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
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
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
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)
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)
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)
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)
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
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
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)
Cookie settings
We use cookies so that we can offer you the best possible website experience. This includes cookies which are necessary for the operation of the website and to manage our corporate commercial objectives, as well as other cookies which are used solely for anonymous statistical purposes, for more comfortable website settings, or for the display of personalised content. With the exception of strictly necessary cookies, your are free to decide which categories you would like to permit. Please note that depending on the settings you choose, the full functionality of the website may no longer be available. Further information can be found in our privacy statement and cookie policy.
For more infos on the cookies we use and how you can manage them, please visit our cookie policy.