCross Support-Catheter, 135 cm (SPECTRANETICS)
    - 4F 90 cm sheath (COOK)
    - Wirion-Protection system (ALLIUM-MEDICAL)

    4. Atherectomy of the superficial femoral artery
    - HawkOne directional atherectomy system, 9 cm tip (MEDTRONIC)

    5. PTA with drug-coated balloons
    - Ranger DCB 5.0/120 mm (BOSTON SCIENTIFIC)
    View image
  • Friday, January 29th: - , Room 3 - Technical Forum

    Case 90 – LEI 31: High grade stenosis brachiocphalic trunk

    Center:
    Leipzig, Dept of Angiology
    Case 90 – LEI 31: male, 62 years (R-K)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Minor stroke right hemispheric 2011, no residual symptoms
    Intermittent vertigo
    Intermittent atrial fibrillation
    CAD, MI 2012
    COPD

    RISK FACTORS
    Art. hypertension, former smoker, diabetes mellitus type 2

    DUPLEX
    Retrograde flow right vertebral artery

    MR-ANGIOGRAPHY
    High grade stenosis origin of the brachiocephalic trunk

    PROCEDURAL STEPS

    1. Right groin access
    - 5F-Judkins Right diagnostic catheter (CORDIS / CARDINAL HEALTH)
    - 0.035" SupraCore guidewire 300 cm (ABBOTT)
    - 7F 90 cm Check-Flo Performer sheath (COOK)
    - Guidewire-position into the subclavian artery

    2. Potentially cerebral protection with a filter via a right brachial access
    - 6F 25 cm Radiofocus sheath (TERUMO)
    - 6F IMA guiding catheter (MEDTRONIC)
    - Filterwire EZ (BOSTON SCIENTIFIC) from brachial to the internal carotid artery

    3. Predilatation and stenting
    - 5.0/40 mm Admiral balloon, 135 cm (MEDTRONIC)
    - BeGraft 10/27 mm Covered Stent (BENTLEY INNOMED)
    View image
  • Friday, January 29th: - , Room 1 - Main Arena 1

    Case 92 – LEI 33

    Center:
    Leipzig, Dept of Angiology
    Case 92 – LEI 33: male, 55 years
    New case! Information will follow in due time. Thank you for your understanding.
  • Friday, January 29th: - , Room 1 - Main Arena 1

    Case 93 – LEI 34

    Center:
    Leipzig, Dept of Angiology
    Case 93 – LEI 34: female, 60 years
    New case! Information will follow in due time. Thank you for your understanding.

Dendermonde

5 livecase(s)
  • Tuesday, January 26th: - , Room 1 - Main Arena 1

    Case 04 – DEN 01: TASC D SFA CTO left

    Center:
    Dendermonde
    Case 04 – DEN 01: male, 83 years (F-P)
    Operators:
    • Koen Deloose,
    • Lieven Maene
    CLINICAL DATA
    2007 CAS Right
    Since 3 months bilateral claudication left > right after <100 m (Rutherford 3)
    Good CFA pulses
    No popliteal/distal pulses

    RISK FACTORS
    Diabetes mellitus type 2, arterial hypertension
    Hypercholesterolemia

    ANGIOGRAPHY
    MR Angio lower limbs

    PROCEDURAL STEPS
    1. Right CFA access - crossover
    - 0.035", 260 cm Glide wire (TERUMO)
    - RIM catheter (COOK MEDICAL)
    - Destination 6F, 45 cm (TERUMO)

    2. Recanalization
    - 0.018", 260 cm Advantage (TERUMO)
    - CXI catheter 0.018", 150 cm (COOK MEDICAL)

    3. Predilatation
    - Advance 18 LP, 5 mm (COOK MEDICAL)

    4. Stenting
    - ZILVER PTX (6 mm – 120 mm) (COOK MEDICAL)

    5. Post-dilatation
    - Advance 35 LP 6 mm (COOK MEDICAL)

    6. Assistance GE Healthcare
    - Vessel assist – "Center Line Tracking"

    7. Plan B
    - Distal puncture + retrograde/bidirectional recanalization
    View image
  • Tuesday, January 26th: - , Room 3 - Technical Forum

    Case 26 – DEN 02

    Center:
    Dendermonde
    Case 26 – DEN 02
    New patient! Information will follow in due time. Thank you for your understanding.
  • Tuesday, January 26th: - , Room 3 - Technical Forum

    Case 28 – DEN 03: TASC C SFA lesion right

    Center:
    Dendermonde
    Case 28 – DEN 03: male, 83 years ( F-P)
    Operators:
    • Koen Deloose,
    • Lieven Maene
    CLINICAL DATA
    History: 2007 CAS Right
    Since 3 months bilateral claudication left > right after <100 m (Rutherford 3)
    Good CFA pulses
    No popliteal/distal pulses

    RISK FACTORS
    Diabetes mellitus type 2, arterial hypertension, hypercholesterolemia
    MR Angio lower limbs

    PROCEDURAL STEPS
    1. Left CFA access
    - Glidewire 0.035" (TERUMO)
    - RIM Catheter (COOK MEDICAL)
    - Fortress 6F, 45 cm (BIOTRONIK)

    2. Recanalisation
    - Advantage 0.018", 260 cm (COOK MEDICAL)
    - CXI Catheter 0.018", 150 cm (COOK MEDICAL)

    3. Predilatation
    - Passeo 18 Lux 6 mm (BIOTRONIK)

    4. Stenting
    - Pulsar 18 6 mm (BIOTRONIK)

    5. Postdilatation
    - Passeo 18 6 mm (BIOTRONIK)

    6. GE Healthcare
    - Vessel Assist - Center Line Tracking
    View image
  • Wednesday, January 27th: - , Room 5 - Global Expert Exchange

    Case 59 – DEN 05: Left calcified popliteal CTO

    Center:
    Dendermonde
    Case 59 – DEN 05: female, 83 years (S-L)
    Operators:
    • Koen Deloose,
    • Joren Callaert
    CLINICAL DATA
    History: 2008 CAS right, 2010 PTAS popliteal right, 2010 CEA left, 2011
    PTCA + CABG, 2015 PTRA bilateral
    Present State: non-healing ulcer left leg since 1 month

    RISK FACTORS
    Insuline dependent diabetes mellitus
    Arterial hypertension, hypercholesterolemia
    MR Angio lower limbs

    PROCEDURAL STEPS
    1. Right CFA access - crossover
    - 0.035", 260 cm glidewire (TERUMO)
    - RIM catheter (COOK)
    - Destination 6F, 45 cm (TERUMO)

    2. Recanalization
    - 0.018", 260 cm Advantage (TERUMO)
    - CXI catheter 0.018", 150 cm (COOK)

    3. Predilatation
    - Armada 0.018", 5 or 6 mm (ABBOTT VASCULAR)
    - Angiosculpt 5 or 6 mm (SPECTRANETICS)

    4. Stenting
    - Supera VMI (5 or 6 mm) (ABBOTT VASCULAR)

    5. Postdilatation
    - Armada 0.018", 5 or 6 mm (ABBOTT VASCULAR)

    6. Assistance GE Healthcare
    - Vessel assist - "Center Line Tracking"

    7. Plan B
    - Distal puncture + retrograde / bidirectional recanalization
  • Wednesday, January 27th: - , Room 1 - Main Arena 1

    Case 36 – DEN 04: In-stent reocclusion right SFA

    Center:
    Dendermonde
    Case 36 – DEN 04: male, 61 years (B-F)
    Operators:
    • Koen Deloose,
    • Joren Callaert
    CLINICAL DATA
    History: 2001 PTAS bilateral SFA, 2011 PTA ATI left, 2011 PTA ISR
    Stenosis right SFA, 2014 DCB right SFA ISR + poplitea
    Present state: Recurrent claudication < 100m (Rutherford 3)
    CT Angio Lower Limb

    RISK FACTORS
    Diabetes mellitus, hypercholesterolemia, smoking

    PROCEDURAL STEPS
    1. Left CFA Access
    - 0.035" Glide wire (TERUMO)
    - RIM Catheter (COOK MEDICAL)
    - Destination 6F, 45 cm (TERUMO)

    2. Recanalization
    - 0.018", 260 cm Advantage (TERUMO)
    - CXI Catheter 0.018", 150 cm (COOK MEDICAL)

    3. Predilatation
    - Armada 0.018", 5 or 6 mm (ABBOTT VASCULAR)

    4. Stenting
    - Viabahn 5 or 6 mm, 250 mm (GORE)

    5. Postdilatation
    - Armada 0.018", 5 or 6 mm (ABBOTT)

    6. Plan B
    Direct Stent Puncture right SFA + Retrograde / Bidirectional Recanalization

Cotignola

5 livecase(s)
  • Tuesday, January 26th: - , Room 3 - Technical Forum

    Case 23 – COT 04: Asymptomatic rapid progression of right ICA stenosis

    Center:
    Cotignola
    Case 23 – COT 04: male 78 years (M-T)
    Operators:
    • Antonio Micari,
    • Fausto Castriota
    CLINICAL DATA
    Asymptomatic for cerebrovascular events. Recent successful PTA to left ICA
    (December 2015), angiography showed rapid progression of right ICA disease.

