Leipzig, Dept. of Angiology

• Tuesday, January 28th: 8:13 - 8:38, Room 1 - Main Arena 1

  Case 01 – Long SFA-reocclusion right

  Center:

  Leipzig, Dept. of Angiology

  Case 01 – LEI 01: male, 59 years (K-A)

  Operators:

  • Sven Bräunlich,
  • Matthias Ulrich

  CLINICAL DATA
  PAOD Rutherford 3, severe claudication right calf,
  walking capacity 150m, ABI right 0.65
  PTA with DCBs 10/18
  Osteoporosis
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia, current smoker (40PY)
  
  PROCEDURAL STEPS
  1. Left groin retrograde and cross-over approach
  – 0.035'' SupraCore guidewire 190 cm (ABBOTT)
  – 7F 40 cm Balkin Up&Over sheath (COOK)
  2. Guidewire passage
  – Command 18 and Armada 18 balloon (ABBOTT) or
  – 0.035'' Radiofocus soft angled guidewire, 260 cm (TERUMO)
  3. In case of failure to pass the CTO
  – GoBackTM Crossing Catheter (Upstream Peripheral)
  4. PTA
  – 4.0 – 6.0 mm Armada 35 balloon (ABBOTT)
  – Conquest high pressure balloon on indication (BARD)
  5. Stenting
  – 5.0 or 6.0/150 mm Supera Interwoven Selfexpanding Nitinol stent (ABBOTT)

  View image
• Tuesday, January 28th: 8:54 - 9:19, Room 1 - Main Arena 1

  Case 02 –Calcified CTO of the left distal SFA and left popliteal artery

  Center:

  Leipzig, Dept. of Angiology

  Case 02 – LEI 02: male, 67 years (H-F)

  Operators:

  • Andrej Schmidt,
  • Axel Fischer

  CLINICAL DATA
  PAOD Rutherford III left, painfree walking distance 10 m, ABI left: 0.3
  CAD, CABG 2017, terminal kidney disease (dialysis)
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia
  
  PROCEDURAL STEPS
  1. Right groin retrograde and cross-over approach
  – 0.035'' SupraCore guidewire 190 cm (ABBOTT)
  – 7F 40 cm Balkin Up&Over sheath (COOK)
  2. Guidewire passage
  – Command 18 and Armada 18 balloon (ABBOTT) or
  – 0.035'' Radiofocus soft angled guidewire, 260 cm (TERUMO)
  3. In case of failure to pass the CTO
  – Retrograde approach via left peroneal artery
  4. Vessel preparation/ PTA
  – 4.0 – 6.0 mm Armada 35 balloon (ABBOTT)
  – Conquest high pressure balloon on indication (BARD/ BD)
  5. Stenting
  – 5.5/120 mm Supera Interwoven Selfexpanding Nitinol stent (ABBOTT)

  View image
• Tuesday, January 28th: 9:44 - 10:04, Room 2 - Main Arena 2

  Case 11 – Chronic occlusion of the abdominal aorta, Leriche-Syndrome

  Center:

  Leipzig, Dept. of Angiology

  Case 11 – LEI 06: female, 59 years (M-P)

  Operators:

  • Andrej Schmidt,
  • Matthias Ulrich

  CLINICAL DATA
  PAOD Rutherford 5 left, ulceration Dig. 5 left, ABI right 0.22, left 0.33
  Severe claudication both calves, absolute walking capacity 30–50 meters
  
  RISK FACTORS
  Art. hypertension, diabetes mellitus type 2, nicotine abuse (35PY)
  
  CT
  Chronic, thrombus-containing occlusion of the infrarenal aorta and severe stenosis both iliac arteries
  
  PROCEDURAL STEPS
  1. Transbrachial approach
  – 6F 90 cm Check-Flo performer sheath (COOK)
  – 5F 125 cm diagnostic Judkins Right catheter (CORDIS/CARDINAL HEALTH)
  – SupraCore 300 cm 0.035'' guidewire (ABBOTT)
  2. Passage of the occlusions
  – Stiff angled 0,035'' guidewire, 260 cm (TERUMO)
  – Together with 5F 125 cm Judkins Right catheter
  3. Bilateral groin access
  – 7F 10 cm Radiofocus sheath (TERUMO)
  – Snaring of the antegrade guidewire from above into the groin-sheath or
  – Into 6F-Judkins-Right
  4. PTA/ thrombectomy via the groin access bilateral
  – Rotarex 10F thrombectomy (STRAUB MEDICAL)
  – SupraCore 300 cm 0,035'' guidewire (ABBOTT)
  – Admiral balloon 6.0/120 mm bilateral (MEDTRONIC)
  5. Implantation of covered stents
  – VBX covered stents for both renal arteries (GORE)
  – VBX covered stents bilateral in kissing technique (GORE)

