LINC 2016 live case guide

Conference day 4

• 9:00 - 9:40, Room 1 - Main Arena 1

  Case 87 – MUN 10: LP-branched endovascular aortic repair – Part 1

  Center:

  Münster

  Case 87 – MUN 10: female, 61 years (W-H)

  Operators:

  • Martin Austermann,
  • Bernd Gehringhoff,
  • M. Bosiers

  CLINICAL DATA
  Thoracoabdominal aortic aneurysm
  Narrow iliac arteries
  
  RISK FACTORS
  Art. hypertension
  Panarteritis nodosa
  
  PROCEDURAL STEPS
  1. Percutanous approach both groins
  - Prostar XL (ABBOTT)
  - 14F (COOK) both groins
  
  2. Left axillary access 5F sheath via cut down
  
  3. Placement of a LP-CMD - Zenith-endograft (COOK) with four branches and closure of the groins to avoid SCI
  
  4. Cannulation of celiac trunk, SMA and renal arteries through the branches and implantation of the bridging stentgafts
  
  5. Final angiography
  
  6. Closure left axillary access

  View image
• 9:00 - 9:45, Room 3 - Technical Forum

  Case 89 – LEI 30: Complex SFA-occlusion right

  Center:

  Leipzig, Dept of Angiology

  Case 89 – LEI 30: male, 54 years (G-M)

  Operators:

  • Andrej Schmidt,
  • Matthias Ulrich

  CLINICAL DATA
  Severe claudication bilateral, right > left, restpain right foot, Rutherford 4
  walking capacity 60 meters
  ABI right 0.55
  PTA of iliac stenosis bilateral 11/2015
  Persistent symptoms
  
  CLINICAL DATA
  Art. hypertension, current smoker
  
  PROCEDURAL STEPS
  1. Left groin retrograde and cross-over approach
  - 7F 55 cm Check-Flow-Performer sheath (COOK)
  
  2. Atherectomy of the profunda femoris stenosis right
  - HawkOne directional atherectomy system, 9 cm tip (MEDTRONIC)
  
  3. Passage of the SFA-occlusion and filter placement
  - 0.018" Connect guidewire 300 cm (ABBOTT)
  - 0,018" QuickCross Support-Catheter, 135 cm (SPECTRANETICS)
  - 4F 90 cm sheath (COOK)
  - Wirion-Protection system (ALLIUM-MEDICAL)
  
  4. Atherectomy of the superficial femoral artery
  - HawkOne directional atherectomy system, 9 cm tip (MEDTRONIC)
  
  5. PTA with drug-coated balloons
  - Ranger DCB 5.0/120 mm (BOSTON SCIENTIFIC)

  View image
• 10:15 - 10:45, Room 1 - Main Arena 1

  Case 87 – MUN 10: LP-branched endovascular aortic repair – Part 2

  Center:

  Münster

  Case 87 – MUN 10: female, 61 years (W-H)

  Operators:

  • Martin Austermann,
  • Bernd Gehringhoff,
  • M. Bosiers

  CLINICAL DATA
  Thoracoabdominal aortic aneurysm
  Narrow iliac arteries
  
  RISK FACTORS
  Art. hypertension
  Panarteritis nodosa
  
  PROCEDURAL STEPS
  1. Percutanous approach both groins
  - Prostar XL (ABBOTT)
  - 14F (COOK) both groins
  
  2. Left axillary access 5F sheath via cut down
  
  3. Placement of a LP-CMD - Zenith-endograft (COOK) with four branches and closure of the groins to avoid SCI
  
  4. Cannulation of celiac trunk, SMA and renal arteries through the branches and implantation of the bridging stentgafts
  
  5. Final angiography
  
  6. Closure left axillary access

  View image
• 10:20 - 11:00, Room 3 - Technical Forum

  Case 90 – LEI 31: High grade stenosis brachiocphalic trunk

  Center:

  Leipzig, Dept of Angiology

  Case 90 – LEI 31: male, 62 years (R-K)

  Operators:

  • Andrej Schmidt,
  • Matthias Ulrich

  CLINICAL DATA
  Minor stroke right hemispheric 2011, no residual symptoms
  Intermittent vertigo
  Intermittent atrial fibrillation
  CAD, MI 2012
  COPD
  
  RISK FACTORS
  Art. hypertension, former smoker, diabetes mellitus type 2
  
  DUPLEX
  Retrograde flow right vertebral artery
  
  MR-ANGIOGRAPHY
  High grade stenosis origin of the brachiocephalic trunk
  
  PROCEDURAL STEPS
  
  1. Right groin access
  - 5F-Judkins Right diagnostic catheter (CORDIS / CARDINAL HEALTH)
  - 0.035" SupraCore guidewire 300 cm (ABBOTT)
  - 7F 90 cm Check-Flo Performer sheath (COOK)
  - Guidewire-position into the subclavian artery
  
  2. Potentially cerebral protection with a filter via a right brachial access
  - 6F 25 cm Radiofocus sheath (TERUMO)
  - 6F IMA guiding catheter (MEDTRONIC)
  - Filterwire EZ (BOSTON SCIENTIFIC) from brachial to the internal carotid artery
  
  3. Predilatation and stenting
  - 5.0/40 mm Admiral balloon, 135 cm (MEDTRONIC)
  - BeGraft 10/27 mm Covered Stent (BENTLEY INNOMED)

  View image
• 11:20 - 12:00, Room 1 - Main Arena 1

  Case 88 – MUN 11

  Center:

  Münster

  Case 88 – MUN 11

  Operators:

  • Martin Austermann,
  • Bernd Gehringhoff,
  • M. Bosiers

  New patient! Information will follow in due time. Thank you for your understanding.
• 11:20 - 12:00, Room 1 - Main Arena 1

  Case 92 – LEI 33

  Center:

  Leipzig, Dept of Angiology

  Case 92 – LEI 33: male, 55 years

  New case! Information will follow in due time. Thank you for your understanding.
• 11:20 - 12:00, Room 1 - Main Arena 1

  Case 93 – LEI 34

  Center:

  Leipzig, Dept of Angiology

  Case 93 – LEI 34: female, 60 years

  New case! Information will follow in due time. Thank you for your understanding.