    RISK FACTORS
    Diabetes, smoking, hypertension
    Severe asymptomatic right ICA stenosis

    ANGIOGRAPHY
    80% right ICA stenosis (progressed from 50% one year ago)

    PROCEDURAL STEPS
    1. Right femoral approach

    2. MOMA positioning for proximal cerebral protection (MEDTRONIC)

    3. Wire crossing during endovascular clamping

    4. Direct stenting with an Xact-Stent (ABBOTT)

    5. Postdilation with Maverick XI Balloon (BOSTON SCIENTIFIC)

    6. Debris (if any) aspiration and declamping
    View image
  • Tuesday, January 26th: - , Room 1 - Main Arena 1

    Case 05 – COT 01: Left SFA long occlusion

    Center:
    Cotignola
    Case 05 – COT 01: female, 56 years (L-P)
    Operators:
    • Antonio Micari,
    • Fausto Castriota
    CLINICAL DATA
    Severe bilateral claudication
    Previous right SFA and popliteal artery PTA with DEB (December 2015)

    RISK FACTORS
    Smoking, hypertension
    Previous CABG (LIMA to LAD) in 2000
    Severe left leg claudication

    ANGIO
    Left SFA long occlusion

    PROCEDURAL STEPS
    1. Contralateral (right) femoral access and placement of a cross-over sheath
    - 6F 45 cm Destination sheath (TERUMO)

    2. Crossing the occlusion
    - 0.035'' Glidewire (TERUMO)

    3. Lesion predilatation
    - 4.0/120 mm Pacific balloon (MEDTRONIC)

    4. Dilatation
    - 5.0/120 mm Admiral Inpact balloon (MEDTRONIC)

    5. Spot stenting if needed
    View image
  • Tuesday, January 26th: - , Room 2 - Main Arena 2

    Case 18 – COT 02

    Center:
    Cotignola
    Case 18 – COT 02
    Operators:
    • Fausto Castriota,
    • Antonio Micari
    New patient! Information will follow in due time. Thank you for your understanding.
  • Tuesday, January 26th: - , Room 2 - Main Arena 2

    Case 19 – COT 03

    Center:
    Cotignola
    Case 19 – COT 03
    Operators:
    • Fausto Castriota,
    • Antonio Micari
    New patient! Information will follow in due time. Thank you for your understanding.
  • Tuesday, January 26th: - , Room 3 - Technical Forum

    Case 29 – COT 05

    Center:
    Cotignola
    Case 29 – COT 05
    Operators:
    • Fausto Castriota,
    • Antonio Micari
    New patient! Information will follow in due time. Thank you for your understanding.

New York

2 livecase(s)
  • Tuesday, January 26th: - , Room 3 - Technical Forum

    Case 25 – NYC 02: In-stent occlusion with stent fractures RSFA

    Center:
    New York
    Case 25 – NYC 02: female, 65 years, (D-J)
    Operators:
    • Prakash Krishnan,
    • Karthik Gujja,
    • Vishal Kapur
    CLINICAL DATA
    Subacute onset R leg pain 2 to 3 months, Rutherford Class II, Category III
    US Duplex showed instent occlusion of RSFA
    Failed R Fem pop bypass, multiple PTA and stenting of RSFA
    at outside hospital, failed revascularization of RSFA due to stent fracture

    RISK FACTORS
    Hypertension, dyslipidemia, coronary artery disease,
    polycythemia vera (ongoing work up)

    PROCEDURAL STEPS
    1. Left Common femoral access and up and over
    - 7F Pinnacle destination sheath 45 cm, up and over (TERUMO)
    - If necessary, R pedal posterior tibial retrograde access (4F COOK sheath) and direct stent access

    2. Intra-luminal approach
    - 0.014" 4 Fr Viance catheter, 150 cm (MEDTRONIC)
    - 0.038" Vertip catheter, 125 cm (CORDIS / CARDINAL HEALTH)
    - 0.014" Confianza wire, 300 cm (ABBOTT VASCULAR)

    3. Thrombectomy
    - Angiojet Rheolytic aspiration thrombectomy (BOSTON SCIENTIFIC) or
    - PENUMBRA aspiration thrombectomy (PENUMBRA)

    4. Filter placement
    - exchanged with 0.014/Bare wire, 315 cm (ABBOTT VASCULAR)
    - Emboshield filter 4/7 mm embolic protection system (ABBOTT VASCULAR)

    5. PTA and Stenting as indicated
    - INPACT drug coated balloons 6.0/120 mm (MEDTRONIC)
    - Supera stenting 5.5/100 mm (ABBOTT VASCULAR)
    View image
  • Tuesday, January 26th: - , Room 1 - Main Arena 1

    Case 08 – NYC 01: Severely calcified severe stenosis of LSFA

    Center:
    New York
    Case 08 – NYC 01: female, 83 years, (P-M)
    Operators:
    • Prakash Krishnan,
    • Karthik Gujja,
    • Vishal Kapur
    CLINICAL DATA
    PAD, Rutherford Class II, category III, claudication of L calf at 1 to 2 blocks,
    ABI R LE - 0.5 and L LE - 0.6
    Jet stream athrectomy, PTA and stenting of RSFA in 09/2015

    RISK FACTORS
    Hypertension, diabetes mellitus type II,
    dyslipidemia, moderate aortic regurgitation

    PROCEDURAL STEPS
    1. Right common femoral access and cross over approach
    - 7F Pinnacle destination sheath 45 cm up and over sheath (TERUMO)

    2. Guidewire passage
    - 0.014" Spartacore wire, 300 cm (ABBOTT VASCULAR)
    - 0.038" Vertebral 135" Tempa Aqua catheter, 125 cm (CORDIS)

    3. Filter placement
    - exchanged with 0.014" Bare wire, 315 cm (ABBOTT VASCULAR)
    - Emboshield filter 4/7 mm embolic protection system (ABBOTT VASCULAR)

    4. Athrectomy and thrombectomy, if embolization occurs
    - Jet stream Pathway rotational athrectomy 2.4/3.4 (BOSTON SCIENTIFIC)
    - PENUMBRA aspiration thrombectomy (PENUMBRA)

    5. PTA and stenting on indication
    - IN-PACT drug coated balloons 6.0/120 mm (MEDTRONIC)
    - SUPERA stenting 5.5/150 mm (ABBOTT VASCULAR)
    View image

Berne

7 livecase(s)
  • Tuesday, January 26th: - , Room 2 - Main Arena 2

    Case 10 – BER 01: Iliofemoral venous intervention

    Center:
    Berne
    Case 10 – BER 01: male, 52 years (T-H)
    Operators:
    • Nils Kucher,
    • Torsten Fuß
    CLINICAL DATA
    Iliac vein thrombosis left side in 2013 treated with anticoagulation
    Iliac vein thrombosis left side 06/2015
    Mechanical compression of the left iliac vein (ostheosynthesis L4/5)

    PRESENT STATE
    Venous claudication (painfree walking distance 500 m)
    Swelling (2 cm plus in thigh circumference) despite compression therapy
    No skin changes
    No varicose veins

    DUPLEX
    Postthrombotic changes in iliac and femoral veins

    CT
    Mechanical compression of the left iliac vein through ostheosynthetic material

    PROCEDURAL STEPS
    1. Venous access with ultrasound guidance in left popliteal
    - 10F sheath