  View image
• Tuesday, January 28th: 11:06 - 11:26, Room 1 - Main Arena 1

  Case 03 – Subacute occlusion of the right SFA

  Center:

  Leipzig, Dept. of Angiology

  Case 03 – LEI 03: male, 63 years (A-F)

  Operators:

  • Sven Bräunlich,
  • Andrej Schmidt

  CLINICAL DATA
  PAOD Rutherford 3, walking capacity 100 m, ABI right 0.49
  PTA/stent left SFA 12/2019
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia, former smoker (30PY)
  
  PROCEDURAL STEPS
  1. Left groin and cross-over approach
  – Judkins Right 5F diagnostic catheter (CORDIS/CARDINAL HEALTH)
  – 0.035'' SupraCore guidewire 30 cm (ABBOTT)
  – 7F - 40 cm Balkin Up&Over sheath (COOK)
  2. Guidewire passage of the occlusion
  – 0.018'' Command 18 300 cm (ABBOTT)
  – 0.035'' QuickCross support catheter, 135 cm (PHILIPS)
  – Exchange to a 0.014'' Floppy ES guidewire 300 cm (ABBOTT)
  – Confirm intraluminal position with Vision PV 0.14 IVUS (PHILIPS)
  3. Laser atherectomy
  – 7F Turbo Power Laser with Turbo Elite 2.3 mm catheter (PHILIPS)
  4. PTA with DCBs
  – Stellarex 5.0/120 mm or 6.0/120 mm DCBs (PHILIPS)
  5. Stenting on indication:
  - Tack Endovascular System (INTACT VASCULAR INC.)

  View image
• Tuesday, January 28th: 11:32 - 11:52, Room 1 - Main Arena 1

  Case 03b – LEI 03b

  Center:

  Leipzig, Dept. of Angiology

  Case 03b – LEI 03b

  Operators:

  • Andrej Schmidt,
  • Matthias Ulrich

  Detailed information will be shown in the video itself!
• Tuesday, January 28th: 14:15 - 15:00, Room 3 - Technical Forum

  Case 20 – CTO of the proximal SFA right

  Center:

  Leipzig, Dept. of Angiology

  Case 20 – LEI 07: male, 68 years, (V-S)

  Operators:

  • Matthias Ulrich,
  • Axel Fischer

  CLINICAL DATA
  PAOD Rutherford 3 right, walking capacity 150m
  DCB-PTA right 11/2017, ABI right 0.66
  Multiple interventions left SFA (stent, PTA, DCB) COPD
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia, nicotin abuse (50PY)
  
  PROCEDURAL STEPS
  1. Left groin retrograde and cross-over approach
  – 0.035'' SupraCore guidewire 190 cm (ABBOTT)
  – 7F 40 cm Balkin Up&Over sheath (COOK)
  2. Passage of the occlusion right SFA
  – 0.035'' Radiofocus angled stiff guidewire, 260 cm (TERUMO)
  – 0.035'' CXC support catheter, 135 cm (COOK)
  
  In case of failure guidewire passage from antegrade:
  3. Retrograde approach via distal SFA
  – 7 cm 21 Gauge needle (COOK)
  – 0.018'' V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
  – 4F 10 cm Radiofocus introducer (TERUMO)
  – Pacific Plus 4.0/40 mm balloon, 90 cm (MEDTRONIC)
  4. Vessel preparation
  – Pacific 2.0/120 mm balloon (MEDTRONIC)
  – VascuTrak 5.0/120 mm balloon (BARD/BD)
  5. Stenting on indication
  – 5 mm or 6 mm Biomimics 3D stent (VERYAN MEDICAL)

  View image
• Tuesday, January 28th: 14:24 - 14:49, Room 1 - Main Arena 1

  Case 06 – 3-vessel disease BTK right

  Center:

  Leipzig, Dept. of Angiology

  Case 06 – LEI 04: male, 78 years (A-T)

  Operators:

  • Andrej Schmidt,
  • Matthias Ulrich

  CLINICAL DATA
  Critical limb ischemia right, rest-pain right forefoot
  Walking capacity 50 meters, ABI right 0.49
  
  Imaging
  Duplex: occlusion of all BTK-arteries
  DSA: TPT-occlusion, long occlusions of the ATA and PTA
  
  PROCEDURAL STEPS
  1. Antegrade access right
  – 6F 55 cm sheath Flexor Check-Flo Introducer Raabe Modification (COOK)
  2. Guidewire passage of the TPT
  – 0.014'' Command ES (ABBOTT) or
  – 0.014'' Winn 200 T (ABBOTT)
  3. Atherectomy of the TPT
  – TurboHawk SX-C (MEDTRONIC)
  potentially also atherectomy of the ATA-origin
  4. Balloon dilatation of the TPT and ATA
  – Amphirion Deep (MEDTRONIC)
  5. Stenting on indication:
  - Tack Endovascular System (INTACT VASCULAR INC.)

