LINC 2016 live case guide


Find all live cases and live case centers listed below.

 

 

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