    2. Wire crossage
    - Terumo 0.035 stiff angled

    3. Phlebography, IVUS

    4. Predilatation
    - Atlas Balloon 14 mm (BARD)

    5. Implantation of dedicated Iliac vein stents
    - Sinus-Obliquus 14–16 mm (OPTIMED),
    - Sinus-XL Flex 14–16 mm (OPTIMED), or
    - Vici 14–16 mm (VENITI)

    6. High-pressure postdilation of stents
    - Atlas Balloon 14 mm (BARD)
    View image
  • Tuesday, January 26th: - , Room 2 - Main Arena 2

    Case 14 – BER 02: Iliofemoral venous intervention – Part 1

    Center:
    Berne
    Case 14 – BER 02: male, 48 years (J-Z)
    Operators:
    • Nils Kucher,
    • Torsten Fuß
    MEDICAL HISTORY
    Ilio-femoro-popliteal thrombosis 1986 after severe car accident with polytrauma
    Permanent neurocognitive deficits
    Ongoing anticoagulation therapy

    RISK FACTORS
    Chronic venous insufficiency left leg with: venous claudication, varicose veins,
    hyperpigmentation, leg swelling
    Villalta-Score: 6 points

    CT
    May Thurner compression of the left common iliac vein

    PROCEDURAL STEPS
    1. Venous access with ultrasound guidance in left popliteal (10F sheath)

    2. Wire crossage
    - TERUMO 0.035 stiff angled

    3. Phlebography, IVUS

    4. Predilation
    - Atlas Balloon 14 mm (BARD)

    5. Implantation of dedicated Iliac vein stents
    - Sinus-Obliquus 14–16 mm (OPTIMED),
    - Sinus-XL Flex 14–16 mm (OPTIMED), or
    - Vici 14–16 mm (VENITI)

    6. High-pressure postdilation of stents
    - Atlas Balloon 14 mm (BARD)
    View image
  • Tuesday, January 26th: - , Room 2 - Main Arena 2

    Case 14 – BER 02: Iliofemoral venous intervention – Part 2

    Center:
    Berne
    Case 14 – BER 02: male, 48 years (J-Z)
    Operators:
    • Nils Kucher,
    • Torsten Fuß
    MEDICAL HISTORY
    Ilio-femoro-popliteal thrombosis 1986 after severe car accident with polytrauma
    Permanent neurocognitive deficits
    Ongoing anticoagulation therapy

    RISK FACTORS
    Chronic venous insufficiency left leg with: venous claudication, varicose veins,
    hyperpigmentation, leg swelling
    Villalta-Score: 6 points

    CT
    May Thurner compression of the left common iliac vein

    PROCEDURAL STEPS
    1. Venous access with ultrasound guidance in left popliteal (10F sheath)

    2. Wire crossage
    - TERUMO 0.035 stiff angled

    3. Phlebography, IVUS

    4. Predilation
    - Atlas Balloon 14 mm (BARD)

    5. Implantation of dedicated Iliac vein stents
    - Sinus-Obliquus 14–16 mm (OPTIMED),
    - Sinus-XL Flex 14–16 mm (OPTIMED), or
    - Vici 14–16 mm (VENITI)

    6. High-pressure postdilation of stents
    - Atlas Balloon 14 mm (BARD)
    View image
  • Tuesday, January 26th: - , Room 2 - Main Arena 2

    Case 16 – BER 03: Iliofemoral venous intervention

    Center:
    Berne
    Case 16 – BER 03: female, 38 years (A-M)
    Operators:
    • Nils Kucher,
    • Torsten Fuß
    CLINICAL DATA
    Past medical history: No personal or familiy history of DVT
    Previously healthy
    Chronic venous insufficiency left leg with:
    Venous claudication (walking distance 600 m)
    Leg swelling (thigh 7 cm plus)
    No varicose veins or skin changes

    DUPLEX/CT
    Stenosis of the external iliac vein left side

    PROCEDURAL STEPS
    1. Venous access with ultrasound guidance in left popliteal (10F sheath)

    2. Wire crossage
    - TERUMO 0.035 stiff angled

    3. Phlebography, IVUS

    4. Predilation
    - Atlas Balloon 14 mm (BARD)

    5. Implantation of dedicated iliac vein stents
    - Sinus-XL Flex 14 mm (OPTIMED), or
    - Vici 14 mm (VENITI)

    6. High-pressure postdilation of stents
    - Atlas Balloon 14 mm (BARD)
    View image
  • Tuesday, January 26th: - , Room 2 - Main Arena 2

    Case 20 – BER 04: Pelvic congestion syndrome

    Center:
    Berne
    Case 20 – BER 04: female, 52 years (M-B)
    Operators:
    • Nils Kucher,
    • Torsten Fuß
    MEDICAL HISTORY
    Appendectomy and removal of ovarian cyst 1996
    Laparoscopic adhesiolysis and tubal sterilisation 2005
    Last menstrual cycle 03/2015
    Recent gynecologic exam unremarkable

    PRESENT STATE
    Left sided abdominal dull pain, lower quadrant since 6 months
    The pain is worse during defecation
    No pain during or after sexual intercourse or during voiding
    Pain dependence on position (no pain during bed rest, worse while standing and sitting)

    CT
    Prominent left-sided ovarian vein, varicose, parauterine veins

    VENOGRAPHY
    Refluxing left-sided ovarian vein, no reflux in hypogastric and right ovarian vein

    PROCEDURAL STEPS
    1. Venous access in right femoral vein (5F sheath)
    2. Cobra 4F diagnostic catheter
    3. Selective venography of distal left ovarian vein
    4. Foam sclerotherapy of varicose uterine veins
    5. Coil embolization of ovarian veins (0.018, 8-12 mm)
    View image
  • Wednesday, January 27th: - , Room 1 - Main Arena 1

    Case 34 – BER 05: Complex intervention of IVC and iliac veins

    Center:
    Berne
    Case 34 – BER 05: male, 34 years (R-V)
    Operators:
    • Nils Kucher,
    • Torsten Fuß
    CLINICAL DATA
    Past medical history:
    Thrombosis of IVC and bilateral Iliac veins 08/2013 treated with anticoagulation
    Varicocele, hemorrhoids
    Thrombophilia testing negative
    Failed endovascular recanalisation attempts in 2015 in two tertiary care hospital

    PRESENT STATE
    Bilateral venous claudication
    Lumbar pain, bilateral swelling despite compression therapy, varicose veins
    Currently no anticoagulation therapy
    CT: postthrombotic IVC, large hemiazygos vein,
    Failed endovascular treatment

    PROCEDURAL STEPS
    1. Bilateral common femoral vein access, right jugular vein access with ultrasound guidance (10F sheath)

    2. Wire crossage
    - TERUMO 0.035 stiff angled

    3. Phlebography, IVUS

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

    5. Implantation of dedicated Iliac vein stents
    over TERUMO stiff angled wire 0.035":
    - IVC stents: Sinus XL 22 mm (OPTIMED),
    - Kissing Iliac vein stents: Sinus-XL Flex 14–16 mm (OPTIMED)

    6. High-pressure post-dilation of stents
    - Atlas balloon 14–18 mm (BARD)
    View image
  • Wednesday, January 27th: - , Room 2 - Main Arena 2

    Case 46 – BER 06: Percutaneous EVAR of infrarenal AAA under local anaesthesia

    Center:
    Berne
    Case 46 – BER 06: male, 79 years (F-L)
    Operators:
    • Dai-Do Do,
    • V. Makaloski
    CLINICAL DATA
    Asymptomatic infrarenal AAA with progressively increasing diameter
    Femorotibial bypass on the right side 2006
    Lower extremity chronic venous disorders CEAP C4 on both sides
    PTCA 2006

    RISK FACTORS
    Type 2 diabetes, arterial hypertension, hyperlipidemia,
    65-pack-year cigarette smoking history

    PROCEDURAL STEPS
    1. Percutaneous femoral access in both groins
    - Local anaesthesia, retrograde puncture of the CFA on both sides
    - 0.035" Radiofocus M stiff guidewire, 180 cm (TERUMO)
    - Preclosure of the access sites using ProGlide devices (ABBOTT)

    2. Implantation of the INCRAFT®AAA Stent Graft System (CORDIS, CARDINAL HEALTH)
    - the delivery system (14-F OD) with the main body inside up to the lower accessory right renal artery, deployment of the main body
    - Implantation of the contralateral and then the ipsilateral iliac stentgraft (12-F OD)

    3. Sealing ot the percutaneous access sites in both groins
    - ballon dilatation of the main body and the iliac limbs: Reliant balloon (MEDTRONIC)
    - control angiogram, then withdrawing the delivery system respectively the 12F sheath
    - advancing and tying the knots using the knot pusher of the ProGlide system
    View image

Galway

4 livecase(s)
  • Tuesday, January 26th: - , Room 2 - Main Arena 2

    Case 11 – GAL 01: Chronic left iliac reconstruction

    Center:
    Galway
    Case 11 – GAL 01: female, 41 years (N-W)
    Operators:
    • Ian Davidson,
    • Gerard O'Sullivan
    PRESENT STATE
    First DVT in 2009 – just post partum – see CT
    Waited 9 months, attempted endovascular reconstruction – failed.
    Has had 2 more children.
    Symptoms: weight gain, 50 m claudication up hill, heavy dead tired leg.

