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LINC 2020 live case guide

During the Leipzig Interventional Course 2020
more than 70 interventional and surgical live cases
are scheduled to be performed and transmitted
to the auditorium.

 

 

LINC 2020 live case guide


Find all live cases and live case centers listed below.

 

 

Conference day 2

  • - , 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
  • - , Room 2 - Main Arena 2

    Case 33 – MUN 01

    Center:
    Münster
    Case 33 – MUN 01
    Operators:
    • Martin Austermann,
    • E. Beropoulis,
    • Y. Shehada
    Detailed information will be shown in the video itself!
  • - , Room 3 - Technical Forum

    Case 39 – Percutaneous CT-guided microwave ablation of hepatocellular carcinoma post TACE

    Center:
    Frankfurt/Main
    Case 39 – FRA 01: male, 81 years (K-H)
    Operators:
    • M. Nour Eldin,
    • Bita Panahi
    CLINICAL DATA
    Histologically confirmed HCC lesion in Segment 5
    Highly differentiated HCC, no liver cirrhosis
    Initial tumor stage: T3 Nx M0. Etiology NASH, no extrahepatic metastases
    3 cycles of TACE were carried out for downsizing

    PROCEDURAL STEPS
    1. Revision of the previous images for confirmation of the size and location of the lesion
    2. Non contrast enhanced CT of the liver for planning
    3. Surface marking of the location of the lesion as well as the site of puncture on the skin
    4. Sterile covering followed by infiltration of the local anesthetic
    Conscious sedation would be given
    5. Stepwise insertion of the Microwave antenna (COVIDIEN¨ SYSTEM) within the lesion
    6. The energy required for ablation will be given to induce complete ablation of the lesion
    Intermittent CT images to observe the changes during the ablation procedure
    7. After applying the required energy for ablation, needle track ablation will be done followed by removal of the antenna
    8. Transfer of the patient to the recovery room for clinical observation
  • - , 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!
  • - , Room 3 - Technical Forum

    Case 40 – Holmium 166-SIRT of intrahepatic cholangiocellular carcinoma of the left liver lobe

    Center:
    Jena
    Case 40 – JEN 02: male, 75 years (K-U)
    Operators:
    • René Aschenbach,
    • R. Drescher
    CLINICAL DATA
    iCCC, Grade II of the left lobe, not resectable due to advanced liver fibrosis

    IMPORTANT ITEMS
    ITB waived at first line therapy resection
    Intra-operative advanced fibrosis
    Liver surgeons stated this as not resectable
    ITB reviewed the case and recommended SIRT (probably radio-segmentectomy if possible)

    PROCEDURAL STEPS
    1. Right groin puncture
    – 5F sheath (TERUMO)
    2. Access to liver
    – 5F Cobra catheter (BOSTON SCIENTIFIC)
    3. Access to tumor
    – Microcatheter Progreat (TERUMO)
    4. Application of estimated activity
    – QuiremSpheres/Holmium 166 (TERUMO)
    5. Vascular closure device of the right groin
    – Exoseal (CORDIS)
    View image
  • - , 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
  • - , 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
  • - , Room 3 - Technical Forum

    Case 41 – FRA 02

    Center:
    Frankfurt/Main
    Case 41 – FRA 02
    Operators:
    • M. Nour Eldin,
    • E. Emara
    Detailed information will be shown in the video itself!
  • - , 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
  • - , Room 3 - Technical Forum

    Case 42 – DEB-TACE of hepatocellular carcinoma HCC of the left lobe

    Center:
    Jena
    Case 42 – JEN 03: male, 64 years (H-D)
    Operators:
    • René Aschenbach,
    • Florian Bürckenmeyer
    CLINICAL DATA
    22 mm HCC in the left lobe, bridging to transplant, liver cirrhosis Child-PUGH B7, in-side MILAN, no extrahepatic disease, no macrovascular invasion

    IMAGING
    Typical appearence in CT Scan, in-side Milan, no extrahepatic disease

