LINC 2016 live case guide


Find all live cases and live case centers listed below.

 

 

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
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