    RISK FACTORS
    Underlying May Thurner

    PROCEDURAL STEPS
    1. Prep
    - R IJV; left groin and thigh; right groin

    2. UltraSound (SIEMENS) guided access to left profunda and RIJV (COOK Micropuncture set)
    - 10F sheath (COOK) to neck; 5F sheath BRITE TIP (CORDIS) left PFV
    - 5000u IV Heparin
    - Triforce (COOK MEDICAL) to gain access to and attempt to cross left iliac venous occlusion

    3. Wires
    - Hydrophilic 0.035" wire (MERIT MEDICAL)/stiff
    hydrophilic 0.035" wire (MERIT MEDICAL)/
    Roadrunner 0.035" wire (COOK MEDICAL)
    - Asahi Astante 0.014" 30g tip CTO wire with back up 2.5 mm balloon
    - Possibly snare (AndraSnare, ANDRAMED) if needed/
    Lunderquist 0.035" wire 260 cm (COOK MEDICAL) once across

    4. Balloon predilatation
    - BARD Atlas 16/14 mm
    to minimum 16 atm x 30s each zone

    5. Stenting
    - BARD Venovo 16/14/12 from low IVC down
    to either low CFV or else into PFV

    6. Postdilatation
    - BARD Atlas again to same pressures and diameters
    - IVUS (VOLCANO / PHILIPS) to confirm stent apposition and identify any intra-luminal debris
    - Cone Beam CTV (SIEMENS) to confirm stent apposition

    7. Aftercare
    - Thigh high class 2 compression stockings (JOBST)
    - Pneumatic compression boots (COVIDIEN / MEDTRONIC) x 24h until US performed
    - Colour doppler US day 1 post op CTV direct at 6/52
    View image
  • Tuesday, January 26th: - , Room 2 - Main Arena 2

    Case 15 – GAL 02 - Part 1

    Center:
    Galway
    Case 15 – GAL 02 - Part 1
    Operators:
    • Ian Davidson,
    • Gerard O'Sullivan
    New patient! Information will follow in due time. Thank you for your understanding.
  • Tuesday, January 26th: - , Room 2 - Main Arena 2

    Case 15 – GAL 02 - Part 2

    Center:
    Galway
    Case 15 – GAL 02 - Part 2
    Operators:
    • Ian Davidson,
    • Gerard O'Sullivan
    New patient! Information will follow in due time. Thank you for your understanding.
  • Tuesday, January 26th: - , Room 2 - Main Arena 2

    Case 17 – GAL 03: Failed varicose vein treatment; pelvic vein source

    Center:
    Galway
    Case 17 – GAL 03: female, 40 years (E-S)
    Operators:
    • Gerard O'Sullivan,
    • Ian Davidson
    CLINICAL DATA
    Three children, haemorrhoids and vulval varicosities
    during pregnancy
    Varicose veins left posterior thigh and calf
    treated by foam and RFA in June 2015
    At clinical follow-up 6 weeks satisfactory
    At 6 months ALL recurred

    IMAGING
    Mildly enlarged L ovarian vein
    Tight left common iliac vein compression on MRV
    CDUS – large varicose veins posterior thigh and
    upper calf - extend close to introitus

    PROCEDURAL STEPS
    1. GA
    - R I JV access
    - Selective catheterisation of L ovarian vein: both internal iliac veins;
    possibly right ovarian V
    - Coils (COOK MEDICAL) +/– EMBA medical "hourglass"
    - Foam (Sclerovein 3% diluted 3:1 with air)

    2. IVUS to examine is iliac vein compression syndrome real

    3. I f IVCS suggests it is real the predilate to 16 mm BARD Atlas

    4. Stenting if IVCS is real
    - COOK Zilver Vena 16 mm/VENITI Vici 16 mm/Wallstent 16 mm
    - OPTIMED Sinus Venous/Obliquus 16 mm

    5. Postdilate to 16 mm

    6. Foam sclerotherapy and RFA to thigh veins

    7. Transvaginal US to confirm ablationof all veins at 6/52
    View image

Berlin

5 livecase(s)
  • Tuesday, January 26th: - , Room 3 - Technical Forum

    Case 22 – BLN 01: Tripple protection in a high-grade left ICA stenosis (double filter and micro-mesh stent)

    Center:
    Berlin
    Case 22 – BLN 01: female, 59 years, (E-P)
    Operators:
    • Ralf Langhoff,
    • Andrea Behne
    RISK FACTORS
    Arterial hypertension (controlled),
    hyperlipidemia (LDL 141mg/dl, Chol. 227mg/dl, HDL 49 mg/dl)

    PROCEDURAL STEPS
    1. Transfemoral retrograde approach
    - 8F short sheath (TERUMO)
    - Diagnostic 5F catheter Weinberg shape (COOK)
    - TERUMO stiff angled 0.035" wire into left ECA

    2. Exchange to
    - Vista Brite Tip IG guiding catheter MPA1 shape into left CCA (CORDIS)

    3. Distal protection
    - Filter Wire EZ (BOSTON SCIENTIFIC) into distal ICA left

    4. Stenting
    - Roadsaver Carotid Micromesh stent (TERUMO) 8 x 25 mm

    5. Carotid postdilatation
    - 5 x 20 mm Paladin balloon with integrated embolic protection (40 micron pore size) (CONTEGO-MEDICAL)

    6. Paladin filter closure and combined filter/balloon-system removal
    - Removal of the distal EPD-Filter Wire EZ
    - Removal of guiding catheter (wire controlled)

    7. Closure of puncture site
    - Angioseal 8F
    Transfer patient ICU
    View image
  • Tuesday, January 26th: - , Room 3 - Technical Forum

    Case 24 – BLN 02

    Center:
    Berlin
    Case 24 – BLN 02
    Operators:
    • Ralf Langhoff,
    • M. Boral
    New patient! Information will follow in due time. Thank you for your understanding.
  • Tuesday, January 26th: - , Room 5 - Global Expert Exchange

    Case 31 – BRL 04: DES in a CLI patient with BTK Revascularisation

    Center:
    Berlin
    Case 31 – BRL 04: male, 74 years, (M-S)
    Operators:
    • Ralf Langhoff,
    • Normund Jabs
    CLINICAL DATA
    Bilateral severe claudication left > right since years,
    recently deterioration of walking distance and lesion
    at the the dorsal side of the 2nd toe

    RISK FACTORS
    Hyperlipidemia, former smoker, controlled hypertension,
    MRA with BTK vessel occlusions
    ABI at rest: 0.5 left, 0.64 right

    ABI at rest
    Left 0.5, right 0.64

    PROCEDURAL STEPS
    1. Antegrade access left CFA
    - 4F Fortress sheath (BIOTRONIK)

    2. Approaching the lesion
    - 0.014" wire approach, Advantage wire (TERUMO)
    - Backup with CXI support catheter (COOK)

    3. PTA and stenting of the occluded tibioperoneal trunc
    - 3.0 x 38 mm Cr8 BTK Stent (ALVIMEDICA)

    4. Recanalisation of the anterior tibial artery
    - Primary PTA 2.5 x 200 mm Coyote balloon (BOSTON SCIENTIFIC)
    View image
  • Tuesday, January 26th: - , Room 3 - Technical Forum

