Conference day 3

• 8:00 - 8:25, Room 1 - Main Arena 1

  Case 56 – Multilevel disease with CLI right

  Center:

  Leipzig, Dept. of Angiology

  Case 56 – LEI 21: male, 72 years (P-F)

  Operators:

  • Andrej Schmidt,
  • Yvonne Bausback

  CLINICAL DATA
  Critical limb ischemia right leg, restpain, Rutherford class 4
  PTA SFA and popliteal artery right and failed antegrade recanalization
  of a tibioperoneal trunk occlusion right elsewhere 12/2015
  Persistent atrial fibrillation
  
  ANGIOGRAPHY
  high-grade stenosis SFA and popliteal artery right,
  occlusion of the tibioperoneal trunk
  ABI 0,21
  
  PROCEDURAL STEPS
  1. Left groin retrograde and cross-over approach
  - 0.035" SupraCore guidewire 190 cm (ABBOTT)
  - 6F-40 cm Balkin Up&Over Sheath (COOK)
  
  2. Guidewire-passage of the SFA/popliteal stenoses and PTA
  - predilatation with 0.014" NanoCross balloon (MEDTRONIC)
  
  After failed antegrade GW-passage:
  3. Retrograde passage via the peroneal artery
  - 21 Gauge 7 cm needle (COOK)
  - 0.018" V-18 Controll-GW 300 cm (BOSTON SCIENTIFIC)
  - 0.018" QuickCross support catheter 90 cm (SPECTRANETICS)
  
  4. PTA with a drug-coated balloon
  - Chocolate Touch 6.0/120 mm (TRIREME MEDICAL)
  

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• 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)
  
• 8:00 - 9:30, Room 3 - Technical Forum

  Case 74 – Hybrid operation for ilio-femoral occlusion

  Center:

  Münster

  Case 74 – MUN 13: male, 58 years (H-H)

  Operators:

  • Theodosios Bisdas,
  • Martin Austermann,
  • Stefan Stahlhoff

  CLINICAL DATA
  Rutherford 3 right limb, ABI:0.4, no peripheral pulses
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia, current smoker (30 p/y)
  
  PROCEDURAL STEPS
  1. Cut down right groin, Puncture of the CFA and recanalization of the EIA occlusion with a 0.035" wire (Advantage, TERUMO) or an 0.018" wire (V18, BOSTON SCIENTIFIC)
  Use of a Quick Cross catheter (SPECTRANETICS)
  
  2. Arteriotomy and endarterectomy of CFA and proximal SFA
  Use of a ring stripper and a Forgarty catheter for endarterectomy of the EIA
  
  3. Stenting of the EIA with a 7 x 80 mm Complete stent (MEDTRONIC)
  
  4. Patchplasty of the CFA with a Dacron Patch (MAQUET) and control angiography
  
  5. Wound closure
  

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• 8:46 - 9:11, Room 1 - Main Arena 1

  Case 57 – Diffuse occlusion of P3, BTK, and BTA

  Center:

  Abano Terme

  Case 57 – ABT 01: male, 77 years

  Operators:

  • Marco Manzi,
  • Luis Mariano Palena,
  • Cesare Brigato

  Information will follow in due time.

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• 8:48 - 9:23, Room 2 - Main Arena 2

  Case 67 – TEVAR of a subacute Type B aortic dissection

  Center:

  Leipzig, Dept. of Angiology

  Case 67 – LEI 25: male, 64 years

  Operators:

  • Andrej Schmidt,
  • Daniela Branzan

  CLINICAL DATA
  Acute Type-B dissection 6 weeks ago, since then intermittend thoracic pain
  CT 4 weeks later: diameter-increase of the descending aorta of 5 mm
  Coiling of intercostal arteries to reduce the risk of spinal cord ischemia during TEVAR
  Art. hypertension, former smoker
  
  CT-SCAN
  2 focal dissections of the descending thoracic aorta,
  both have an entry without reentry,
  max. diameter of the aorta 46m
  
  PROCEDURAL STEPS
  1. Bilateral femoral access
  - Preloading of Proglide-Systems right (ABBOTT)
  
  2. Positioning of guidewire
  - LunderQuist 0.035" 260 cm (COOK)
  
  3. Implantation of 2 thoracic stentgrafts
  - Ankura thoracic graft (LIFETECH)
  - Stengraft from left subclavian artery to the celiac trunk
  

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• 9:30 - 11:30, Room 3 - Technical Forum

  Case 75 – Abano Terme

  Center:

  Abano Terme

  Case 75 – ABT 02: female, 82 years

  Operators:

  • Marco Manzi,
  • Luis Mariano Palena,
  • Cesare Brigato

  Information will follow in due time.