    PROCEDURAL STEPS
    1. Right groin puncture
    – 5F sheath (TERUMO)
    2. Access to hepatic
    – 5F Cobra catheter (BOSTON SCIENTIFIC)
    3. Access to feeding vessel
    – OccluSafe Micro-Catheter (TERUMO)
    4. Inflation of Ballon on MicroCath to drop the arterial stump pressure
    5. Embolization with doxorubicin loaded particels
    – Embozene Tandem 40 μm (Varian Medical Systems)
    – Doxorubicin load: 50 mg/ml
    6. Embolization up to complete filling of tumor
    7. Control angiography with proof of stasis
    8. Vascular closure
    – Exoseal 5F (CORDIS)
    View image
  • - , Room 1 - Main Arena 1

    Case 26 – PAR 01

    Center:
    Paris
    Case 26 – PAR 01
    Detailed information will be shown in the video itself!
  • - , Room 2 - Main Arena 2

    Case 35 – MUN 02

    Center:
    Münster
    Case 35 – MUN 02
    Operators:
    • Martin Austermann,
    • E. Beropoulis,
    • Y. Shehada
    Detailed information will be shown in the video itself!
  • - , Room 3 - Technical Forum

    Case 43 – FRA 03

    Center:
    Frankfurt/Main
    Case 43 – FRA 03
    Operators:
    • M. Nour Eldin,
    • E. Emara
    Detailed information will be shown in the video itself!
  • - , Room 3 - Technical Forum

    Case 44 – KGP 04

    Center:
    Kingsport
    Case 44 – KGP 04
    Operators:
    • Chris Metzger,
    • M. Aziz
    Detailed information will be shown in the video itself!
  • - , 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
  • - , Room 1 - Main Arena 1

    Case 28 – JEN 01

    Center:
    Jena
    Case 28 – JEN 01
    Detailed information will be shown in the video itself!
  • - , 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!
  • - , 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
  • - , Room 2 - Main Arena 2

    Case 37 – FEVAR for type 1a endoleak post EVAR

    Center:
    Paris
    Case 37 – PAR 02: male, 66 years
    Operators:
    • Stéphan Haulon,
    • D. Fabre,
    • A. Girault,
    • P. Charbonneau,
    • A. Schwein
    CLINICAL DATA
    Previous EVAR for AAA

    PRESENT STATE
    71 mm AAA

    PROCEDURAL STEPS
    1. L: Advance 18F 33cm GORE Dryseal sheath in the LCFA over Lunderquist – 1 x 6F 55 cm and 1 x 7F 55 COOK Ansel sheaths
    100 U/kg Heparin (Target ACT³250)
    L (through one of the 6F): advance long pigtail catheter
    R: 10F sheath/Lunderquist/dilators up to 20
    2. Fluoroscopy to locate fenestrations gold markers
    R: Advanced fenestrated endograft – Aortic angiogram – fusion mask registration – fenestrated endograft deployment
    3. R: Rosen wire advanced through preloaded catheter – Exchange preloaded catheter for a 6F-90cm COOK Ansel Shuttle sheath – Exchange Rosen for a Stealcore 0.018 - 300 cm wire – Retrieve 6F to the level of the fenestration – Retrieve the 6F dilator – Puncture valve – DAV + TERUMO/Roadrunner through 6F for renal artery catheterisation – Renal angiogram – Exchange TERUMO for Rosen – Retrieve Stealcore
    wire – Advance 6F into the renal artery – Advance BENTLEY Begraft bridging stent to parking position
    4. Same for controlateral renal artery
    5. L: Through 6F sheath advance BER + TERUMO to catheterize fenestrated endograft lumen steps (cont.): – Advance 6F below the fenestration (SMA/CT) – USL + TERUMO/ Roadrunner through 6F sheath to catheterise target vessel (SMA/CT) – Vessel angiogram / Exchange TERUMO for Rosen wire – Advance 6F into target vessel – Advance BENTLEY Begraft bridging stent to parking position
    6. R: Release diameter-reducing ties – proximal and distal attachments – Nose retrieval under fluoroscopy
    7. L: SMA/CT stent deployment (3-4 mm protruding in the aortic lumen) after sheath retrieval – Flare the aortic portion of stent with 10-20 mm balloon – Advance the sheath in the SMA/CT stent/angiogram (SMA: exchange Rosen for TERUMO wire)
    8. R: Renal artery stent deployment (3-4 mm protruding in aortic lumen) after 6F retrieval – Flare the aortic portion of stent with 9-20 mm balloon – Advance 6F back into the renal stent – angiogram
    9. R: Remove nose under fluoroscopy / Remove fenestrated device delivery system
    L: Withdraw sheaths in 18F – insert and deploy bifurcated device and iliac limbs
    10. CODA balloon to mold overlaps and distal sealing zones
    Pigtail catheter – Angiogram + non-contrast CBCT
    View image
  • - , Room 1 - Main Arena 1

