LINC 2017 live case guide


Find all live cases and live case centers listed below.

 

 

Lille

2 livecase(s)
  • Wednesday, January 25th: - , Room 2 - Main Arena 2

    Case 43 – EVAR + left iliac branched device

    Center:
    Lille
    Case 43 – LIL 01: male, 63 years, (L-D)
    Operators:
    • Stephan Haulon
    CLINICAL DATA
    Incidental finding of AAA during work-up for intermittent claudication
    CTA: AAA 51 mm, aneurysm proximal right CIA, dilatation distal left CIA
    Plan: EVAR + left iliac branched device + embolisation right IIA

    RISK FACTORS
    Former smoker, hypertension

    HISTORY
    Aortic valve stenosis, CVA, bilateral inguinal hernia repair, lumbar herniated disc repair

    PRESENT STATE
    Duplex supra-aortic vessels: normal
    Cardiac ultrasound: EF 74%, AS (3.13 cm2), Ao asc 45 mm

    PROCEDURAL STEPS
    1. L: 10F sheath, Lunderquist, dilators (up to 20F) 50 U/kg Heparin

    2. R: 5F55 sheath, TERUMO, SIM, AMI embolized (Amplatzer 6 mm)

    3. R: 10F Right IIA embolized (Coils 10 mm)

    4. R: 10F sheath, wire exchange: starter, TERUMO, Rosen-GW stiff wire (COOK), 12F sheath, 45cm; tip positioned above aortic bifurcation

    5. L: ZBIS advanced into distal aorta, unsheath until preloaded catheter of ZBIS appears; exchange wire of preloaded catheter for 260 cm TERUMO

    6. R: Snare through-and-through (tat)-wire (TERUMO, 0.035") – advance dilator of 12F sheath

    7. R: 12F dilator connects to tip of preloaded catheter – secure both ends with clamps

    8. Position C-arm and open branch of ZBIS (COOK)

    9. Advance 12F dilator into ZBIS (pull & push, 'nobody holds the wire')

    10. Puncture valve of 12F TERUMO/catheter to catheterize IIA, angio

    11. Wire exchange/Rosen

    12. Over Rosen, advance 55 cm 7F sheath into 12F to IIA, tat-wire under tension

    13. Advance bridging stentgraft in 7F sheath

    14. Remove tat-wire

    15. Pull down ZBIS, depending on angle of IIA

    16. Pull back 7F sheath and inflate bridging stent

    17. Advance 7F sheath again into stentgraft – dilate distal seal if required – Angio

    18. Finish deployment of Zbis – release trigger wires

    19. Secure branch/stentgraft with balloon while removing nose cone

    20. Continue with EVAR

    21. R: release proximal stent

    22. L: iliac angiogram

    23. L: contralateral limb insertion holding the main body, deployment

    24. R: finish bifurcated endograft deployment + distal attachment release

    27. R: ipsilateral limb insertion & deployment + IIE stenting (Nitinol stent LUMINEX 10*60 mm)

    28. R+L: CODA balloon (COOK)

    29. L: Long angio catheter/Angiogram +/- non-contrast CBCT

    30. R+L: sheaths retrieval + close groins
    View image
  • Thursday, January 26th: - , Room 2 - Main Arena 2

    Case 71 – FEVAR for dissecting TAAA

    Center:
    Lille
    Case 71 – LIL 02: male, 61, years (H-M)
    Operators:
    • Stephan Haulon
    CLINICAL DATA
    2013: type B aortic dissection, conservative treatment
    Acute tubular necrosis and occlusion right renal artery with atrophic right kidney
    2014 aneurysmatic evolution infrarenal aorta: Open AAA tubular repair
    Aneurysmatic evolution descending thoracic and thoraco-abdominal aorta,
    with a maximum diameter 61 mm
    November 2016: TEVAR
    January 2017: FEVAR