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• 9:30 - 11:30, Room 3 - Technical Forum

  Case 76 – CLI, popliteal artery occlusion

  Center:

  Leipzig, Dept. of Angiology

  Case 76 – LEI 26: male, 81 years (H-L)

  Operators:

  • Andrej Schmidt,
  • Sven Bräunlich

  CLINICAL DATA
  Critical limb ischemia with gangrene dig 4/5 left, Rutherford 5
  Failed recanalization of a popliteal occlusion left
  CEA left femoral bifurcation 1/2017
  CAD, PTCA 2004
  Chronic heart failure, EF 40%
  Diabetes mellitus, type 2
  Chronic renal insufficiency with GFR 55 ml/min
  
  PRESENT STATE
  Angiography before CEA left groin
  ABI left 1.3, mediasclerosis
  
  PROCEDURAL STEPS
  1. Left groin retrograde and cross-over approach
  - IMA-diagnostic 5F catheter (CORDIS/CARDINAL HEALTH)
  - 0.035" angled soft Radiofocus guidewire, 190 cm (TERUMO)
  - 0.035" SupraCore guidewire, 190 cm (ABBOTT)
  - 6F 55 cm Check-Flow Performer, Raabe Modification (COOK)
  
  2. Guidewire passage
  second attempt from antegarde:
  - 0.018" Connect Flex guidewire, 300 cm (ABBOTT)
  - 0.018" Seeker support catheter, 135 cm (C.R. BARD)
  
  In case of failure of GW-passage from antegrade:
  3. Retrograde approach via the posterior tibial artery
  - 2.9F sheath (pedal puncture set) (COOK)
  - 0.014" CTO-Approach 25 gramm guidewire, 300 cm (COOK)
  - 0.018" CXI support catheter 90 cm (COOK)
  - Advance Micro-Balloon 3.0/120 mm, 90 cm (COOK)
  
  4. PTA of the distal SFA/popliteal artery occlusion
  - AngioSculpt 4.0/100 mm Scoring balloon (SPECTRANETICS)
  - Stellarex 4.0 or 5.0/120 mm DCB (SPECTRANETICS)
  
  5. Stenting on indication
  - Supera Interwoven Nitinol stent (ABBOTT)
  

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• 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)
  
• 10:18 - 10:55, Room 1 - Main Arena 1

  Case 59 – Diffuse subtotal stenosis distal SFA / popliteal artery

  Center:

  Leipzig, Dept. of Angiology

  Case 59 – LEI 22: male, 71 years

  Operators:

  • Sven Bräunlich,
  • Matthias Ulrich

  CLINICAL DATA
  Restpain and Severe claudication left leg, Rutherford class 4
  CAD, PTCA 2012, Chronic heart failure, EF 35%
  Diabetes mellitus, type 2
  Art. hypertension, former smoker
  
  DUPLEX
  Left distal SFA and popliteal artery with long subtotal stenosis,
  Moderately calcified, diffuse BTK-stenoses
  ABI left 0.32
  
  PROCEDURAL STEPS
  1. Right groin retrograde and cross-over approach
  - 6F 55 cm Check-Flo Performer, Raabe Modification (COOK)
  
  2. Guidewire passage
  - PT2 0.014” 300cm guidewire (BOSTON SCIENTIFIC)
  - QuickCross support catheter (SPECTRANETICS)
  
  3. PTA
  
  - AngioSculpt scoring balloon 5.0/100 mm (SPECTRANETICS)
  - Exchange to a 0.035" SupraCore guidewire (ABBOTT)
  - Stellarex DCB (SPECTRANETICS)
  
• 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.
• 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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• 11:53 - 12:18, Room 1 - Main Arena 1

  Case 61 – Münster

  Center:

  Münster

  Case 61 – MUN 08: male, 61 years

  Operators:

  • Arne Schwindt,
  • Stefan Stahlhoff

  Information will follow in due time.

