LINC 2016 live case guide

Berlin

• Tuesday, January 26th: 9:36 - 10:15, 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
  

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• Tuesday, January 26th: 11:45 - 12:30, 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: 13:51 - 14:14, 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)

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• Tuesday, January 26th: 15:10 - 15:40, 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

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• Wednesday, January 27th: 8:29 - 9:00, 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

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