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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 3

  • - , Main Arena 1

    Chronic occlusion of the right PA and stenosis of the left PA

    Center:
    Chengdu
    Case 22 – Chengdu, China 01: Female, late 50s (D-L)
    Operators:
    • Jichun Zhao,
    • Fei Xiong,
    • Bin Huang,
    • Hankui Hu
    CLINICAL DATA
    – Intermittent claudication of both lower limbs for 12 years, rest pain for 3 months, ulcer in left hallux, wound after right BK amputation is unable to heal 3 months, ulcer in left hallux, wound after right BK amputation is unable to heal

    RISK FACTORS
    – Hypertension.
    – Present state: Ulcer in left hallux, non-healing wound in right keen
    – CTA: Occlusion of right PA, and stenosis of left PA with serious calcification

    PROCEDURAL STEPS
    1. Both femoral access (5F)

    2. Lesion crossing: 0.018“ V18, (BOSTON SCIENTIFIC),0.014“ GAIA (ASAHI). 0.018 “
    Seeker support catheter (BD) if needed

    3. Balloon dilation: Chocolate: 4x60, 4x80, 4x120 (MEDTRONIC)

    4. DCB: IN.PACT Admiral DCB: 4x60,4x80, 4x120 (MEDTRONIC)

    5. BTK: Sterling 3x150 (BOSTON SCIENTIFIC), Saber 2.5x250, 2x250 (CORDIS) if needed.
    View image
  • - , 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.
    View image
  • - , Main Arena 1

    Complex CTO right femoropopliteal, CLI-Patient

    Center:
    Leipzig, Universitätsklinikum, Abt. Angiologie
    Case 23 – LEI 07: Male, 71 years (R-R)
    Operators:
    • Axel Fischer
    CLINICAL DATA
    – Ulcerations right forefoot and heel, severe claudication,
    – maxmial walking capacity 100 meters, ABI right 0,41, Rutherford class 6
    – CLI with endovascular treatment left leg 5/2022
    – Chronic renal insufficiency, GFR 57mm/min
    – Diabetes mellitus type 2, Hypertension, Former smoker

    RISK FACTORS
    – Angiography during PTA left leg showing diffuse disease of the right femoropopliteal tract, Severe calcifications

    PROCEDURAL STEPS
    1. 7Fr Cross-over approach from left to right
    – 7Fr 40cm Balkin Up&Over Sheath (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

    High-grade Internal Carotid Artery Stenosis

    Center:
    Leipzig, Universitätsklinikum, Abt. Angiologie
    Case 24 – LEI 08: Male, 71 years (A-S)
    Operators:
    • Sandra Düsing
    CLINICAL DATA
    – Progressive internal carotid artery stenosis right – 4.8m/sec. flow-velocity (3.2m/sec. 2021)
    – CAD, PTCA 2016 and 2021
    – COPD

    RISK FACTORS
    – Duplex-sonography 4.8m/sec.

    PROCEDURAL STEPS
    1. Right groin access
    – 5F Judkins Right diagnostic catheter (CORDIS)
    – 0.035"" SupreCore Guidewire 300cm (ABBOTT
    – 7Fr 90cm Check Flo Performer Sheath (COOK)

    2. Cerebral protection
    – Filterwire EZ (BOSTON SCIENTIFFIC)

    3. Predilatation
    – Armada XT 4.0/20mm Rapid Exchange Balloon (ABBOTT)

    4. Stentimplantation
    – 8/30mm CGuard Stent (InspireMD)

    5. Postdilatation in indication
    – Sterling Rapid Exchange Balloon 5.0/20mm (BOSTON SCIENTIFIC)
  • - , 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
  • - , 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
  • - , Main Arena 1

    Endovascular Treatment of chronic superficial femory artery stent occlusion

    Center:
    Zurich
    Case 25 – Zurich 05: Male, 72 years (K-G)
    Operators:
    • Nils Kucher,
    • Erik Holy
    CLINICAL DATA
    – Symptomatic PAD of the left lower leg since 01/2022, currently worsening and Fontaine stage IIb (100 m)

    RISK FACTORS
    – CVRF: former smoker, Dyslipidemia
    – Left SFA: PTA/Stenting chronic occlusion 2018, PTA in 2019 Stent restenosis,
    – PTA/DEB/Stenting 2021 In-Stent occlusion (currently on DAPT)
    – TEA and resection of a right CFA anuerysm 2018
    – Duplex 05/2022 (Figure 1 and 2): occluded Stent, reconstitution of distal popliteal artery via collateral vessels

    PROCEDURAL STEPS
    1. Antegrade access left CFA (6 F)

