Bad Krozingen

• Thursday, January 26th: 8:00 - 9:30, Room 3 - Technical Forum

  Case 73 – Stent reconstruction of aortic bifurcation in a patient with Leriche syndrome

  Center:

  Bad Krozingen

  Case 73 – BK 06: female, 55 years (B-I-M)

  Operators:

  • Thomas Zeller,
  • Elias Noory

  CLINICAL DATA
  Bilateral buttock and leg claudication after 50 to 100 meters (PAOD Rutherford 2 / Fontaine IIb) since a couple of months
  
  PRESENT STATE
  CVRF: arterial hypertension, ex nicotine
  ABI at rest: right leg: 0.8; left leg: 0.8; post exercise 0.6 / 0.6
  Duplex: distal occlusion of infrarenal abdominal aorta and the origins of both CIAs
  Patent inferior mesenteric artery, bilateral internal and external iliac arteries
  
  PROCEDURAL STEPS
  1. Retrograde access
  - Insertion of 6F 90 cm shuttle sheath via left brachial artery and insertion of a 23 cm long 7F sheath into each CFA
  
  2. Antegrade crossing attempt of the aortic occlusion
  - 5F vertebral catheter, 0.035'' Gluidewire (TERUMO) into one of the CIAs
  
  3. Predilatation
  - 5 mm Admiral balloon (MEDTRONIC)
  
  4. Retrograde crossing attempt of the contralateral CIA
  
  5. Predilatation
  - 5 mm Powerflex balloon (CORDIS)
  
  6. Stenting of distal abdominal aorta
  - Smart 14/40 mm stent (CORDIS)
  
  7. Stenting of both CIAs
  - Restorer balloon expandable stents (iVASCULAR)
  
• Thursday, January 26th: 9:38 - 9:58, Room 1 - Main Arena 1

  Case 58 – Excimer laser assisted drug coated balloon recanalisation of popliteal ISR

  Center:

  Bad Krozingen

  Case 58 – BK 01: male, 66 years (K-K)

  Operators:

  • Thomas Zeller

  CLINICAL DATA
  Calf claudication left leg after 100m since 3 months (PAOD Fontaine IIb/Rutherford 3)
  Stent recanalisation left popliteal artery 2012
  DCB angioplasty and stent-in-stent angioplasty of left popliteal ISR 01/2016
  
  PRESENT STATE
  CVRF: arterial hypertension, ex nicotine, hypercholesterinemia
  ABI at rest: right leg: 1.1; left leg: 0.3
  Duplex: instent reocclusion of left popliteal artery
  
  PROCEDURAL STEPS
  1. Antegrade access, 6F, left CFA
  
  2. Crossing attempt of the popliteal artery occlusion
  - 0.014'' Advantage 14 GW (TERUMO)
  
  3. Laser debulking of the occlusion
  
  - Turbo elite, 2.3 mm (SPECTRANETICS)
  
  4. Postdilatation
  - 5/100 mm Stellarex DCB (SPECTRANETICS)
  
• Thursday, January 26th: 10:30 - 10:55, Room 2 - Main Arena 2

  Case 68: Bad Krozingen

  Center:

  Bad Krozingen

  Case 68 – BK 05: male, 60 years

  Operators:

  • Martin Czerny

  Information will follow in due time.
• Thursday, January 26th: 11:17 - 11:36, Room 1 - Main Arena 1

  Case 60 – Stent angioplasty of le5 distal SFA with implanta on of a 3-dimensional helical stent

  Center:

  Bad Krozingen

  Case 60 – BK 02: male, 70 years (EW)

  Operators:

  • Elias Noory,
  • P. Krause

  CLINICAL DATA
  Calf claudication left leg after 200m (PAOD Fontaine IIb / Rutherford 3
  Stentangioplastie left renal artery 11/2016
  Rekanalisation (stent & DCB) right SFA 7/2015
  Stent angioplasty CIA&EIA both sides and PTA IIA right 09/201
  
  PRESENT STATE
  Ex-Nicotine
  Hypertension
  Hypercholesterinemia
  Diabetes mellitus type II
  ABI at rest: 0.5 / 0.6
  Oscillometry: Reduced amplitudes right tigh, calf & ankle
  Reduced amplitudes left calf & ankle
  Duplex:Calcified high grade stenosis of left distal SFA
  
