Münster

• Monday, June 6th: 14:13 - 14:33, Main Arena 2

  Transradial carotid artery stenting for right side recurrent stenosis of internal carotid artery after surgical TEA

  Center:

  Münster

  Case 06 – Münster 02: Female, 71 years (A-K)

  Operators:

  • Yousef Shehada

  CLINICAL DATA
  – Eversion-endarterectomy of right carotid 2004
  – in yearly duplex FU high grade recurrent stenosis of right ICA, vmax 300cm/sec., asymptomatic
  
  RISK FACTORS
  – CVRF: Hypertension, hyperlipidemia
  
  PROCEDURAL STEPS
  1. Radial puncture right side with micropuncture set (COOK)
  
  2. Change to 5F 90cm destination sheath (TERUMO)
  
  3. Canulation of right CCA with 0,35 wire (Advantage, TERUMO) and Berenstein catheter (CORDIS)
  
  4. Canulation of ICA-stenosis with 0,014 Epifilter wire (BOSTON SCIENTIFIC)
  
  5. Implantation of dual layer micromesh-stent (Roadsaver, TERUMO)
  
  6. Post dilatation with rx-balloon 5/6x30mm (Sterling, BOSTON SCIENTIFIC)
  
  7. Withdrawal of catheters ad puncture site management with radial compression device (TR-band, TERUMO)

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• Monday, June 6th: 18:10 - 18:40, Main Arena 1

  OCT-guided Atheterectomy of Tosaka III ISR right SFA and distal popliteal stenosis

  Center:

  Münster

  Case 04 – Münster 01: Female, 65 years (F-D)

  Operators:

  • Safa Al-Qudah

  CLINICAL DATA
  – Rutherford III right leg, painfree wd 50m, ABI right leg 0,3
  – 2012 nitinol stent right SFA
  
  RISK FACTORS
  – CVRF: Hypertension, hyperlipidemia
  
  PROCEDURAL STEPS
  1. Left femoral access, 7F 45cm Destination x-over sheath (TERUMO) to right CFA
  
  2. Wire-passage with 0,018 V18 wire (BOSTON SCIENTIFIC) and 0,035 Quick-cross (PHILIPS) support catheter
  
  3. Placement of 4mm Spiderfilter (MEDTRONIC) to peroneal artery
  
  4. OCT-guided atherectomy with Pantheris 3.0 7F directional atherectomy catheter (AVINGER) of SFA ISR and popliteal artery
  
  5. Post PTA with 5x120mm paclitaxel eluting balloons, passeo lux (BIOTRONIK)
  
  6. Filter removal via 0,035 Quickcross
  
  7. Closure of access site with Proglide VCD (ABBOTT)

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• Tuesday, June 7th: 9:36 - 9:56, Main Arena 1

  IVUS controled atherectomy of popliteal artery in patient with CLI

  Center:

  Münster

  Case 11 – Münster 03: Male, 84 years (H-R)

  Operators:

  • Yousef Shehada

  CLINICAL DATA
  – Patient with gangrene of first digit right foot, Rutherford VI, ABI 0,3
  
  RISK FACTORS
  – CVRF: Hypertension, IDDM
  – CTA: Subtotal stenosis of right popliteal artery,
  – occlusion of posterior tibial artery and stenosis of anteror tibial artery
  
  PROCEDURAL STEPS
  1. Antegrade access right common femoral artery and intrduction 7F 10cm sheath (TERUMO)
  
  2. Canulation of popliteal artery stenosis with 0,018 wire (V12 BOSTON SCIENTIFIC) and 0,018 support catheter (Quickcross/PHILIPS), change to 0,014 300cm Phoenix wire (PHILIPS)
  
  3. Analysis of lesion with IVUS catheter (Visions PV .018, PHILIPS)
  
  4. Atherectomy of lesion with Phoenix 2.2 deflected cathete (PHILIPS)
  
  5. DCB-PTA of popliteal artery with Stellarex Ballon (PHILIPS)
  
  6. Control of lesion with IVUS catheter (Visions PV .018, PHILIPS)
  
  7. Adjunctive stenting if needed with either InTact Tack (PHILIPS) or Supera stent (ABBOTT)
  
  8. Treatment of BTK-vessels with Phoenix 1,5 (PHILIPS) and DCB (Stellarex, PHILIPS)
  
  9. Angiographic and IVUS control of result

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• Tuesday, June 7th: 14:50 - 15:25, Main Arena 1

  Transradial approach for iliac stenting in PAD patient

  Center:

  Münster

  Case 14 – Münster 04: Male, 60 years (B-D)

  Operators:

  • Yousef Shehada

  CLINICAL DATA
  – Rutherford III WD 100mABI bilateral 0,6 CTA: High grade bilateral common iliac artery stenosis, right side external iliac artery stenosis
  – CVRF: Hypertension, Nicotine use
  
  PROCEDURAL STEPS
  1. Radial puncture left side with micropuncture set (COOK)
  
  2. Change to 120cm 6F (8.5FOD) guiding catheter (SheathLessPV ASAHI INTECC)
  
  3. Canulation of right iliac lesions with 0,035 wire (Advantage TERUMO)
  
  4. Treatmet of external iliac artery with 8x60mm SES and common iliac artery with 8x38mm cobalt chromium stent, 170cm delivery system (Dynetic BIOTRONIK)
  
  5. Treatment of left common iliac with 10x38 cobalt chromium stent,
  170cm delivery system (Dynetic BIOTRONIK); Puncture site management with radial compression device (TR-band TERUMO)
  
  6. Withdrawal of catheters ad puncture site management with radial compression device (TR-band, TERUMO)

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• Wednesday, June 8th: 8:15 - 8:40, Main Arena 2

  IBD for common iliac aneurysm with internal artery stenosis and buttock claudication

  Center:

  Münster

  Case 28 – Münster 05: Male, 71 years (R-L)

  Operators:

  • Marco Virgilio Usai,
  • Efthymios Beropoulis

  CLINICAL DATA
  Healthy patient with casually diagnosed iliac aneurysm on the right side
  because of buttock claudication when going upstairs after few meters
  
  RISK FACTORS
  Arterial hypertension, otherwise healthy. On CT 3,5 cm Iliac aneurysm on the right side with high grade stenosis of the internal iliac
  
  PROCEDURAL STEPS
  1. Percutaneous bilateral femoral access with Prostar XL (ABBOTT)
  
  2. Introducing 14 F Sheath (COOK) on the right side and a 12 F flexor (COOK) Sheath on the left. Change on the rigth side to a Lunderquist wire.
  
  3. Retrograde Angiography in 35' LAO to localise the internal ilic artery.
  
  4. Introducing the IBD device, over the right side Creation of a through and through wire with the Help of Indy Snare (COOK) and a TERUMO 35 260 cm stiff wire.
  
  5. Releasing the graft until the sidebranch is free. Push in cross over of the 12 F sheat.
  
  6. Cannulation of the internal artery after angiographic control with Bern (MERIT) and a 35 TERUMO stiff.
  
  7. Predilatation of the internal artery to reduce the stenosis. Change to a Rosenwire (COOK)
  
  8. Implantation og a 8x59 VBX (GORE). Withdrawal of the Through and Through Wire and completion fo the IBD deployment.
  
  9. Deployment of the Aortic main Graft (COOK), cannulation of the controlateral leg and deployment of the iliac extension (COOK), then deployment of the ipsilateral with Cool Iliac.
  
  10. Angiography and closure of the Prostar XL.

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