  View image
• Tuesday, January 28th: 16:03 - 16:20, Room 1 - Main Arena 1

  Case 07 – LEI 05

  Center:

  Leipzig, Dept. of Angiology

  Case 07 – LEI 05

  Operators:

  • Andrej Schmidt,
  • Axel Fischer

  Detailed information will be shown in the video itself!
• Tuesday, January 28th: 16:30 - 18:00, Room 3 - Technical Forum

  Case 22 – Total occlusion of the left CIA and EIA

  Center:

  Leipzig, Dept. of Angiology

  Case 22 – LEI 08: female, 55 years (B-A)

  Operators:

  • Sven Bräunlich,
  • Matthias Ulrich

  CLINICAL DATA
  PAOD Rutherford 3, claudication left calf, walking capacitiy 50m, ABI left 0.45
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia, nicotine abuse (35PY)
  
  PROCEDURAL STEPS
  1. Left femoral access
  – 7F 25 cm Radiofocus Introducer (TERUMO)
  – 0.035'' SupraCore guidewire 300 cm (ABBOTT)
  Left brachial approach:
  – 6F 90 cm Check-Flo Performer (COOK)
  2. Antegrade and retrograde guidewire passage
  brachial:
  v5F 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
  – Ultraverse or Dorado balloon (BARD/BD)
  – LifeStream covered stent 8/58 mm bilateral common iliac arteries in kissing-technique (BARD/BD)
  – Covera Plus vascular covered stent for the external iliac artery (BARD/BD)

  View image
• Wednesday, January 29th: 8:00 - 8:20, Room 5 - Global Expert Exchange

  Case 50 – Calcified distal SFA-occlusion right

  Center:

  Leipzig, Dept. of Angiology

  Case 50 – LEI 17: female, 73 years (K-R)

  Operators:

  • Sven Bräunlich,
  • Axel Fischer

  CLINICAL DATA
  PAOD Rutherford 5, ulceration dig. 1 right, severe claudication right calf, walking capacity 20 m, ABI right 0.45
  Amputation Dig. 5 right 2015
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia, diabetes mellitus type 2
  
  PROCEDURAL STEPS
  1. Left groin and cross-over approach
  – Judkins Right 5F diagnostic catheter (CORDIS/ CARDINAL HEALTH)
  – 0,035'' SupraCore guidewire 30 cm (ABBOTT)
  – 6F-40 cm Balkin Up&Over sheath (COOK)
  2. Guidewire passage
  – 0.035'' stiff, angled glidewire, 260 cm (TERUMO)
  – 0.035'' Seeker support catheter, 135 cm (BARD/ BD)
  3. Angioplasty
  – UltraScore 5.0/300 mm balloon (BARD/BD)
  – Lutonix GEOALIGN marking system DCB 6.0/120 mm (BARD/ BD)
  4. Stenting on indication
  – LifeStent (BARD/ BD)

  View image
• Wednesday, January 29th: 8:35 - 8:55, Room 1 - Main Arena 1

  Case 24 – LEI 09

  Center:

  Leipzig, Dept. of Angiology

  Case 24 – LEI 09

  Operators:

  • Andrej Schmidt,
  • Matthias Ulrich

  Detailed information will be shown in the video itself!
• Wednesday, January 29th: 10:02 - 10:27, Room 1 - Main Arena 1

  Case 25 – Calcified SFA-occlusion left

  Center:

  Leipzig, Dept. of Angiology

  Case 25 – LEI 10: male, 77 years (N-B)

  Operators:

  • Sven Bräunlich,
  • Axel Fischer

  CLINICAL DATA
  PAOD Rutherford class 3, severe claudication left, walking capacity 50 m, ABI 0.5
  Multiple interventions both SFA
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia
  
  PROCEDURAL STEPS
  1. Right femoral retrograde and cross-over approach
  – 7F 55 cm Check-Flo Performer, Raab Modification (COOK)
  2. Passage of the occlusion left SFA
  – 0.018'' V-18 or Victory guidewire (BOSTON SCIENTIFIC)
  – 0.018'' Rubicon support catheter (BOSTON SCIENTIFIC)
  3. Guidewire passage and filter placement
  – 0.018'' V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
  4. Atherectomy
  – 2.4/3.4 mm JetStream atherectomy device (BOSTON SCIENTIFIC)
  5. PTA with DCBs and/or stenting
  – Ranger DCB balloon (BOSTON SCIENTIFIC)
  – Eluvia drug-eluting stent (BOSTON SCIENTIFIC)