    Case 27 – BLN 03: SFA combination therapy

    Center:
    Berlin
    Case 27 – BLN 03: male, 75 years ( R-D)
    Operators:
    • Ralf Langhoff,
    • Andrea Behne
    CLINICAL DATA
    PAD Rutherford 3 left calf,
    PTA and stenting right SFA occlusion 1/2016

    RISK FACTORS
    Arterial hypertension, hyperlipidemia

    ABI
    Right 0.75, left 0.63

    PROCEDURAL STEPS
    1. Transfemoral retrograde approach
    - 6F cross over sheath (Fortress, BIOTRONIK)

    2. Recanalisation left SFA occlusion
    - 35" TERUMO Stiff wire and glidecath catheter

    3. PTA
    - Passeo 18 (BIOTRONIK)

    4. SFA stenting
    - Pulsar 18 (BIOTRONIK)

    5. PTA
    - DEB Passeo 18 Lux

    6. Closure of puncture site
    - Angioseal 6F if possible
    View image
  • Wednesday, January 27th: - , Room 1 - Main Arena 1

    Case 33 – BLN 05: High grade calcification and stenosis of the right common femoral artery

    Center:
    Berlin
    Case 33 – BLN 05: male, 66 years (N-R)
    Operators:
    • Ralf Langhoff,
    • Andrea Behne
    CLINICAL DATA
    PAD Rutherford 3 right calf,
    former Stenting of the left common iliac and external iliac artery,
    former PTA and Stenting left SFA

    ABI
    Right 0.73; left 0.91

    RISK FACTORS
    Hypercholesterinemia ( Chol.282 mg/dl, LDL 174, HDL 55)
    Arterial Hypertension

    PROCEDURAL STEPS
    1. Transfemoral retrograde approach
    - 7F cross over sheath (TERUMO)
    - 35" TERUMO stiff guidewire

    2. Embolic protection
    - Filter Wire EZ (BOSTON SCIENTIFIC)

    3. Artherectomy
    - Jetstream XC 7F, 120 cm (BOSTON SCIENTIFIC / BAYER)

    4. PTA
    - DEB Ranger 5 x 60 and 6 x 40 mm (BOSTON SCIENTIFIC)

    4. Closure of puncture site
    - Starclose 6F
    View image

Kingsport

4 livecase(s)
  • Wednesday, January 27th: - , Room 3 - Technical Forum

    Case 56b – KPT 05

    Center:
    Kingsport
    Case 56 – KPT 05: male, 82 years
    Operators:
    • Chris Metzger,
    • R. Sakhuja,
    • M. Aziz
    New case! Information will follow in due time. Thank you for your understanding.
    View image
  • Wednesday, January 27th: - , Room 1 - Main Arena 1

    Case 39 – KPT 01: High grade stenosis of the right internal carotid

    Center:
    Kingsport
    Case 39 – KPT 01: male, 81 years Case 39 – KPT 01: male, 81 years
    Operators:
    • Chris Metzger,
    • R. Sakhuja,
    • M. Aziz
    CLINICAL DATA
    CAD w 2 DES LAD 10/14, COPD
    FEV1 0.9, NIDDM
    Recent R hemispheric TIA X2 with L arm and leg weakness
    R amarousis fugax 6 months ago

    RISK FACTORS
    Htn, dyslipidemia, former smoker
    CDU: R PSV 447 cm/sec, EDV 179 cm/sec, ICA/CCA 6
    CTA (shown): ≥ 80% high RICA stenosis

    PROCEDURAL STEPS
    1. 9F MoMa proximal embolic protection (MEDTRONIC)

    2. Predilatation with 4.0/30mm Quantum (BOSTON SCIENTIFIC)

    3. Implantaiton of a 8-10/40 Xact Stent (ABBOTT)

    4. Postdilation with 5/20 Quantum (BOSTON SCIENTIFIC)
    View image
  • Wednesday, January 27th: - , Room 1 - Main Arena 1

    Case 40 – KPT 02

    Center:
    Kingsport
    Case 40 – KPT 02
    Operators:
    • Chris Metzger,
    • R. Sakhuja,
    • M. Aziz
    New patient! Information will follow in due time. Thank you for your understanding.
  • Wednesday, January 27th: - , Room 1 - Main Arena 1

    Case 42 – KPT 03: CTO of the right SFA

    Center:
    Kingsport
    Case 42 – KPT 03: active male, 60 years
    Operators:
    • Chris Metzger,
    • R. Sakhuja,
    • M. Aziz
    CLINICAL DATA
    L subclavian AND LICA artery occlusions
    Severe lifestyle-limiting R claudication @ 50'

    RISK FACTORS
    Current smoker, HTN, dyslipidemia

    ABI
    Right 0.50 → 0.16

    CTA
    ≈ steep iliac bifurcation, R SFA/popliteal CTO

    PROCEDURAL STEPS
    1. Contralateral access
    - 7F Ansel cross-over sheath (COOK)
    cross CTO (tibial access prn)
    - QUickCross catheter (SPECTRANETICS)
    - 0.035" Glidewire (TERUMO)

    2. PTA and DCB R SFA/popliteal
    - Armada Balloon (ABBOTT)
    - Lutonix DCB (BARD)

    3. If dissections after DCB, provisional placement of nitinol "tacks"
    (INTACTSOLUTIONS)
    View image

Münster

11 livecase(s)
  • Wednesday, January 27th: - , Room 2 - Main Arena 2

    Case 43 – MUN 01: EVAR with Sandwich left acc. RA

    Center:
    Münster
    Case 43 – MUN 01: male, 72 years (K-V)
    Operators:
    • Bernd Gehringhoff,
    • M. Bosiers
    CLINICAL DATA
    Juxtarenal aneurysm 59 mm max. below a left acc. RA

    RISK FACTORS
    CAD, art. hypertension, hypertensive heart disease, LE 12/15

    PROCEDURAL STEPS
    - Percutanous approach both groins Prostar XL (ABBOTT).
    - Placement of 14F sheaths (COOK).
    - Placement of Endurant bifurcated endograft (MEDTRONIC) just below the LRA.
    - Cannulation of the lower left renal artery and placement of the sandwich graft (GORE-Viabahn).
    - Extension of the the aortic endograft with an Endurant-tubegraft (MEDTRONIC) in order to complete the sandwich-repair.
    - Closure of the groins.
    View image
  • Wednesday, January 27th: - , Room 3 - Technical Forum

    Case 51 – MUN 03: Persisting Type II Endoleak via AMI with aneurysm enlargement

    Center:
    Münster
    Case 51 – MUN 03: male, 83 years (H-K)
    Operators:
    • Arne Schwindt,
    • N. Varcoe Varcoe
    CLINICAL DATA
    EVAR for AAA 2013 with bifurkated stentgraft, initial diameter of AAA 56 mm, in follow-up
    CT-angiograms persisting Type II Endoleak via lumbar arteries and inferior mesenteric
    artery (IMA). In 2015 enlargement of AAA to 70 mm in maximum axial diameter.

    RISK FACTORS
    Art. hypertension, former smoker, CHD

    PROCEDURAL STEPS
    1. Left transbrachial approach
    - 6F 70 cm Raabe sheath (COOK) insertion into ostium of superior mesenteric artery

    2. Cannulation of middle colic artery
    - 0,035" Glidewire and 4F 120 cm Glidecath (TERUMO)

    3. Cannulation of IMA and Endoleak
    - 0,014" Choice PT II wire (BOSTON SCIENTIFIC)

    4. Catheter insertion
    - 0,014" Echelon or 0,010" Marathon microcatheter into Endoleak and following angiogram

    5. Embolisation of Endoleak with alcohol-colymer
    - Onyx 34/34L (MEDTRONIC)

    6. After microcatheter removal final angiogram via IMA and hypogastric artery to confirm complete Endoleak embolisation
    View image
  • Wednesday, January 27th: - , Room 3 - Technical Forum

    Case 52 – MUN 04: Endoleak embolisation of iliac artery aneurysm after iliac-sidebranch endograft

    Center:
    Münster
    Case 52 – MUN 04: male, 63 years (F-D. P.)
    Operators:
    • Arne Schwindt,
    • N. Varcoe Varcoe
    CLINICAL DATA
    2013 Complex EVAR for aorto-biiliac AAA with Zentih bifurcated endograft and bilateral Zenith iliac-sidebranch endografts, 2013 embolisation of Type II Endoleak via AMI. In CT-angiogram aneurysm enlargement of left iliac aneurysm from initially 55mm to 65 mm and persisting type II EL via left deep circumflex iliac artery.

