LINC 2016 live case guide


Find all live cases and live case centers listed below.

 

 

Conference day 3

  • - , 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.
  • - , 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)
  • - , 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
  • - , 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.
  • - , 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
  • - , 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
  • - , 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.
  • - , 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.
  • - , 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.
  • - , 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
  • - , 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.
  • - , 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.
  • - , 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.
  • - , 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
  • - , 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.
  • - , 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!
  • - , 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
  • - , 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
  • - , 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.
  • - , 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
  • - , 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)
  • - , 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.
  • - , 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
  • - , 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.
  • - , 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)