  PROCEDURAL STEPS
  1. Antegrade access, 6F, left CFA
  
  2. Crossing of the SFA lesion with a 0.035’’ Glidewire (TERUMO)
  
  3. Predilatation of distal SFA (Powerflex 5mm, CORDIS)
  
  4. Implantation of a BioMimics stent 6 or 7 mm (VERYAN)
  
  5. Postdilatation (6/20mm Powerflex, CORDIS)
  
  

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• Thursday, January 26th: 13:30 - 17:00, Room 3 - Technical Forum

  Case 78 – Combined antegrade and retrograde recanalisation of right ATA & PTA

  Center:

  Bad Krozingen

  Case 78 – BK 07: male, 62 years, (B-N)

  Operators:

  • Thomas Zeller

  CLINICAL DATA
  Non-healing crural ulcer right calf (PAOD Fontaine IV / Rutherford 5)
  11/2016 recanalisation of right SFA, popliteal artery & TPT
  11/2014 recanilsation of right SFA, popliteal artery & TPT (DCB and spot stenting)
  DVT right leg 10/2014
  
  RISK FACTORS
  CVRF: hyperlipidemia, obesity
  ABI at rest: right leg: 0.6; left leg: 1.0
  Duplex: persistent occlusion of right ATA /& PTA
  
  PROCEDURAL STEPS
  1. Antegrade sheath insertion 6F, right CFA
  Insertion of a 5F Envoy guiding catheter (CORDIS)
  
  2. Attempt to antegradely recanalise the PTA (predilatation followed by DCB, Chocolate touch, TRIREME)
  
  3. Retrograde recanalisation of ATA (predilatation followed by DCB)
  
  4. Sheath removal in the groin with Femoseal (TERUMO)
  

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• Thursday, January 26th: 14:23 - 14:48, Room 1 - Main Arena 1

  Case 63 – Stentgraft reconstruction of ISR of aortic bifurcation

  Center:

  Bad Krozingen

  Case 63 – BK 03: female, 41 years (G-A)

  Operators:

  • Elias Noory,
  • Aljoscha Rastan

  CLINICAL DATA
  Bilateral PAOD Rutherford 2 / Fontaine IIa
  Bilateral CIA stent-angioplasty 10/2014
  Bilateral chronic venous insufficiency
  
  PRESENT STATE
  CVRF: ex-smoker, hyperlipidemia, obesity
  ABI at rest: right leg: 0.8; left leg: 0.6
  Duplex: Bilateral high grade ISR at the origin of the CIA
  
  PROCEDURAL STEPS
  1. Bilateral retrograde access
  - 23 cm long 7F sheath into the CFA (CORDIS)
  
  2. Crossing of ISR
  - 0.035'' guidewire (TERUMO)
  
  3. Bilateral stentgraft implantation in a modified kissing stent fashion
  - BeGraft 8 mm (BENTLEY)
  
  4. Sheath removal
  - Femoseal (TERUMO)
  

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• Thursday, January 26th: 16:44 - 17:08, Room 1 - Main Arena 1

  Case 65 – Directional atherectomy & DCB of right CFA

  Center:

  Bad Krozingen

  Case 65 – BK 04: female, 56 years (B-M)

  Operators:

  • Aljoscha Rastan,
  • Thomas Zeller

  CLINICAL DATA
  PAOD Rutherford 2 / Fontaine IIb right leg
  Recanalisation left CIA 12/2016
  Stent reconsruction of aortic bifurcation 2014
  
  PRESENT STATE
  CVRF: ex-smoker, hyperlididemia
  ABI right leg: 0.6; left leg: 1.0
  Duplex: high grade stenosis of right CFA
  
  PROCEDURAL STEPS
  1. Left transbrachial retrograde access
  - 6F 90 cm shuttle sheath (COOK)
  
  2. Filter placement
  - 6 mm Spider filter (MEDTRONIC) distal right SFA
  
  3. Directional atherectomy
  - Turbohawk SX-C (MEDTRONIC)
  
  4. Drug coated balloon angioplasty
  - 7/40 mm Inpact Pacific (MEDTRONIC)
  
  5. Stenting on indication
  

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