    RISK FACTORS
    Arterial hypertension, CHD, RCX-PTCA 2012, hyperlipidemia

    PROCEDURAL STEPS
    1. Access via retrograde left femoral puncture
    - Insertion of 5F 10 cm sheath (TERUMO)

    2. Cannulation of deep circumflex iliac artery
    - 0,035 Glidewire and 4F 90 cm Glidecath (TERUMO)

    3. Cannulation of Endoleak
    - 0,014 Choice PT II wire (BOSTON SCIENTIFIC) via the pelvic collaterals

    4. Catheter insertion
    - 0,014" Echelon microcatheter (MEDTRONIC) into Endoleak and following angiogram

    5. Embolisation of Endoleak
    - Alcohol-colymer Onyx 34/34L (MEDTRONIC)

    6. After microcatheter removal final angiogram via deep circumflex iliac artery to confirm complete Endoleak embolisation
    View image
  • Wednesday, January 27th: - , Room 2 - Main Arena 2

    Case 45 – MUN 02: Endovascular aortic repair of an abdominal aneurysm

    Center:
    Münster
    Case 45 – MUN 02: male 64 years (H-H)
    Operators:
    • Bernd Gehringhoff,
    • M. Bosiers
    CLINICAL DATA
    66 mm rapid growing AAA

    RISK FACTORS
    Hypertension, obesity, hypercholesterinemia
    Anxiety disorder Krea 0,9 mg/dl

    PROCEDURAL STEPS
    Percutanous approach both groins
    - Prostar XL (ABBOTT)
    - 14F sheath (COOK)

    - Placement of a pigtail catheter via the left groin
    - Lunderquist wire right side

    - Placement of the main body through the right side directly below the renals - Treovance-Endograft (BOLTON-MEDICAL)
    - Probing and positioning of the iliac limb extension contralateral
    - Ipsilateral positioning of the iliac endograft

    - Postballooning
    - Final angiography
    - Closing access with Prostar (preclose technique)
    View image
  • Thursday, January 28th: - , Room 2 - Main Arena 2

    Case 76 – MUN 07

    Center:
    Münster
    Case 76 – MUN 07
    Operators:
    • Piergiorgio Cao,
    • Bernd Gehringhoff,
    • Martin Austermann,
    • M. Bosiers
    New patient! Information will follow in due time. Thank you for your understanding.
    View image
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 66 – MUN 05

    Center:
    Münster
    Case 66 – MUN 05
    Operators:
    • Arne Schwindt,
    • S. Stahlhoff
    New patient! Information will follow in due time. Thank you for your understanding.
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 67 – MUN 06

    Center:
    Münster
    Case 67 – MUN 06
    Operators:
    • Arne Schwindt,
    • S. Stahlhoff
    New patient! Information will follow in due time. Thank you for your understanding.
  • Thursday, January 28th: - , Room 2 - Main Arena 2

    Case 79 – MUN 08: EVAR with chimney both renal arteries

    Center:
    Münster
    Case 79 – MUN 08: male, 71 years (H-M)
    Operators:
    • Martin Austermann,
    • Bernd Gehringhoff,
    • M. Bosiers
    CLINICAL DATA
    Juxtarenal growing aneurysm 62 mm
    PAD with severe calcified and stenosed iliac arteries
    Common ostium of the CT and SMA

    RISK FACTORS
    Art. hypertension
    CAD

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

    2. Cut down left axillary artery and double puncture

    3. Placement of two 7F Shuttle sheaths from above. Cannulation of both renal arteries with a 7F shuttle sheath (COOK)

    4. Placement of Endurant bifurcated endograft (MEDTRONIC) just below the SMA

    5. Placement of the chimney stent-grafts (Advanta-MAQUET) in both renal arteries

    6. Closure of the groin
    View image
  • Friday, January 29th: - , Room 1 - Main Arena 1

    Case 87 – MUN 10: LP-branched endovascular aortic repair – Part 1

    Center:
    Münster
    Case 87 – MUN 10: female, 61 years (W-H)
    Operators:
    • Martin Austermann,
    • Bernd Gehringhoff,
    • M. Bosiers
    CLINICAL DATA
    Thoracoabdominal aortic aneurysm
    Narrow iliac arteries

    RISK FACTORS
    Art. hypertension
    Panarteritis nodosa

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

    2. Left axillary access 5F sheath via cut down

    3. Placement of a LP-CMD - Zenith-endograft (COOK) with four branches and closure of the groins to avoid SCI

    4. Cannulation of celiac trunk, SMA and renal arteries through the branches and implantation of the bridging stentgafts

    5. Final angiography

    6. Closure left axillary access
    View image
  • Friday, January 29th: - , Room 1 - Main Arena 1

    Case 87 – MUN 10: LP-branched endovascular aortic repair – Part 2

    Center:
    Münster
    Case 87 – MUN 10: female, 61 years (W-H)
    Operators:
    • Martin Austermann,
    • Bernd Gehringhoff,
    • M. Bosiers
    CLINICAL DATA
    Thoracoabdominal aortic aneurysm
    Narrow iliac arteries

    RISK FACTORS
    Art. hypertension
    Panarteritis nodosa

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

    2. Left axillary access 5F sheath via cut down

    3. Placement of a LP-CMD - Zenith-endograft (COOK) with four branches and closure of the groins to avoid SCI

    4. Cannulation of celiac trunk, SMA and renal arteries through the branches and implantation of the bridging stentgafts

    5. Final angiography

    6. Closure left axillary access
    View image
  • Friday, January 29th: - , Room 1 - Main Arena 1

    Case 88 – MUN 11

    Center:
    Münster
    Case 88 – MUN 11
    Operators:
    • Martin Austermann,
    • Bernd Gehringhoff,
    • M. Bosiers
    New patient! Information will follow in due time. Thank you for your understanding.

Heidelberg

5 livecase(s)
  • Wednesday, January 27th: - , Room 3 - Technical Forum

    Case 53 – HEI 03

    Center:
    Heidelberg
    Case 53 – HEI 03
    Operators:
    • Boris Radeleff,
    • Nikolas Kortes,
    • M. Sumkauskaite,
    • D. Gnutzmann,
    • Natalie Tessendorf,
    • S. Schreiner,
    • C. Ernst
    New patient! Information will follow in due time. Thank you for your understanding.
  • Wednesday, January 27th: - , Room 2 - Main Arena 2

    Case 47 – HEI 01: Fusion imaging in endovascular infrarenal aneurysm repair – Part 1

    Center:
    Heidelberg
    Case 47 – HEI 01: female, 77 years (H. B.)
    Operators:
    • Dittmar Böckler,
    • Alexander Hyhlik-Dürr,
    • Bischoff
    CLINICAL DATA
    Asymptomatic infrarenal aneurysm (50mm), diagnosed in 12/2015

    RISK FACTORS
    COPD GOLD III
    1-vessel coronary artery disease
    Hx of smoking (50py)
    Hx of art. hypertension
    ABI 1.0 palpable pulses

    PROCEDURAL STEPS
    1. Percutaneous access both sides
    Perclose ProGlide (ABBOTT)

    2. Sheath insertion
    DrySeal sheath (GORE)

    3. Fusion Imaging
    Prototype syngo X Workplace with AAA Guidance software (SIEMENS)
    - Segmentation of the contrasted aorta
    - Selection of operative landmarks (Renal artery ostia, hypogastric artery ostia)
    - 2D-3D registration
    - Fusion imaging overlay

    4. Implantation of endoprosthesis
    GORE C3-Exluder
    - Main body: 28/145/14
    - Contralateral leg: 16/16/95

    5. Completion angiography

    6. Contrast enhanced cone beam CT (Dyna CT)
    View image
  • Wednesday, January 27th: - , Room 2 - Main Arena 2

    Case 47 – HEI 01: Fusion imaging in endovascular infrarenal aneurysm repair – Part 2