    Case 29 – KGP 01

    Center:
    Kingsport
    Case 29 – KGP 01
    Operators:
    • Chris Metzger,
    • M. Aziz
    Detailed information will be shown in the video itself!
  • - , Room 3 - Technical Forum

    Case 47 – FRA 04

    Center:
    Frankfurt/Main
    Case 47 – FRA 04
    Operators:
    • M. Nour Eldin,
    • Bita Panahi
    Detailed information will be shown in the video itself!
  • - , Room 3 - Technical Forum

    Case 46 – Prostate artery embolization

    Center:
    Jena
    Case 46 – JEN 04: male, 61 years
    Operators:
    • Tobias Franiel,
    • René Aschenbach
    CLINICAL DATA
    Lower urinary tract symptoms (LUTS)
    IPSS 19, mainly obstructive symptoms (0-30)
    QoL 5 (0-6), IIEF-5 25
    Prostate volume 75 ml, PSA 2,4 ng/ml
    Qmax 8,9ml/s
    Residual urinary volume 30ml
    Unsuccessful medication therapy for at least 6 mo
    Counselling about urol. alternative treatments

    PROCEDURAL STEPS
    1. Cone beam CT
    2. Identification of prostate arteries and their origin
    3. Cannulation of prostate arteries (left side first)
    4. Guiding catheter: 4F RIM 65 cm (Merit Medical)
    alternative 4F SIM1 65 cm (Merit Medical)
    5. Microcatheter: Progreat 2.7F 130 cm (TERUMO)
    alternative Progreat 2.0F 130 cm (TERUMO)
    6. Embolic agent: Embozene 400 μm (Boston Scienfic)
    7. Microcoils for embolization of possible accessory and collateral arteries: Azur18 helica 2 mm x 2 cm (TERUMO)
  • - , Room 1 - Main Arena 1

    Case 30 – KGP 02

    Center:
    Kingsport
    Case 30 – KGP 02
    Operators:
    • Chris Metzger,
    • M. Aziz
    Detailed information will be shown in the video itself!
  • - , 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
  • - , Room 3 - Technical Forum

    Case 48 – JEN 05

    Center:
    Jena
    Case 48 – JEN 05
    Operators:
    • René Aschenbach,
    • Ioannis Diamantis
    Detailed information will be shown in the video itself!
  • - , Room 2 - Main Arena 2

    Case 38 – Growing left hypogastric artery aneurysm due to type II EL

    Center:
    Münster
    Case 38 – MUN 03: male, 69 years (BF-J)
    Operators:
    • Arne Schwindt,
    • Angeliki Argyriou,
    • A. Sohr
    CLINICAL DATA
    October 2016 emergency EVAR (Endurant MEDTRONIC) for ruptured AAA with overstenting of left hypogastric artery aneurysm, surgigal graft interposition for left CFA aneurysm

    PRESENT STATE
    Growing of left hypogastric from 5.5 cm 2016 to 70 mm January 2020, CT angiograms show type II EL via left inferior hypogastic artery

    PROCEDURAL STEPS
    1. Duplex guided antegrade puncture of proximal left CFA insertion of 5F 10 cm sheath (TERUMO) into profunda artery
    2. Cannulation of left internal circumflex artery with 4F Glidecath (TERUMO)
    3. Angiography and cannulation of pelvic collaterals to hypogastric aneurysm with 0,014'' wire (CONNECT, ABBOTT) and 0,014'' Microcatheter (ECHELON, MEDTRONIC)
    4. Catheter flush with DMSO and embolization of EL with alcohol coplymer (ONYX, MEDTRONIC)
    View image
  • - , Room 1 - Main Arena 1

    Case 32 – KGP 03

    Center:
    Kingsport
    Case 32 – KGP 03
    Operators:
    • Chris Metzger,
    • M. Aziz
    Detailed information will be shown in the video itself!
  • - , 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!
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