  View image
• Wednesday, January 29th: 10:03 - 10:23, Room 2 - Main Arena 2

  Case 34 – Symptomatic infrarenal aortic aneursym

  Center:

  Leipzig, Dept. of Angiology

  Case 34 – LEI 13: female, 75 years (R-S)

  Operators:

  • Andrej Schmidt,
  • J. Rusinovich

  CLINICAL DATA
  Symptomatic infarenal aortic aneurysm (max. diam. 47 mm)
  Occasionally back-pain and abdominal pain
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia
  
  PROCEDURAL STEPS
  1. Bilateral femoral percutaneous access
  – Preloading of Proglide-Systems (ABBOTT)
  2. Coilembolisation of lumbar segmental arteries before EVAR
  – IMA 6F guiding catheter (MEDTRONIC)
  – SIM-I 5F diagnostic catheter (CORDIS-CARDINAL HEALTH)
  – 0.014'' PT2 guidewire (BOSTON SCIENTIFIC)
  – Progreat Micro Catheter System 2.7F 130 cm (TERUMO)
  – Microvascular Plugs (MEDTRONIC) and Amplatzer Plug for the IMA (ABBOTT)
  3. Implantation of stentgraft system
  – Altura Ultra Low Profile stentgraft system (LOMBARD MEDICAL)

  View image
• Wednesday, January 29th: 10:30 - 10:55, Room 5 - Global Expert Exchange

  Case 51 – Directional atherectomy of CFA and DFA origin left

  Center:

  Leipzig, Dept. of Angiology

  Case 51 – LEI 18: female, 63 years (P-D)

  Operators:

  • Matthias Ulrich,
  • Sven Bräunlich

  CLINICAL DATA
  PAOD Rutherford 3, severe claudication left > right, walking capacity 20 m, ABI left 0.45, ABI right 0.7
  Aorto-bifemoral bypass (on CFA) 2007, failled recanalization attempt left elsewere
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia, former smoker, diabetes mellitus type 2
  
  IMAGING
  Angiography 01/20: midgrade infrarenal aortic stenosis, high grade stenosis of distal bypass-anastomosis and DFA left, SFA-occlusions both sides
  
  PROCEDURAL STEPS
  1. Right groin retrograde and cross-over approach
  – 0.035'' SupraCore guidewire 190 cm (ABBOTT)
  – 7F 40 cm Balkin Up&Over sheath (COOK)
  2. Guidewire passage and placement of an embolic protection
  – Command 18 guidewire, 300 cm (ABBOTT)
  – Placement of a SpiderFX 6 mm Embolic Protection System (MEDTRONIC)
  3. Atherectomy
  – Directional atherectomy with HawkOne (MEDTRONIC) of CFA and DFA origin
  4. PTA with DCB
  – 5 or 6 mm IN.PACT Admiral balloon (MEDTRONIC)
  5. Stenting on indication:
  - Tack Endovascular System (INTACT VASCULAR INC.)

  View image
• Wednesday, January 29th: 13:30 - 15:00, Room 3 - Technical Forum

  Case 45 – Subtotal asymptomatic restenosis of the left ICA after CEA

  Center:

  Leipzig, Dept. of Angiology

  Case 45 – LEI 15: female, 71 years (G-U)

  Operators:

  • Andrej Schmidt,
  • Sven Bräunlich

  CLINICAL DATA
  Asymptomatic highgrade stenosis of the internal carotid artery left, dizziness
  Mamarian carcinoma 2016 (surgery and radiation)
  CEA left 09/18, stroke 2013
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia, renal impairment G3
  
  DUPLEX
  4.2 m/sec, left distal internal carotid artery
  
  PROCEDURAL STEPS
  1. Right groin access
  – 5F Judkins Right diagnostic catheter (CORDIS/CARDINAL HEALTH)
  – 0.035'' SupraCore guidewire (ABBOTT)
  – 7F 90 cmTuohy-Borst sheath (COOK)
  2. Cerebral protection
  – Filter-wire EZ (BOSTON SCIENTIFIC)
  3. Predilatation and stenting
  – 3.5/20 mm MiniTrek Monorail balloon (ABBOTT)
  – 8/20 mm Roadsaver Carotid stent (TERUMO)