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• 12:30 - 13:25, Room 1 - Main Arena 1

  Case 61b - Total ATA-occlusion, CLI left forefoot

  Center:

  Leipzig, Dept. of Angiology

  Case 61b - LEI22b: male, 72 years (W-J)

  Operators:

  • Andrej Schmidt,
  • Sven Bräunlich

  CLINICAL DATA
  Critical limb ischemia left, gangrene Dig 2-4,
  CAD, PTCA 2012, chronic heart failure, NYHA II-III
  Art. Hypertension, diabetes mellitus type 2
  Previous PTA / stenting BTK for CLI 2010
  Failed recanalization-attempt 1/2017
  
  ANGIOGRAPHY
  from previous unsuccessful recanalization attempt
  
  PROCEDURAL STEPS
  1. Left antegrade access
  - 6Fr-55cm Check-Flo Sheath, Raabe Modification (COOK)
  
  2. Retrograde access via dorsalis pedis artery
  - 2.9 Pedal Introducer Access Set (COOK)
  
  3. Passage of the occlusion (retrograde)
  - CXI support-catheter, 0.018”, 90 cm (COOK)
  - Hydro-ST 0.014” Guidewire, 300cm (COOK)
  - Approach CTO 25gramm Guidewire, 300cm (COOK)
  
  4. PTA (BTK-bifurcation in kissing technique)
  - retrograde: Advance Micro Balloon 3.0/120mm, 90cm (COOK)
  - antegrade: Advance LP 3.0/40mm Balloon (COOK)

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• 12:30 - 13:30, Room 1 - Main Arena 1

  Case 61c – Leipzig

  Center:

  Leipzig, Dept. of Angiology

  Case 61c – LEI 22c: male, 66 years

  Operators:

  • Andrej Schmidt,
  • Sven Bräunlich

  CLINICAL DATA
  - CLI, Ulceration D5 right
  - ABI right 0.4
  
  RISK FACTORS
  - Arterial hypertension
  - Former smoker
  - Diabetes mellitus, type 2
  
  PROCEDURAL STEPS
  1. Right groin antegrade access
  3. Recanalization of the anterior tibial artery
  3. Retrograde access 3F: dorsalis pedis artery
• 13:30 - 13:55, Room 1 - Main Arena 1

  Case 62 – Total occlusion of the common iliac artery left

  Center:

  Leipzig, Dept. of Angiology

  Case 62 – LEI 23: female, 70 years (C-L)

  Operators:

  • Sven Bräunlich,
  • Andrej Schmidt

  CLINICAL DATA
  Severe claudication left, walking capacity 50-100 meters
  Art. hypertension, nicotine-abuse
  CAD, PTCA 11/2015
  
  ANGIOGRAPHY ELSEWHERE
  Common iliac artery occlusion left moderately calcified
  
  PROCEDURAL STEPS
  1. Left femoral access
  - 7F 25 cm Radiofocus Introducer (TERUMO)
  - 0.035" SupraCore guidewire 300 cm (ABBOTT)
  Left brachial approach:
  - 7F 90 cm Check-Flo Performer (COOK)
  
  2. Antegrade and retrograde guidewire passage
  brachial:
  - 5F Judkins Right diagnostic catheter 125 cm (CORDIS/CARDINAL HEALTH)
  from femoral:
  - 5F Multipurpose diagnostic catheter 80 cm (CORDIS/CARDINAL HEALTH)
  - 0.035" stiff angled glidewire, 260 cm (TERUMO)
  
  3. Predilatation and stenting of the aorto-iliac bifurcation
  - Armada 35 6/40 mm ballon (ABBOTT)
  - LifeStream covered stent 7/58 bilateral in kissing-technique (C.R. BARD)
  

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• 13:30 - 17:00, Room 3 - Technical Forum

  Case 77 – Extremely calcified SFA CTO left, "pave and crack"-technique

  Center:

  Leipzig, Dept. of Angiology

  Case 77 – LEI 27: male, 69 years (S-F)

  Operators:

  • Andrej Schmidt,
  • Matthias Ulrich

  CLINICAL DATA
  Restpain during night and severe calcification left, Rutherford 4
  Failed recanalization attempt left leg 11/2015
  PTA/stenting right SFA-CTO 12/2016
  Art. hypertension, diabetes mellitus, type 2
  Former smoker
  
  PROCEDURAL STEPS
  1. Right groin retrograde and cross-over approach
  - IMA 5F diagnostic catheter (CORDIS/CARDINAL HEALTH)
  - 0.035" soft angled Radiofocus guidewire, 190 cm (TERUMO)
  - 0.035" SupraCore guidewire 190 cm (ABBOTT)
  - 7F 55 Check-Flo Performer Sheath, Raabe Modification (COOK)
  
  2. Antegrade guidewire passage
  - 0.035" Stiff angled Glidewire, 260 cm (TERUMO)
  - CXC 0.035" support catheter, 135 cm (COOK)
  
