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LINC 2022 live case guide

During the Leipzig Interventional Course 2022 more than 40 interventional and surgical live cases
are scheduled to be performed and transmitted to the auditorium.

 

 

LINC 2022 live case guide


Find all live cases and live case centers listed below.

 

 

Conference day 1

  • - , Main Arena 1

    Complex obstruction of the aortoiliac bifurcation

    Center:
    Leipzig, Universitätsklinikum, Abt. Angiologie
    Case 01 – LEI 01: Male, 54 years (M-T)
    Operators:
    • Axel Fischer
    CLINICAL DATA
    – Severe claudication bilateral, maximal walking-capactiy 150 meters,
    – Pain left > right buttock, thigh and calf
    – Unsuccessful recanalization-attempt elsewhere 5/2022
    – Guidewire-passage from antegrade (transbrachial) and retrograde impossible

    RISK FACTORS
    – ABI right 0.76; left 0.60
    – Hypertension
    – Smoker

    PROCEDURAL STEPS
    1. Transbrachial and left femoral access
    – 7F 90cm Check-Flo Performer Sheath (COOK)
    – 7F 25cm Radiofocus Introducer II (TERUMO)
    – SupraCore 300cm 0.035" Guidewire (ABBOTT)

    2. Passage of the CTO left common iliac artery:
    Via brachial access:
    – Stiff straight 0.035" Radifocus Guidewire 260cm (TERUMO)
    – 6Fr Launcher Guiding-Catheter 100cm (MEDTRONIC)
    – 5Fr 125cm Judkins Right Diagnostic Catheter (CORDIS)

    3. Passage into the CTO left CIA from left retrograde for reversed CART-technique:
    – Stiff straight 0.035" Radifocus Guidewire 260cm (TERUMO)
    – 5.0/40mm Mustang Balloon (BOSTON SCIENTIFIC)

    4. Balloon-angioplasty and stenting in kissing-technique:
    – Mustang-balloons 6/40 (BOSTON SCIENTIFIC)
    – Advanta V12 Balloonexpandable Covered Stent (GETINGE)
    – 8.0/37mm right CIA; 8.0/57mm left CIA
    View image
  • - , Main Arena 2

    Right internal carotid stenosis, calcified

    Center:
    Milan
    Case 05 – Milan 01: Male, 67 years (Q-G)
    Operators:
    • Piero Montorsi,
    • Stefano Galli
    CLINICAL DATA
    – Long-standing type 2 diabetes (on target), hypertension, hypercholesterolemia
    – 2021 CAD with 3-vessel disease treated by multiple DES. EF 55%
    – 2022 Bilateral carotid artery disease (right 85%, left 65%). Asymptomatic.
    – Moderate renal failure (GFR 40ml/min/m2)

    RISK FACTORS
    – Doppler US: RICA PSV 3.29 m/sec
    – CT-angiography: Type 1 aortic arch. Critical RICA stenosis with >180° calcium distribution followed by long soft plaque; Normal brain CT scan

    PROCEDURAL STEPS
    1. Right radial approach
    – TERUMO slender sheath "6 in 5"

    2. Right carotid axes engagement with coaxial system
    – 6F MP guide over 5F 125cm-long Simmons-2 catheter

    3. Baseline RICA and intracranial views angiography

    4. Distal filter positioning
    – Spider FX 5.0mm, MEDTRONIC or Filterwire EZ, BOSTON SCIENTIFIC

    5. IVUS assessment
    – Opticross, BOSTON SCIENTIFIC

    6. Intra vascular lithotripsy with 4.0x12mm balloon
    – SHOCKWAVE

    7. IVUS assesmnet of the initial result
    – Opticross, BOSTON SCIENTIFIC

    8. Stenting with Roadsaver 8x30
    – TERUMO

    9. Stent post-dilation
    – Sterling 5.0mm x 20mm, BOSTON SCIENTIFIC

    10. Final IVUS assessment
    – Opticross, BOSTON SCIENTIFIC

    11. Final angiography
    View image
  • - , Main Arena 1

    Complex obstruction of the aortoiliac bifurcation

    Center:
    Leipzig, Universitätsklinikum, Abt. Angiologie
    Case 01 – LEI 01: Male, 54 years (M-T)
    Operators:
    • Axel Fischer
    CLINICAL DATA
    – Severe claudication bilateral, maximal walking-capactiy 150 meters,
    – Pain left > right buttock, thigh and calf
    – Unsuccessful recanalization-attempt elsewhere 5/2022
    – Guidewire-passage from antegrade (transbrachial) and retrograde impossible