    Center:
    Heidelberg
    Case 47 – HEI 01: female, 77 years (H. B.)
    Operators:
    • Dittmar Böckler,
    • Alexander Hyhlik-Dürr,
    • Bischoff
    CLINICAL DATA
    Asymptomatic infrarenal aneurysm (50mm), diagnosed in 12/2015

    RISK FACTORS
    COPD GOLD III
    1-vessel coronary artery disease
    Hx of smoking (50py)
    Hx of art. hypertension
    ABI 1.0 palpable pulses

    PROCEDURAL STEPS
    1. Percutaneous access both sides
    Perclose ProGlide (ABBOTT)

    2. Sheath insertion
    DrySeal sheath (GORE)

    3. Fusion Imaging
    Prototype syngo X Workplace with AAA Guidance software (SIEMENS)
    - Segmentation of the contrasted aorta
    - Selection of operative landmarks (Renal artery ostia, hypogastric artery ostia)
    - 2D-3D registration
    - Fusion imaging overlay

    4. Implantation of endoprosthesis
    GORE C3-Exluder
    - Main body: 28/145/14
    - Contralateral leg: 16/16/95

    5. Completion angiography

    6. Contrast enhanced cone beam CT (Dyna CT)
    View image
  • Wednesday, January 27th: - , Room 2 - Main Arena 2

    Case 49 – HEI 02: Asymptomatic aortoiliac aneurysmal disease – Part 1

    Center:
    Heidelberg
    Case 49 – HEI 02: male, 73 years (G-K)
    Operators:
    • Dittmar Böckler,
    • Alexander Hyhlik-Dürr,
    • Bischoff
    CLINICAL DATA
    Small AAA 31 mm, left common iliac artery 31 mm
    and left thrombosed internal iliac artery aneurysm 38 mm
    Diagnosed in 9/2105 in an external institution, asymptomatic status

    RISK FACTORS
    Ascending aneurysm (46 mm)
    Ectatic infrarenal aorta (31 mm)
    Ectatic popliteal arteries (right 13 mm: left: 14 mm)
    Hx of smoking (40 py)
    Hx of art. hypertension
    ABI 1,0 both sides with palpable pulses

    PROCEDURAL STEPS
    Ultrasound guided percutaneous access
    - Perclose ProGlide (ABBOTT)

    - Sheath insertion
    - Wire change (guidewire - stiff wire)
    - DrySeal sheath (GORE)

    - Angiography and Fusion Imaging
    - Prototype syngo X Workplace with AAA Guidance software (SIEMENS)

    - Implantation of Endoprosthesis (GORE Excluder Leg Endoprosthesis 16/16/135)
    - Ballooning

    - Completion angiography
    - Puncture site closure

    - Contrast enhanced cone beam CT (Dyna CT)
    View image
  • Wednesday, January 27th: - , Room 2 - Main Arena 2

    Case 49 – HEI 02: Asymptomatic aortoiliac aneurysmal disease – Part 2

    Center:
    Heidelberg
    Case 49 – HEI 02: male, 73 years (G-K)
    Operators:
    • Dittmar Böckler,
    • Alexander Hyhlik-Dürr,
    • Bischoff
    CLINICAL DATA
    Small AAA 31 mm, left common iliac artery 31 mm
    and left thrombosed internal iliac artery aneurysm 38 mm
    Diagnosed in 9/2105 in an external institution, asymptomatic status

    RISK FACTORS
    Ascending aneurysm (46 mm)
    Ectatic infrarenal aorta (31 mm)
    Ectatic popliteal arteries (right 13 mm: left: 14 mm)
    Hx of smoking (40 py)
    Hx of art. hypertension
    ABI 1,0 both sides with palpable pulses

    PROCEDURAL STEPS
    Ultrasound guided percutaneous access
    - Perclose ProGlide (ABBOTT)

    - Sheath insertion
    - Wire change (guidewire - stiff wire)
    - DrySeal sheath (GORE)

    - Angiography and Fusion Imaging
    - Prototype syngo X Workplace with AAA Guidance software (SIEMENS)

    - Implantation of Endoprosthesis (GORE Excluder Leg Endoprosthesis 16/16/135)
    - Ballooning

    - Completion angiography
    - Puncture site closure

    - Contrast enhanced cone beam CT (Dyna CT)
    View image

Leipzig, Dept of Radiology

2 livecase(s)
  • Wednesday, January 27th: - , Room 3 - Technical Forum

    Case 50 – LEI 18: Aneurysm right renal segmental artery

    Center:
    Leipzig, Dept of Radiology
    Case 50 – LEI 18: male, 60 years (B-P)
    Operators:
    • Michael Moche,
    • Jochen Fuchs
    CLINICAL DATA
    Incidental finding of a 19 x 15mm renal artery aneurysm
    CT due to upper abdominal pain
    Gastritis 12/2015

    RISK FACTORS
    Arterial hypertension

    PROCEDURAL STEPS
    1. Right groin 4F access

    2. Cannulation of the renal artery
    - Judkins Right 4Fr diagnostic catheter
    - Micro-Catheter

    3. Coiling of the aneurysm
    - PENUMBRA detachable coils (PENUMBRA)
    View image
  • Wednesday, January 27th: - , Room 3 - Technical Forum

    Case 54 – LEI 19: Selective Internal Radiation Therapy (SIRT) for colorectal liver metastases

    Center:
    Leipzig, Dept of Radiology
    Case 54 – LEI 19: male, 57 years
    Operators:
    • Tim Ole Petersen,
    • Michael Moche,
    • T. Lincke
    CLINICAL DATA
    Liver metastases following rectal cancer (T3 N2b M1 G2 KRAS wild type)
    Rectum resection 11 month ago, followed by nine cycles of FOLFIRI-Cetuximab
    chemotherapy. After initial regressive disease now persisting metastases in the liver.
    Hepatic function not impaired.

    RISK FACTORS
    Art. hypertension
    Slight focal cholestasis from tumor mass in liver segment VII

    PROCEDURAL STEPS
    1. Right femoral approach
    - 4F 10 cm sheath (TERUMO)

    2. Catheterization of the hepatic artery
    - 4F-SIM2 100 cm diagnostic catheter (CORDIS)

    3. Placement of the microcatheter precisely in the same position 1 and 2 for the injection of the therapeutic agent
    - Microcatheter System 2.7F 130 cm (TERUMO PROGREAT)

    4. Selective application of the Yttrium-90 glass microspheres with a dedicated injection system (TheraSphere, BTG)
    View image

Abano Terme

3 livecase(s)
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 63 – ABT 01

    Center:
    Abano Terme
    Case 63 – ABT 01
    Operators:
    • Marco Manzi,
    • Luis Mariano Palena,
    • Cesare Brigato
    New patient! Information will follow in due time. Thank you for your understanding.
  • Thursday, January 28th: - , Room 3 - Technical Forum

    Case 83 – ABT 03

    Center:
    Abano Terme
    Case 83 – ABT 03
    Operators:
    • Marco Manzi,
    • Luis Mariano Palena,
    • Cesare Brigato
    New patient! Information will follow in due time. Thank you for your understanding.
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 69 – ABT 02

    Center:
    Abano Terme
    Case 69 – ABT 02
    Operators:
    • Marco Manzi,
    • Luis Mariano Palena,
    • Cesare Brigato
    New patient! Information will follow in due time. Thank you for your understanding.

