Hamburg

• Wednesday, June 8th: 11:30 - 12:00, Main Arena 2

  Low profile branched EVAR in TAAA

  Center:

  Hamburg

  Case 29 – Hamburg 01: Female, 56 years (M-J)

  Operators:

  • Fiona Rohlffs,
  • Gesche Homfeld

  CLINICAL DATA
  – TAAA (max. diameter 7cm)
  Past medical history:
  – Frozen Elephant-Trunk 2021
  – ascendens replacement 2019
  
  RISK FACTORS
  – Small access and target vessels, kinked anatomy
  – Pseudo-occluded celiac trunk, hepartic artery from SMA
  – History of right axillary artery occlusion with stenting
  – Liquordrainage
  
  PROCEDURAL STEPS
  1. Percutaneous femoral access (Prostar, ABBOTT)
  
  2. Lunderquistwire (extra stiff wire, COOK) to ascending aorta from right side, angiocatheter from left side
  
  3. Deployment of low profile TEVAR and low profile branched graft (CMD, COOK)
  
  4. Transfemoral retrograde access to antegrade branches with steerable sheeth (Fustar sheeth 10F/70cm, LaMed) and placement of bridging stents (Viabahn/VBX, GORE; Advanta V12, GETINGE; VisiPro stent, MEDTRONIC; Fluency, BD)
  
  5. Completion angiogramme

  View image
• Wednesday, June 8th: 12:10 - 12:15, Main Arena 2

  Low profile branched EVAR in TAAA

  Center:

  Hamburg

  Case 29 – Hamburg 01: Female, 56 years (M-J)

  Operators:

  • Fiona Rohlffs,
  • Gesche Homfeld

  CLINICAL DATA
  – TAAA (max. diameter 7cm)
  Past medical history:
  – Frozen Elephant-Trunk 2021
  – ascendens replacement 2019
  
  RISK FACTORS
  – Small access and target vessels, kinked anatomy
  – Pseudo-occluded celiac trunk, hepartic artery from SMA
  – History of right axillary artery occlusion with stenting
  – Liquordrainage
  
  PROCEDURAL STEPS
  1. Percutaneous femoral access (Prostar, ABBOTT)
  
  2. Lunderquistwire (extra stiff wire, COOK) to ascending aorta from right side, angiocatheter from left side
  
  3. Deployment of low profile TEVAR and low profile branched graft (CMD, COOK)
  
  4. Transfemoral retrograde access to antegrade branches with steerable sheeth (Fustar sheeth 10F/70cm, LaMed) and placement of bridging stents (Viabahn/VBX, GORE; Advanta V12, GETINGE; VisiPro stent, MEDTRONIC; Fluency, BD)
  
  5. Completion angiogramme

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• Thursday, June 9th: 8:05 - 8:35, Main Arena 2

  TEVAR (CMD TEVAR, low-radial force distally)

  Center:

  Hamburg

  Case 37 – Hamburg 02: Male, 36 years (J-M)

  Operators:

  • Fiona Rohlffs,
  • Gesche Homfeld

  CLINICAL DATA
  – Type A aortic dissection with David Procedur and Frozen Elephant Trunk 2021
  
  RISK FACTORS
  – TGFB3 gene variation
  
  PROCEDURAL STEPS
  1. Percutaneous femoral access (Manta, TELEFLEX)
  
  2. Confirmation of true lumen access (angiogramm)
  
  3. Lunderquistwire (extra stiff wire, COOK) to ascending aorta from right side, angiocatheter from left side
  
  4. Deployment of CMD-TEVAR (COOK)
  
  5. Completion angiogramm

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• Thursday, June 9th: 15:35 - 16:00, Main Arena 2

  TEVAR extension and 5-branched EVAR with fenestration of the dissection membrane

  Center:

  Hamburg

  Case 41 – Hamburg 03: Female, 68 years (G-M)

  Operators:

  • Fiona Rohlffs,
  • Gesche Homfeld

  CLINICAL DATA
  – Chronic Type B Aortic dissection with Type Ia endoleak and progression of false lumen aneurysm
  Past medical history:
  – Carotid-subclavian-bypass and TEVAR religning in 2022
  – first TEVAR 2020
  
  RISK FACTORS
  – FBN2-mutation
  – Two right renal arteries from false lumen, lower renal artery with dissection
  
  PROCEDURAL STEPS
  1. Percutaneous femoral access (Prostar, ABBOTT)
  
  2. Lunderquistwire (extra stiff wire, COOK) to ascending aorta from right side, Angiocatheter from left side
  
  3. Deployment of low profile TEVAR and 5-branched graft (CMD, COOK), 5th branch retrograde orientation
  
  4. Transfemoral retrograde access to antegrade branches with steerable sheeth (Fustar sheeth 10F/70cm, LaMed) and placement of bridging stents (Viabahn/VBX, GORE; Advanta V12, GETINGE; VisiPro stent, MEDTRONIC; Fluency, BD)
  
  5. Catheterisation and stenting of retrograde branch into false lumen with fenestration of the dissection membrane using Basilika-Technique
  
  6. Potentially staged procedure, completion angiogramm according to approach

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