    RISK FACTORS
    – ABI right 0.76; left 0.60
    – Hypertension
    – Smoker

    PROCEDURAL STEPS
    1. Transbrachial and left femoral access
    – 7F 90cm Check-Flo Performer Sheath (COOK)
    – 7F 25cm Radiofocus Introducer II (TERUMO)
    – SupraCore 300cm 0.035" Guidewire (ABBOTT)

    2. Passage of the CTO left common iliac artery:
    Via brachial access:
    – Stiff straight 0.035" Radifocus Guidewire 260cm (TERUMO)
    – 6Fr Launcher Guiding-Catheter 100cm (MEDTRONIC)
    – 5Fr 125cm Judkins Right Diagnostic Catheter (CORDIS)

    3. Passage into the CTO left CIA from left retrograde for reversed CART-technique:
    – Stiff straight 0.035" Radifocus Guidewire 260cm (TERUMO)
    – 5.0/40mm Mustang Balloon (BOSTON SCIENTIFIC)

    4. Balloon-angioplasty and stenting in kissing-technique:
    – Mustang-balloons 6/40 (BOSTON SCIENTIFIC)
    – Advanta V12 Balloonexpandable Covered Stent (GETINGE)
    – 8.0/37mm right CIA; 8.0/57mm left CIA
    View image
  • - , 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)
    View image
  • - , Main Arena 1

    Directional atherectomy followed by drug-coated balloon angioplasty of deep femoral artery in the presence of a chronic SFA occlusion

    Center:
    Bad Krozingen
    Case 02 – Bad Krozingen 01: Male, 70 years (K-G)
    Operators:
    • Börries Jacques
    CLINICAL DATA
    – Claudication Rutherford 3 left leg
    – October 2021 DCB angioplasty of DFA main trunk due to PAOD Rutherford 5, wounds healed in the meantime
    – September 2021 stent-recanalisation of chronic CTO of SFA right leg

    RISK FACTORS
    – CVRF: Nicotine abuse, arterial hypertension, hypercholesterolemia
    – Coronary artery disease, cardiomyopathy with mid-grade impaired cardiac function

    PROCEDURAL STEPS
    1. Retrograde right transfemoral access 7F

    2. Placement of a Spider filter (MEDTRONIC) into the DFA

    3. Directional atherectomy (HawkOne 7F LS, MEDTRONIC)

    4. Postdilatation with DCB (Tulip, ACOTEC)

    5. Sheath removal with closure device
    View image
  • - , Main Arena 2

    Stent graft of cephalic arch

    Center:
    Varese
    Case 07 – Varese 01: Male, 21 years
    Operators:
    • Matteo Tozzi,
    • Federico Fontana,
    • Marco Franchin
    CLINICAL DATA
    – Brachio-cephalic AV fistula

    RISK FACTORS
    – CT scan: Double stenosis in cephalic arch. From 6 to 9 mm in diameter

    PROCEDURAL STEPS
    1. Vascular access cannulation
    – 6F TERUMO, 0,35 J Radiofocus TERUMO

    2. Femoral access
    – 9F TERUMO , 0,35 J Radiofocus TERUMO, Emerald CORDIS J 0,35 260 cm

    3. Balloons:
    – Predilatation 10X40 Advance enforcer COOK

    4. Stent Graft
    – Wrapsody by MERIT from 9 to 12 in diameter and 50/75 or 100 in length
    View image
  • - , Main Arena 2