  View image
• Wednesday, January 29th: 13:54 - 14:04, Room 2 - Main Arena 2

  Case 36 – LEI 14

  Center:

  Leipzig, Dept. of Angiology

  Case 36 – LEI 14

  Operators:

  • Andrej Schmidt,
  • Manuela Matschuck

  Detailed information will be shown in the video itself!
• Wednesday, January 29th: 14:16 - 14:36, Room 1 - Main Arena 1

  Case 27 – Occlusion left tibial anterior artery, CLI

  Center:

  Leipzig, Dept. of Angiology

  Case 27 – LEI 11: male, 79 years (W-K)

  Operators:

  • Andrej Schmidt,
  • Axel Fischer

  CLINICAL DATA
  PAOD Rutherford 5, non-healing forefoot ulcerations, severe claudication left, walking capacity 20 m, ABI left 0.2
  PTA left peronal artery 12/19 with no clinical improvement
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia, diabetes mellitus
  
  PROCEDURAL STEPS
  1. Antegrade access left groin
  – 6F 55 cm Check-Flow Performer (COOK MEDICAL)
  2. Guidewire passage anterior tibial artery
  – 0.014'' Command (ABBOTT)
  – 0.014'' PT2 guidewire 300 cm (BOSTON SCIENTIFIC)
  In case of failure: retrograde approach
  3. Vessel preparation
  – 2.5/100 m Amphirion Deep ballon catheter (MEDTRONIC)
  4. PTA with Sirolimus coated balloon
  – 3.0/40 mm MagicTouch SCB balloon (CONCEPT MEDICAL)
  5. Stenting on indication:
  - Tack Endovascular System (INTACT VASCULAR INC.)

  View image
• Wednesday, January 29th: 16:41 - 17:01, Room 1 - Main Arena 1

  Case 31 – Long SFA-occlusion right in a CLI-Patient

  Center:

  Leipzig, Dept. of Angiology

  Case 31 – LEI 12: female, 74 years (S-P)

  Operators:

  • Andrej Schmidt,
  • Axel Fischer,
  • Sandra Düsing

  CLINICAL DATA
  Critical limb ischemia, minor gangrene dig 1 - 4 right, restpain and severe claudication right, ABI right 0.3
  PTA right EIA and CFA 12/19
  CAD, stroke 10/2019, COPD, MGUS
  
  RISK FACTORS
  Heavy smoker (50PY), arterial hypertension, hyperlipidemia
  
  PROCEDURAL STEPS
  1. Left femoral access and cross-over approach
  – 6F 45 cm cross-over sheath Fortress (BIOTRONIK)
  2. Passage of the occlusion right SFA
  – 0.018'' Command guidewire (ABBOTT)
  – 0.018'' Carnelian support catheter, 135 cm (BIOTRONIK)
  In case of failure guidewire passage from antegrade:
  3. Retrograde approach via distal SFA
  – 9 cm 20 Gauge spinal needle (BD)
  – 0.018'' V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
  – 4F 10 cm Radiofocus introducer (TERUMO)
  – Passeo 18 4.0/40 mm balloon, 90 cm (BIOTRONIK)
  4. PTA
  – Passeo 18 Ballon 5 x 150 mm (BIOTRONIK)
  – 5 mm Passeo 18 Lux DCB (BIOTRONIK)
  5. Stenting on indication
  – Pulsar 18-T3 stent (BIOTRONIK)

  View image
• Wednesday, January 29th: 17:44 - 18:00, Room 3 - Technical Forum

  Case 49 – LEI 16

  Center:

  Leipzig, Dept. of Angiology

  Case 49 – LEI 16

  Operators:

  • Andrej Schmidt,
  • Sven Bräunlich

  Detailed information will be shown in the video itself!
• Thursday, January 30th: 8:00 - 9:00, Room 3 - Technical Forum

  Case 67 – Long, moderately calcified SFA-occlusion left

  Center:

  Leipzig, Dept. of Angiology

  Case 67 – LEI 26: male, 61 years, (K-W)

  Operators:

  • Sven Bräunlich,
  • Matthias Ulrich

  CLINICAL DATA
  PAOD Rutherford 3, claudication left calf, walking capacity 150m, ABI left 0.63
  