Bad Krozingen

6 livecase(s)
  • Thursday, January 28th: - , Room 3 - Technical Forum

    Case 82 – BK 05: Recanalisation of EIA/CFA and SFA left leg

    Center:
    Bad Krozingen
    Case 82 – BK 05: male, 61 years (G-H)
    Operators:
    • Thomas Zeller,
    • Elias Noory
    CLINICAL DATA
    Calf & leg claudication left leg, calf claudication right leg about 200 m
    with progressive deterioration since a couple of weeks
    Interventional treatment of the left CFA 2007 in an external hospital
    Coronary 2-vessel disease
    PCI / DES 2009, 3/2010, 6/2010
    AMI (posterior wall) 2009
    Moderate reduction of LV function
    ABI at rest: 0.4 / 0.3, ABI after exercise: 0.2 / 0.1
    Oscillometry: reduced amplitudes right calf & ankle
    Reduced amplitudes left tigh, calf & ankle
    Duplex left leg: Occlusion of EIA & CFA (vessel diameter 11 mm!)
    Moderate to high grade stenosis of DFA
    Proximal occlusion of SFA (reperfusion distally)
    Crea/eGFR: 1.3 mg/dl / 76.3 ml/min

    PROCEDURAL STEPS
    1. 8F cross-over sheath right groin
    - Balkin Up&Over (COOK)

    2. Intraluminal passage of EIA/CFA occlusion
    - 0.018" % 0.035" Advantage GW (TERUMO)

    3. 8F Rotarex (STRAUB MEDICAL) if soft tissue
    - Turbohawk atherectomy (MEDTRONIC) if solid

    4. DEB angioplasty
    - Lutonix (C.R.BARD) if vessel size >7 mm In.Pact (MEDTRONIC)

    5. Lesion crossing of SFA with a 0.018" GW

    6. Predilatation (conventional balloon)

    7. DEB and spot stent on indication
    - BioMimics (VERYAN MEDICAL)

    8. Closure device
    - 8F Angioseal (ST JUDE)
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 64 – BK 01: Plaque modulation (Angiosculpt) and DCB femoro-popliteal lesions

    Center:
    Bad Krozingen
    Case 64 – BK 01: female, 59 years (R-S)
    Operators:
    • Elias Noory,
    • Peter Flügel
    CLINICAL DATA
    Claudication Rutherford 3 (<200 m) right calf

    RISK FACTORS
    Hypertension, diabetes mellitus, hyperlipidemia

    ABI AT REST
    Right: 0.6, left: 0.9

    DUPLEX
    Multiple high grade stenoses distal SFA and popliteal artery right leg

    PROCEDURAL STEPS
    1. 6F cross-over sheath from the left groin

    2. Crossing the lesions
    - 0.014" or 0.018" Advantage GW (TERUMO)

    3. Plaque modulation
    - Angiosculpt balloon catheter (SPECTRANETICS)

    4. Predilatation
    - 5 mm Angiosculpt catheter (SPECTRANETICS)

    5. Long-term (3 minutes) postdilatation
    - 5 or 6 mm Stellarex DCB (SPECTRANETICS)

    6. No stents if possible
  • Thursday, January 28th: - , Room 3 - Technical Forum

    Case 84 – BK 06

    Center:
    Bad Krozingen
    Case 84 – BK 06
    Operators:
    • Thomas Zeller
    New patient! Information will follow in due time. Thank you for your understanding.
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 70 – BK 02: male, 64 years (P-W)

    Center:
    Bad Krozingen
    Case 70 – BK 02: male, 64 years (P-W)
    Operators:
    • Thomas Zeller,
    • Elias Noory
    CLINICAL DATA
    Claudication Rutherford 3 (50m) left calf since 1 year
    Sudden onset of symptoms
    Embolic nature, source: intra cardiac thrombus as a result of an anterior wall infarction
    Oral anticoagulation

    RISK FACTORS
    CVRF: Nicotine, family history
    ABI: right 1.1, left 0.6

    DUPLEX
    Thrombotic occlusion of distal left SFA

    PROCEDURAL STEPS
    1. 7F antegrade sheath left CFA

    2. I ntraluminal lesion passage
    - 4F vertebral diagnostic catheter (CORDIS) 0.018’’ or
    - 0.014” Advantage GW (TERUMO)

    3. Mechanical thrombectomy
    - Rotarex 6F (STRAUB MEDICAL) or directional atherectomy
    - Silverhawk LX-M (MEDTRONIC)

    4. DCB angioplasty
    - I N.PACT Pacific (MEDTRONIC)

    5. Local lysis if indicated

    6. No stents!
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 72 – BK 03: Stent angioplasty of renal artery stenosis right side

    Center:
    Bad Krozingen
    Case 72 – BK 03: female, 64 years (M-F)
    Operators:
    • Thomas Zeller,
    • Elias Noory
    CLINICAL DATA
    Since more than 15 years known history of hypertension
    Sudden onset of symptoms of recurrent hypertensive crisis in September 2015
    Coronary 2-vessel disease
    PCI / DES LAD and Rcx 2012
    Normal LV function
    Negative stress echo up to 125 W 10/2015

    PRESENT STATE
    OBP: 190/80 mmHg
    ABPM: 164/81 mmHg
    Creatinine: 0.8 mg/dl
    eGFR: 80 ml/min

    DUPLEX
    Kidney length R/L: 119 mm/118 mm
    Acceleration time: > 70 ms/< 70 ms
    Intrarenal RI R/L: 0,74/0,81
    RA PSV- ratio R/L: 4.5/1.8

    PROCEDURAL STEPS
    1. 6F retrograde sheath right groin (11 cm)

    2. 6F IMA guiding catheter via standard 0.038" GW

    3. Non-selective angiography (DSA)

    4. Selective angiography

    5. Lesion crossing with a 0.014" GW (Galeo ES, BIOTRONIK)

    6. Direct stenting if feasible, predilatation on indication
    - Hippocampus (MEDTRONIC) or Dynamic renal (BIOTRONIK)

    7. Closure device
    - Femoseal (ST. JUDE)
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 74 – BK 04: Chronic occlusion of left SFA, popliteal and BTK arteries

    Center:
    Bad Krozingen
    Case 74 – BK 04: male, 79 years (B-H)
    Operators:
    • Thomas Zeller,
    • Elias Noory
    CLINICAL DATA
    Claudication Rutherford 3 (<50m) both legs for years
    with progressive deterioration during a the last couple of months
    ABI: right 0.3, left 0.4

    RISK FACTORS
    Hypertension, former smoker, hyperlipidemia

    DUPLEX
    Chronic bilateral SFA occlusion plus occlusion of left popliteal artery middle segment

    PROCEDURAL STEPS
    1. 7F cross-over Destination- sheath from the right groin (TERUMO)

    2. In the unlikely case of intraluminal lesion passage: Mechanical thrombectomy
    (Rotarex; STRAUB MEDICAL)

    3. If subintimal: predilatation with plain balloon, if result insufficient
    directional atherectomy & DCB angioplasty
    (TurboHawk and In.Pact DCB; MEDTRONIC)

    4. Stent only on indication (provisional stenting) (Supera Interwoven Nitinol-Stent; ABBOTT)

    5. In case of failed antegrade recanalization attempt retrograde access via left ATA
    View image

Teaneck

4 livecase(s)
  • Thursday, January 28th: - , Room 3 - Technical Forum

    Case 86 – TEA 03: Decreased access flow rates

    Center:
    Teaneck
    Case 86 – TEA 03: male, 89 years (R-Q)
    Operators:
    • John Rundback,
    • Kevin Herman,
    • Amish Patel
    CLINICAL DATA
    89 yo male with ESRD on HD with dysfunctional LUE radio-cephalic fistula
    at the wrist, decreased access flow rates greater than 25% drop
    from 900 ml/min to 600 ml/min. Multiple prior interventions in the past
    (beginning in 2009).
    Most recent intervention 3 months prior.

    RISK FACTORS
    DM, CAD, DM

    PROCEDURAL STEPS
    1. US guided left radial artery access
    - 4F or 6F slender sheath (TERUMO)

    2. BOSTON SCIENTIFIC 018" V18 wire

    3. BOSTON SCIENTIFIC Sterling 018" PTA catheter
    View image
  • Thursday, January 28th: - , Room 3 - Technical Forum

    Case 86b – TEA 04

    Center:
    Teaneck
    Case 86b – TEA 04: male, 76 years
    Operators:
    • John Rundback,
    • Kevin Herman,
    • Amish Patel
    New case! Information will follow in due time. Thank you for your understanding.
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 73 – TEA 01

    Center:
    Teaneck
    Case 73 – TEA 01
    Operators:
    • John Rundback,
    • Kevin Herman,
    • Amish Patel
    New patient! Information will follow in due time. Thank you for your understanding.
  • Thursday, January 28th: - , Room 1 - Main Arena 1

    Case 75 – TEA 02

    Center:
    Teaneck
    Case 75 – TEA 02
    New patient! Information will follow in due time. Thank you for your understanding.