    RISK FACTORS
    Smoker, hypertension

    HISTORY
    Gastric ulcers, pancreatitis, OSA, GORD

    PRESENT STATE
    At present asymptomatic
    Renal function: creatinine 12 mg/l, GFR 64
    Cardiac ultrasound: normal EF, mild AI, otherwise normal
    Duplex carotid arteries: normal
    Spirometry: mild obstructive pattern

    PROCEDURAL STEPS
    1. L: 7F sheath/Lunderquist/dilators (up to 20F) + 100 U/kg Heparin (Target ACT≥250)
    2. L: 20F sheath above the aortic bifurcation
    3. L (through 20F): Two 7F sheaths, one 6F sheath
    4. L (through 20F): Advance marked angio catheter through 7F sheath
    5. R: 10F sheath/Lunderquist/dilators up to 20F
    6. Fluoroscopy to locate fenestrated endograft markers
    7. R: Advanced fenestrated endograft (COOK)
    8. Aortic angiogram/fenestrated endograft deployment
    9. L: Catheterization of the fenestrated endograft lumen through 6F sheath with C2/KMP catheter and TERUMO wire
    10. Advance 6F sheath to the endograft lumen
    11. C2/RIM/DAV + TERUMO/Roadrunner through 6F for renal artery catheterisation
    12. Renal angiogram +/- nitro injection
    13. Exchange TERUMO for a Rosen
    14. Advance 6F to the renal artery
    15. Advance stent into the parking position
    16. L: Through last 7F sheath advance C2+ TERUMO to catheterize fenestrated endograft lumen
    17. Advance 7F below the fenestration of SMA
    18. C2/VS1 + TERUMO/Roadrunner through 7F sheath to catheterize SMA
    19. Vessel angiogram to check position in main trunk
    20. Exchange TERUMO for Amplatz (BOSTON SCIENTIFIC) wire
    21. Advance 7F in the target vessel
    22. Advance stent into parking position
    23. 16-19 for the coeliac trunk
    24. R: Release reducing ties / proximal attachment and distal attachment
    25. R: Nose capture & retrieval under fluoroscopy/Molding with CODA balloon (COOK)
    26. L: Renal artery stent deployment (1/3 aortic lumen) after 6F retrieval
    27. L: Flare the stent inside the aortic portion with 10–20 mm balloon
    28. L: Advance 6F in the renal stent/selective angiogram
    29. L: SMA stent deployment (1/3 aortic lumen) after 7F retrieval
    30. L: CT stent deployment (1/3 aortic lumen) after 7F retrieval
    31. L: Flare the stent inside the aortic portion with 10-20 mm balloon
    33. R: Remove fenestrated device delivery system
    34. L: Pull back 20F sheath in common iliac
    35. Continue with EVAR procedure
    36. CODA balloon at the level of overlaps (COOK)
    37. L: Long angio catheter/Angiogram +/- non-contrast CBCT
    View image

Live case transmission centers

During LINC 2017 more than 90 live cases will be performed from 13 national and international centers.

All live case transmissions are coordinated, filmed, and produced by the mediAVentures crew, using the latest in high definition television and wireless technology.

• University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
University Hospital Leipzig, Department of Radiology, Leipzig, Germany
• Policlinico Abano Terme, Abano Terme, Italy
• Heartcenter Bad Krozingen, Bad Krozingen, Germany
• Sankt-Gertrauden-Hospital, Berlin, Germany
• Bern University Hospital, Heart- and Vascular Center, Bern, Switzerland
• OhioHealth Research Institute, Columbus, USA
• Villa Maria Cecilia, Cotignola, Italy
• AZ Sint-Blasius, Dendermonde, Belgium
• Galway University Hospitals, Galway, Ireland
• University Hospital Jena, Jena, Germany
• Centre Hospitalier Régional Universitaire de Lille, Lille, France
• St. Franziskus Hospital, Münster, Germany
• Mount Sinai Hospital, New York, USA