    Ilio-caval occlusion recanalization

    Center:
    Modena
    Case 08 – Modena 01: Male, 44 years
    Operators:
    • Marzia Lugli,
    • Matteo Longhi,
    • Elisa Munari
    CLINICAL DATA
    – Comorbidities: Nephrotic syndrome till 17 (autoimmune cause),
    Coagulation defects: Leiden V hetero, therapy: acenocumarol

    RISK FACTORS
    – Acute DVT in 1998 (left leg) and 1999 (right leg). Bilateral Post-Thrombotic Syndrome
    – Villalta score: 13 left leg, 14 right leg. Venous claudication. CEAP C4b bilateral.
    – US examination: non-phasic flow common femoral vein bilateral, good access at femoral vein, good inflow. Wireless Air-Pletismography: outflow obstruction.
    – Venography: cava occlusion, bilateral iliac stenosis

    PROCEDURAL STEPS

    1. Bilateral ultrasound guided access at mid-thigh under general anesthesia, venography from both access.

    2. Systemic heparinization, Recanalization of the inferior cava and ilio-femoral district with 0.035 Terumo Advantage wire J curve and Cook TriForce Peripheral Crossing Set

    3. IVUS evaluation of the inferior cava and ilio-femoral district (Opticross 35 Peripheral Imaging Catheter – BOSTON SCIENTIFIC)

    4. Multiple dilatation with Atlas Gold PTA Dilatation Catheter (from 12x40 to 20x40 mm) (BD)

    5. IVUS evaluation of proximal and distal inferior cava landing zones and stent sizing according to vessel area (Opticross 35 Peripheral Imaging Catheter – BOSTON SCIENTIFIC)

    6. Inferior cava stenting (Wallstent Endoprosthesis – BOSTON SCIENTIFIC) and postdilatation with Atlas Gold PTA Dilatation Catheter (BD)

    7. IVUS evaluation of proximal and distal ilio-femoral landing zones, evaluation of the profunda vein system and possible extension under the inguinal ligament

    8. Stenting of the iliac bifurcation with Kissing thechnique (Wallstent Endoprosthesis – BOSTON SCIENTIFIC) and postdilatation with Atlas Gold PTA Dilatation Catheter (BD)

    9. According to IVUS evaluation possible stenting of the external iliac vein and common femoral vein (distal landing zone above profunda vein system) with Wallstent (BOSTON SCIENTIFIC) and postdilatation with Atlas Gold (BD)

    10. Final IVUS evaluation and Venography from both access
    View image
  • - , Main Arena 1

    Calcified SFA-CTO left

    Center:
    Leipzig, Universitätsklinikum, Abt. Angiologie
    Case 03 – LEI 02: Male, 65 years (KOP-L)
    Operators:
    • Axel Fischer
    CLINICAL DATA
    – Severe claudication left leg, walking capacity 100 meters
    – ABI left 0.56; Rutherford class 3
    – PTA left and right iliac arteries 1 and 2/2022
    – CAD, PTCA 2008 and 2016
    – COPD
    – Hypertension
    – Former smoker

    RISK FACTORS
    – Angiography during angioplasty of the right iliac arteries

    PROCEDURAL STEPS
    1. Cross-over approach
    – 7Fr Flexor Check-Flo Balkin Up& Over Sheath 40cm (COOK)

    2. Antegrade guidewire-passage:
    – Command 18 300cm Guidewire (ABBOTT)
    – 0.035" Guidewire Straight 260cm (TERUMO)
    – 0.035" QuickCross Support Catheter 130cm (PHILIPS)

    3. In case of failure to pass into the true lumen distal to the CTO
    – GoBack Crossing-Catheter, 4Fr-120cm (UPSTREAM PERIPHERAL)

    4. Vessel-preparation and DCB-angioplasty
    – Ultrascore 5/200 Scoring-Balloon (BD)
    – Orchid Drug-Coated Balloons 5.0mm/120mm (ACOTEC)

    5. Stenting on indication
    – Supera Interwoven Nitinol-Stent (ABBOTT)
    View image
  • - , 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)
    View image
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