Galway

• Tuesday, January 28th: 9:10 - 9:30, Room 2 - Main Arena 2

  Case 10 – Acute left leg DVT

  Center:

  Galway

  Case 10 – GAL 01: female, 54 years (P-C)

  Operators:

  • J. Ward,
  • Gerard O'Sullivan

  CLINICAL DATA
  54 year old lady, normally fit and well, acute onset left leg pain – actually started in the groin, moved inferiorly, went to see family doctor in am; immediately referred to radiology
  
  IMAGING
  US scan shows acute left leg DVT, CTPA clear, CTV images to follow
  
  PROCEDURAL STEPS
  1.Prone, 10F sheath
  2.Initial very gentle venography – 10 cc of dilute contrast
  3. IVUS, then stiff glide wire (Merit Medical) into IVC
  4.Deploy VETEX (VETEX Medical) thrombectomy device, cranial to caudal action x 2
  5.Aspiration – 8F 55 cm Hockey Stick (CORDIS) +/- 7F 90 cm desitination catheter (TERUMO)
  6.IVUS to identify remaining thrombus v underlying lesion
  7.Balloon angioplasty BARD/BD Atlas 14 mm diameter, 60 mm long; to 14 atm for 14 seconds
  8.Stents 14 - 16 mm diameter (BARD/BD Venovo, or COOK Zilver Vena or MEDTRONIC ABRE or Veniti Vici or Optimed Sinus Venous)
  9.Balloon angioplasty BARD/BD Atlas 14 mm diameter, 60 mm long; to 14 atm for 14 seconds
  10.IVUS and one final venogram

  View image
• Tuesday, January 28th: 11:00 - 11:20, Room 2 - Main Arena 2

  Case 12 – Chronic post thrombotic syndrome left leg

  Center:

  Galway

  Case 12 – GAL 02: female, 51 years (E-C)

  Operators:

  • J. Ward,
  • Gerard O'Sullivan

  CLINICAL DATA
  DVT x 3; Factor V Leiden deficiency; venous claudication on hills at 50 m; weight gain 9 kg, no ulcers, minimal oedema when wearing stockings; fully anticoagulated
  
  RISK FACTORS
  Factor V Leiden
  
  PROCEDURAL STEPS
  1. 3 point access RIJV, L FV, R CFV
  2. General anaesthetic, urethral catheter
  3. Full anticoagulation
  4. Cross lesion using multiple obliques – Cxi (COOK), Rubicon (BSCI); Roadrunner wire (COOK)
  5. IVUS to confirm position and to confirm dominant inflow inferiorly
  6. Balloon angioplasty – Atlas high pressure (BARD/BD) – straight to 14 mm @ 14 atm for 14 s minimum
  7. Stents 14 – 16 mm diameter (COOK Zilver Vena or MEDTRONIC ABRE or Veniti Vici or Optimed Sinus Venous or Bard Venovo)
  8. Balloon angioplasty – Atlas high pressure (BARD/BD) – straight to 14 mm @ 14 atm for 14 s minimum
  9. IVUS to confirm full stent expansion
  10. One final venogram to show rapid flow

  View image
• Tuesday, January 28th: 16:30 - 18:00, Room 2 - Main Arena 2

  Case 16 – GAL 04

  Center:

  Galway

  Case 16 – GAL 04

  Operators:

  • J. Ward,
  • Gerard O'Sullivan

  Detailed information will be shown in the video itself!