  3. Retrograde guidewire passage:
  Access via the proximal anterior tibial artery:
  - 7 cm 21 Gauge needle (COOK)
  - 0.018" V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
  - 4Fr-10cm Radiofocus Introducer (TERUMO)
  - Pacific Plus 4.0/40 mm balloon, 90 cm (MEDTRONIC)
  
  4. PTA and stenting
  - 6.0/20mm Admiral Xtreme Balloon (MEDTRONIC)
  - 7.0/20 Conquest non-compliant high-pressure balloon (C.R. BARD)
  - In case of inability to open the balloons fully implantation of a Viabahn 7.0/100 mm (GORE)
  - Relining with Supera Interwoven Nitinol stent (ABBOTT)
  

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• 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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• 13:30 - 17:00, Room 3 - Technical Forum

  Case 79 – POP-BTK and foot vessels occlusion

  Center:

  Abano Terme

  Case 79 – ABT 03: male, 68 year

  Operators:

  • Marco Manzi,
  • Luis Mariano Palena,
  • Cesare Brigato

  Information will follow in due time.

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• 13:30 - 17:00, Room 3 - Technical Forum

  Case 79b – AT-PT and arch occlusion

  Center:

  Abano Terme

  Case 79b – ABT 03b: male, 76 years

  Operators:

  • Marco Manzi

  Information will follow in due time.
• 13:38 - 14:03, Room 2 - Main Arena 2

  Case 69 – Endovascular repair of an AAA with Endurant Endograft and additional proximal fixation with Heli-FX EndoAnchors

  Center:

  Münster

  Case 69 – MUN 10: female, years (H-R)

  Operators:

  • Martin Austermann,
  • Özgun Sensebat,
  • Stefan Stahlhoff

  CLINICAL DATA
  Growing abdominal aortic aneurysm with conical neck from 4,5 cm to 5,5 cm
  PAD with severe calcified and stenosed iliac arteries
  
  RISK FACTORS
  CAD – PTCA and PM-Implantation 5/16, chronic heart failure,
  carotid stenosis both sides, PAD – venous bypass 11/06
  
  PROCEDURAL STEPS
  1. Percutanous approach both groins
  - Prostar XL (ABBOTT)
  - Placement of 14F sheath (COOK)
  
  2. Placement of Endurant bifurcated endograft (MEDTRONIC) just below the RA`s
  
  3. Additional fixation of the proximal sealing zone
  - Heli-FX Endoanchors (MEDTRONIC)
  
  4. Closure of the groin
  - Prostar XL (ABBOTT)
  

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• 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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• 14:27 - 14:50, Room 2 - Main Arena 2

  Case 70 – Münster

  Center:

  Münster

  Case 70 – MUN 11: male, 88 years

  Operators:

  • Theodosios Bisdas,
  • Stefan Stahlhoff

  Information will follow in due time.

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• 15:28 - 16:05, 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
  

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• 15:39 - 16:06, Room 1 - Main Arena 1

  Case 64 – Münster

  Center:

  Münster

  Case 64 – MUN 09: female, 60 years

  Operators:

  • Arne Schwindt,
  • Stefan Stahlhoff

  Information will follow in due time.

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• 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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• 16:54 - 17:32, Room 2 - Main Arena 2

  Case 72 – Münster

  Center:

  Münster

  Case 72 – MUN 12: female, 52 years (S-M)

  Operators:

  • Martin Austermann,
  • Theodosios Bisdas,
  • Giovanni Torsello

  Information will follow in due time.

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• 17:22 - 17:46, Room 1 - Main Arena 1

  Case 66 – Popliteal occlusion left

  Center:

  Leipzig, Dept. of Angiology

  Case 66 – LEI 24: female, 79 years (A-M)

  Operators:

  • Andrej Schmidt,
  • Matthias Ulrich

  CLINICAL DATA
  Restpain left foot, Rutherford class 4
  PTA/stenting aortic bifurcation 11/2016
  D iabetes mellitus, type 2
  Art. Hypertension
  
  ANGIOGRAPHY
  During PTA of the aortic bifurcation:
  moderately calcified distal SFA/P1-occlusion left
  
  PROCEDURAL STEPS
  1. Antegrade approach left
  - 7F 55 cm Check-Flo Sheath, Raabe Modification (COOK)
  
  2. Guidewire passage
  - 5.0/40 mm Pacific Plus balloon, 90 cm (MEDTRONIC)
  - 0.018" Victory guidewire, 18 gramm, 30 cm (BOSTON SCIENTIFIC)
  
  3. PTA and stenting
  - 6.0/40mm Pacific Plus balloon, 90 cm (MEDTRONIC)
  - Supera Interwoven Nitinol stent (ABBOTT)
  

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