  RISK FACTORS
  Hyperlipidemia, current smoker
  
  PROCEDURAL STEPS
  1. Right groin and cross-over access
  – IMA-diagnostic 5F catheter (CORDIS/ CARDINAL HEALTH)
  – 0.035'' angled soft Radiofocus guidewire, 190 cm (TERUMO)
  – 0.035'' SupraCore guidewire, 190 cm (ABBOOTT)
  – 6F Balkin Up&Over sheath, 40 cm (COOK)
  2. Passage of the occlusion left SFA
  – 0.018'' Advantage guidewire (TERUMO)
  – 0.018'' CXI support catheter (COOK)
  in case of failure:
  – GoBack crossing catheter (UPSTREAM PERIPHERAL)
  3. Vessel preparation left SFA with scoring balloon
  – UltraScore 5.0/300 mm balloon (BARD/BD)
  4. Primary stenting
  – 6 mm Eluvia DES (BOSTON SCIENTIFIC)
  

  View image
• Thursday, January 30th: 8:49 - 9:09, Room 1 - Main Arena 1

  Case 53 – CTO of the right anterior tibial artery, CLI-patient

  Center:

  Leipzig, Dept. of Angiology

  Case 53 – LEI 19: male, 76 years (W-M)

  Operators:

  • Andrej Schmidt,
  • Sven Bräunlich

  CLINICAL DATA
  Critical limb ischemia, ulceration dig 2 right,
  restpain and severe claudication right, ABI right 0.2
  PTA/stent right popliteal artery 12/19 with no clinical improvement
  CAD, AMI 2010, CABG 2010
  
  RISK FACTORS
  Arterial hypertension, diabetes mellitus type 2, hyperlipidemia
  
  PROCEDURAL STEPS
  1. Antegrade approach right groin
  – 6F 55 cm sheath (COOK)
  2. Guidewire passage antegrade into anterior tibial artery
  – 0.014'' Command (ABBOTT)
  – 0.014'' PT2 guidewire 300 cm (BOSTON SCIENTIFIC)
  In case of failure: retrograde approach
  3. PTA
  – Vessel preparation – scoring balloon (VascuTrak, BARD/ BD)
  – Lutonix BTK DCB (BARD/ BD)
  4. Stenting on indication:
  - Tack Endovascular System (INTACT VASCULAR INC.)

  View image
• Thursday, January 30th: 9:40 - 10:05, Room 1 - Main Arena 1

  Case 54 – Chronic in-stent reocclusion left SFA

  Center:

  Leipzig, Dept. of Angiology

  Case 54 – LEI 20: male, 70 years (P-H)

  Operators:

  • Sven Bräunlich,
  • Johannes Schuster

  CLINICAL DATA
  Severe claudication left, ABI 0.65; walking capacity 100 meters
  Rutherford class 3
  PTA/stenting left CIA and left SFA 07/19
  Stroke 1997
  
  RISK FACTORS
  Heavy smoker (50PY), arterial hypertension, hyperlipidemia
  
  PROCEDURAL STEPS
  1. Right groin retrograde and cross-over approach
  – 8F Balkin Up&Over sheath (COOK)
  2. Guidewire passage
  – 0.018'' Command 18 guidewire, 300 cm (ABBOTT)
  – 0.018'' Quick-Cross support catheter, 135 cm (PHILIPS)
  3. Thrombectomy
  – Rotarex 8F (STRAUB MEDICAL)
  4. PTA with DCBs
  – Ranger DCB 5 mm (BOSTON SCIENTIFIC)
  

  View image
• Thursday, January 30th: 10:15 - 10:40, Room 1 - Main Arena 1

  Case 55 – LEI 21

  Center:

  Leipzig, Dept. of Angiology

  Case 55 – LEI 21

  Operators:

  • Sven Bräunlich,
  • Matthias Ulrich

  Detailed information will be shown in the video itself!
• Thursday, January 30th: 12:38 - 12:58, Room 1 - Main Arena 1

  Case 56 – LEI 22

  Center:

  Leipzig, Dept. of Angiology

  Case 56 – LEI 22

  Operators:

  • Andrej Schmidt,
  • Daniela Branzan

  Detailed information will be shown in the video itself!
• Thursday, January 30th: 14:12 - 14:32, Room 1 - Main Arena 1

  Case 57 – CLI, deep vein arterialization of a "desert foot" right

  Center:

  Leipzig, Dept. of Angiology

  Case 57 – LEI 23: male, 76 years (E-K)

  Operators:

  • Daniela Branzan,
  • Andrej Schmidt

  CLINICAL DATA
  PAOD Rutherford 5, non-healing forefoot ulcerations, mediasclerosis, ABI > 1.4
  PTA right popliteal artery 12/19 and proximal ATA
  Cholangiocarcinoma with metastasis 02/18
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia, diabetes mellitus type 2
  