    2. Diagnostic angiography

    3. Catheter supported recanalisation of SFA occlusion

    4. Rotarex Atherectomy (6F or 8F) (BD)

    5. PTA +/- stenting of SFA/popliteal artery
    View image
  • - , Main Arena 2

    Thoracoabdominal Aneurysm Crawford III, BEVAR

    Center:
    Leipzig, Universitätsklinikum, Abt. Angiologie
    Case 30 – LEI 10: Male, 76 years (W-K)
    Operators:
    • Daniela Branzan
    CLINICAL DATA
    – Symptomatic thoracoabdominal aneurysm, Crawford III,
    – Recurrent abdominal pain
    – Maximal diameter of the aneurysm 68 mm
    – Preemptive embolization of the inferior mesenteric artery
    – Renal insufficiency GFR 65ml/min
    – CAD

    RISK FACTORS
    – CT-angiography

    PROCEDURAL STEPS
    1. Left axillary percutanous access
    – 12Fr-45 sheath (COOK)

    2. Bilateral groin access and preloading of closure-devices
    – Perclose ProStyle SMCR System (ABBOTT)

    3. Implantation of a branched throcaoabdominal off-the-shelf device
    – E-nside TAA Multibranch Stentgraft System (ARTIVION)

    4. Snaring of preloaded guidwires to facilitate antegrade access to the inner branches
    – Plywire 0.018"" 400cm (OPTIMED)
    – CloverSnare 4-Loop Vascular Retriever (COOK)

    5. Transaxillary implantation of bridging covererd stents into visceral and renal arteries
    – iCover PTFE Covered Stent System (iVASCULAR)

    6. Impantation of an off-the-shelf bifurcated stentgraft
    – E-tegra bifurcated stentgraft (ARTIVION)
    View image
  • - , Main Arena 1

    Complex calcified aortic disease in a patient with severe claudication and CLI

    Center:
    Kingsport
    Case 26 – Kingsport, USA 01: Female, 51 years (JDD)
    CLINICAL DATA
    – Severe bilateral hip and buttock claudiaction @ 50'; embolic events with amputation of toes bilaterally

    RISK FACTORS
    *CAD with prior MI and DES's; *NIDDM; *Hypertension; *ongoing tobacco use; *dyslipidemia; ABI's: R 0.66>0.24 with exercise; L 0.64>0.25 with exercise; *CTA: 90% severely calcified distal aorta, 50–75% calcified common iliac arteries, no significant infra-inguinal disease

    PROCEDURAL STEPS
    1. Vascular ultrasound – assisted micropuncture access bilaterally

    2. Intravascular ultrasound/ IVUS (PHILIPS Volcano)

    3. "Kissing" Shockwave X2 in aorta (SHOCKWAVE Medical)

    4. Abre 16X60 nitinol stent (MEDTRONIC) or Viabahn BX 11X39 covered stent (W. L. GORE)

    5. Viabahn BX covered stents right and left common iliacs (W. L. GORE)
    View image
  • - , Main Arena 2

    BEVAR for 60mm visceral patch aneurysm

    Center:
    Paris
    Case 31 – Paris 01: Female, 62 years, Obese, ASA 3
    Operators:
    • Stéphan Haulon,
    • Thomas Le Houérou,
    • Antoine Gaudin,
    • Côme Bosse,
    • Sean Crawford,
    • Dominique Fabre
    CLINICAL DATA
    – 2008 open TAAA repair, 2017 open ascending aorta repair,
    – 2019 endo branched right common iliac repair

    PROCEDURAL STEPS
    1. Percutaneous axillary and femoral approach

    2. Implantation of branched endograft

    3. Catherization and stenting of 5 branches from axillary access

    4. Completion angiogram and CBCT

    Devices:
    – COOK CMD endograft
    – Begraft + bridging stents (BENTLEY)
    – Viabahn bridging stents (GORE)
    View image
  • - , Main Arena 1

    Complex BTK-CTO right, CLI-Patient

    Center:
    Leipzig, Universitätsklinikum, Abt. Angiologie
    Case 27 – LEI 09: Male, 64 years (HJ-G)
    Operators:
    • Axel Fischer
    CLINICAL DATA
    – Critical Limb Ischemia right, ulcerations rigth forefoot,
    – ABI right 0.32, Rutherford class V
    – CAD, CABG 2018
    – Diabetes mellitus type 2
    – Chronic renal insufficiency, GFR 49ml/min
    – PTA / stenting BTK right 2/2020 (ATA and peroneal artery)
    – Angiography and unsuccessful recanalization attempt elsewhere

    PROCEDURAL STEPS
    1. Rigth groin antegrade access and retrograde anterior tibial artery access
    – 6Fr 55cm sheath (COOK)
    – Micropuncture pedal access kit (COOK)

    2. Antegrade and retrograde wiring of the anterior tib. art. CTO
    – Connect 250 T 0.018"" Guidewire 300cm (ABBOTT)
    – Winn 200 T 0.014"" 300cm Guidewire (ABBOTT)

    3. Predilatation / vessel-preparation
    – Chocolate balloon 3.0/100 (MEDTRONIC)

    4. Drug-coated balloon angioplasty
    – Litos 0.014"" Drug-Coated Balloon (ACOTEC)
    View image
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