  PROCEDURAL STEPS
  1. Right groin antegrade access
  – 7F 55 cm Flexor Check-Flo sheath, Raabe Modification (COOK)
  2. Right distal venous tibial retrograde access
  – 5F sheath Introducer 2¨ (TERUMO)
  3. Arteriography and phlebography to define the optimal level for arterio-venous crossing
  4. Crossing from artery to vein
  – LimFlow Arterial Catheter 7F (LIMFLOW)
  – LimFlow Venous Catheter 5F (LIMFLOW)
  – LimFLow Ultrasound System (LIMFLOW)
  – PT2 0.014'' guidewire to pass from artery into vein (BOSTON SCIENTIFIC)
  – Predilatation with MiniTrek 3.5/20 mm, OTW coronary balloon (ABBOTT)
  5. Guidewire passage through vein and vein preparation
  – PT2 0.014'' guidewire (BOSTON SCIENTIFIC) or
  – Command 18 guidewire (ABBOTT)
  – Push Valvulotome 4F (LIMFLOW)
  – 4.0/120 mm Pacific ballon (MEDTRONIC)
  6. Implantation of covered stentgrafts
  – LimFlow Extension stentgrafts 7F 5.5 mm x 150 mm (LIMFLOW) for vein coverage
  – LimFLow Crossing stentgraft 7F 3.5 x 60 mm (LIMFLOW) for connection artery to vein

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• Thursday, January 30th: 15:00 - 17:00, Room 3 - Technical Forum

  Case 70 – Severely calcified CTO of the left distal SFA and left popliteal artery, "pave and crack"-technique

  Center:

  Leipzig, Dept. of Angiology

  Case 70 – LEI 27: male, 73 years (K-W)

  Operators:

  • Andrej Schmidt,
  • Matthias Ulrich

  CLINICAL DATA
  PAOD Rutherford III left, painfree walking distance 100 m, ABI left: 0.45
  Multiple interventions right SFA and popliteal artery, D1-amputation right 10/19
  CAD, ICM (EF 20%), AMI 2001, CABG 2001, ICA-occlusion left
  
  RISK FACTORS
  Arterial hypertension, current smoker, diabetes mellitus type 2, hyperlipidemia
  
  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:
  – 9 cm 20 Gauge Spinal Needle (BD)
  – 0.018'' V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
  – 4F 10 cm Radiofocus Introducer (TERUMO)
  – GoBack crossing catheter (UPSTREAM PERIPHERAL)
  4. PTA and Stenting
  – 5.0/20 mm and 6.0/20 mm Admiral Xtreme balloon (MEDTRONIC)
  – 6.0/20 Conquest non-compliant high pressure balloon (BARD/BD)
  In case of inability to open the balloons fully:
  – Implantation of a Viabahn 6.0/150 mm (GORE)
  – Relining with Supera Interwoven Nitinol stent (ABBOTT)

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• Thursday, January 30th: 15:10 - 15:35, Room 1 - Main Arena 1

  Case 58 – LEI 24

  Center:

  Leipzig, Dept. of Angiology

  Case 58 – LEI 24

  Operators:

  • Andrej Schmidt,
  • Johannes Schuster

  Detailed information will be shown in the video itself!
• Thursday, January 30th: 16:45 - 17:10, Room 1 - Main Arena 1

  Case 60 – Calcified occlusion of the left SFA

  Center:

  Leipzig, Dept. of Angiology

  Case 60 – LEI 25: male, 62 years (R-A)

  Operators:

  • Andrej Schmidt,
  • Johannes Schuster

  CLINICAL DATA
  PAOD Rutherford 3 left, walking capacity 100 m, claudication left calf, ABI left 0.57
  PTA of a 8 cm long profunda femoris occlusion right 10/2019 and right SFA 12/19
  CAD, ICM (EF 35%), CABG and aortic valve replacement 09/19, atrial fibrillation, pacemaker 09/19
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia, current smoker (40PY)
  
  PROCEDURAL STEPS
  1. Right groin and cross-over approach
  – Judkins Right 5F diagnostic catheter (CORDIS/ CARDINAL HEALTH)
  – 0,035'' SupraCore guidewire 30 cm (ABBOTT)
  – 7F-40 cm Balkin Up&Over sheath (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 occluded SFA
  – 7 cm 18 Gauge needle (COOK)
  – 0.018'' V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
  – 4F-10 cm Radiofocus Introducer (TERUMO)
  – GoBack crossing catheter (UPSTREAM PERIPHERAL)
  4. PTA with normal and high pressure balloons
  – 6.0/ 20 mm Admiral Xtreme balloon (MEDTRONIC)
  – 7.0/ 20 mm Conquest non-compliant high pressure balloon (BARD/ BD)
  5. Stenting
  – 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)
  – Eluvia drug-eluting stent for proximal SFA (BOSTON SCIENTIFIC)
  

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• Friday, January 31st: 9:00 - 13:00, Room 1 - Main Arena 1

  Case 72 – Subacute type-B-dissection, STABILISE-therapy

  Center:

  Leipzig, Dept. of Angiology

  Case 72 – LEI 28: male, 57 years (A-G)

  Operators:

  • Andrej Schmidt,
  • Daniela Branzan

  CLINICAL DATA
  Subacute type-B-dissection, progressive dilatation of the descending thoracic aorta
  EVAR 2019 elsewhere
  Coilembolisation of segmental arteries to reduce the risk of spinal ischemia during Stabilise therapy
  Implantation of a thoracic dissection stentgraft 1/2020
  
  PROCEDURAL STEPS
  1. Access right groin
  – 16F sheath (COOK) right groin after preloading of Proglide systems (ABBOTT)
  2. Confirmation of guidewire position in the true lumen by IVUS
  – Visions PV 0.035'' Digital IVUS catheter (VOLCANO-PHILIPS)
  3. Stent implantation
  – Dissection Endovascular stent (COOK)
  4. Postdilatation of the dissection stent
  – Reliant balloon (MEDTRONIC)
  

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• Friday, January 31st: 9:00 - 13:00, Room 3 - Technical Forum

  Case 74 – Calcified occlusion of the right distal SFA and right popliteal artery

  Center:

  Leipzig, Dept. of Angiology

  Case 74 – LEI 30: female, 72 years (D-M)

  Operators:

  • Matthias Ulrich,
  • Sven Bräunlich

  CLINICAL DATA
  PAOD Rutherford 4, restpain and severe claudication right calf, walking capacity 10 m, ABI right 0.2, failed recanalization attempt 09/19 elsewhere
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia, diabetes mellitus type 2
  
  PROCEDURAL STEPS
  1. Left groin and cross-over approach
  – Judkins Right 5F diagnostic catheter (CORDIS/CARDINAL HEALTH)
  – 0.035'' SupraCore guidewire 30 cm (ABBOTT)
  – 7F-40 cm Balkin Up&Over sheath (COOK)
  2. Second attempt of guidewire passage from antegrade
  – 0.018'' Command 18 guidewire, 300 cm (ABBOTT)
  – GoBack crossing catheter (UPSTREAM PERIPHERAL) or retrograde approach via anterior tibial artery in case of failure to pass
  3. Vessel preparation
  – UltraScore 5.0/300 mm scoring balloon (BARD/ BD)
  – 4.0 - 6.0 mm Armada 35 balloon (ABBOTT)
  – Conquest high pressure balloon on indication (BARD/ BD)
  4. Stenting
  – Supera Interwoven Nitinol stent (ABBOTT)
  

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• Friday, January 31st: 9:00 - 13:00, Room 3 - Technical Forum

  Case 75 – Occlusion left popliteal artery

  Center:

  Leipzig, Dept. of Angiology

  Case 75 – LEI 31: male, 68 years (R-H)

  Operators:

  • Andrej Schmidt,
  • Matthias Ulrich

  CLINICAL DATA
  PAOD Rutherford 4, severe claudication left and rest-pain, walking capacity 20 m, ABI left 0.43
  Failed recanalization attempt left, elsewhere
  
  RISK FACTORS
  Arterial hypertension, hyperlipidemia, nicotine abuse
  
  PROCEDURAL STEPS
  1. Right groin and cross-over approach
  – Judkins Right 5F diagnostic catheter (CORDIS/CARDINAL HEALTH)
  – 0.035'' SupraCore guidewire 30 cm (ABBOTT)
  – 7F-40 cm Balkin Up&Over sheath (COOK)
  2. Second attempt of guidewire passage of the occlusion from antegrade
  – Visions PV 0.035'' Digital IVUS catheter (VOLCANO-PHILIPS)
  3. In case of failure to pass with a GW from antegrade
  – GoBack crossing catheter (UPSTREAM PERIPHERAL)
  or retrograde approach via peroneal artery:
  – 21 Gauge 9 cm needle (B. Braun)
  – 0.018Ó V-18 Control GW, 300 cm (BOSTON SCIENTIFIC)
  – 0.018Ó CXC support catheter, 90 cm (COOK)
  4. Laser atherectomy
  – 7F Turbo Power Laser with Turbo Elite 2.3 mm cathether (PHILIPS)
  5. PTA with DCBs
  – 5.0/80 mm and 6.0/80 mm iLuminor DCB (iVASCULAR)
  6. Stenting
  – Supera Interwoven Nitinol stent in case of severe recoil (ABBOTT)
  

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