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 4

  • - , Main Arena 1

    Long total occulusion of ATA with severe calcification

    Center:
    Amagasaki
    Case 32 – Amagasaki 01: Male, 57 years (S-K)
    Operators:
    • Osamu Iida,
    • Yosuke Hata,
    • Taku Toyoshima,
    • Naoko Higashino
    CLINICAL DATA
    – Nov/2021: drug coated balloon for left popliteal stenosis
    – April/2021: drug coated balloon for right SFA stenosis, plain angioplasty for tibial-peroneal trunk
    – Previous amputation for right toe thumb

    RISK FACTORS
    – Hypertension, Type II diabetes, Dislipidemia, Hemodialysis, Coronary artery disease
    – Skin perfusion pressure: dorsal 24mmHg, plantar 22mmHg
    – WIFI classification: W 1, I 3, fl 0

    PROCEDURAL STEPS
    1. Ipsilateral antegrade approach from rt CFA with 5Fr sheath

    2. Retrograde approach from dorsal pedis artery with micro catheter
    if antegrade approach is failed


    3. Wire: 0.014 inch Regalia, Gladius (ASAHI INTECC), 0.035 inch GLIDEWIRE. Baby-J™ Hydrophilic Coated Guidewire (TERUMO)

    4. Support catheter: CXI 4Fr (COOK), Armet (ASAHI INTECC)

    5. Support catheter: CXI 4Fr (COOK), Armet (ASAHI INTECC)

    6. Imaging modality: intravascular ultrasound (TERUMO)

    7. Treatment: Plain balloon angioplasty (IVUS-guided decision)
    View image
  • - , Main Arena 1

    BTK: Long PT occlusion

    Center:
    Abano Terme
    Case 33 – Abano Terme 01: Male, 81 years (G-F)
    Operators:
    • Salvatore Esposito,
    • Cesare Brigato
    CLINICAL DATA
    – Type 2 DM, ischemic cardiopathy, neurovasculopathy, dyslipedemia, obesity
    – wet gangrene right III° toe
    – TcPO2 = 20 mmHg

    PROCEDURAL STEPS
    1. US guided antegrade 6F sheath

    2. CO2 angio and 2D perfusion of the foot

    3. Antegrade CTO crossing 0,18/0,14 wires

    4. Retrograde with/without puncture (transloop) whenever failure

    5. POBA, DEB and dedicated stents

    Devices:
    – Ranger (BOSTON SCIENTIFIC) or
    – Lutonix DCB (BD)
    View image
  • - , 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
    View image
  • - , Main Arena 1

    Complex popliteal CTO, CLI

    Center:
    Leipzig, Universitätsklinikum, Abt. Angiologie
    Case 34 – LEI 11: Male, 63 years (N-V)
    Operators:
    • Axel Fischer
    CLINICAL DATA
    – Multiple small ulcerations left lower leg, restpain left foot, walking capacity 20 meters,
    – ABI left 0.2; Rutherford VI
    – CAD, PTCA 2021

    RISK FACTORS
    – Angiography elsewhere showing a long popliteal occlusion left
    – Diabetes mellitus type 2
    – Hypertension
    – Former smoker

    PROCEDURAL STEPS
    1. Left antegrade access
    – 6Fr 55cm sheath (COOK)

    2. Retrograde posterior tibial, peroneal or anterior tibial access
    – Micropuncture Pedal Access Kit (COOK)

    3. Antegrade and retrograde intraluminal wiring
    – Hydro ST 0.014"" Guidewire 300cm (COOK)
    – Approach CTO 0.014"" Guidewire 300cm (COOK)
    – CXI Support-Catheter 0.018"" 90cm angled (COOK)

    4. Balloon-angioplasty
    – Advance Serenity 14 (COOK)
    – Micro 14 Angioplasty Balloon (in case of retrograde ballooning) (COOK)
    View image
  • - , Main Arena 2

    Frozen elefant trunk with new hybrid prosthesis

    Center:
    Leipzig, Heart Center
    Case 38 – Leipzig – Heart Center Leipzig 01: Female, 73 years (B-M)
    Operators:
    • Martin Misfeld,
    • Christian Etz
    CLINICAL DATA
    – Aortic arch aneurysm

    RISK FACTORS
    – Advanced age
    – E-vita Open Neo Hybrid Prothesis (ARTIVION)

    PROCEDURAL STEPS
    1. Cardio-pulmonary-bypass 8CPB

    2. Procedure performed in hypothermia

    3. Selective cerebral perfusion

    4. E-vita Open Neo Hybrid prothesis (ARTIVION) implantation in zone 2

    5. Extra-anatomical bypass to left subclavian artery

    6. Rewarming and weaning from CBP
  • - , Main Arena 2

    BEVAR for Arch penetrating ulcer

    Center:
    Paris
    Case 39 – Paris 02: Male, 73 years
    Operators:
    • Stéphan Haulon,
    • Thomas Le Houérou,
    • Antoine Gaudin,
    • Côme Bosse,
    • Sean Crawford,
    • Dominique Fabre
    CLINICAL DATA
    – Severe COPD, ASA 3

    PROCEDURAL STEPS
    1. Percutaneous right axillary and femoral access

    2. RV access from right femoral vein

    3. LV access from right femoral artery

    4. Deployement of the branched endograft under rapid pacing

    5. Deployement of inominate artery bridging limb from right axillary access

    6. Access and deployement of LCC and LSA bridging stents from the groin

    7. Completion angiogram and CBCT

    Devices:
    – COOK CMD endograft
    – Begraft + bridging stents (BENTLEY)
    – Viabahn bridging stents (GORE)
    View image
  • - , Main Arena 2

    Infarenal aortoiliac aneurysm, EVAR with IBD

    Center:
    Leipzig, Universitätsklinikum, Abt. Angiologie
    Case 40 – LEI 13: Male, 72 years (T-F)
    Operators:
    • Axel Fischer
    CLINICAL DATA
    – Incidental finding of an infrarenal aortic aneurysm with extension to the left common iliac artery, maximal diameter 42mm
    – Resuscitation during general anaesthesia for surgery of prostatic cancer 2015
    – Coilembolization of aortic sidebranches to prevent type II endoleaks 4/2022

    RISK FACTORS
    – CAD, PTCA 2016
    – Prostatic cancer 2015
    – Hypertension

    PROCEDURAL STEPS
    1. Treatment under local anaesthesia
    – Bilateral femoral access with preloading of 2 ProStyle-systems per groin (ABBOTT)

    2. Placement of super-stiff guidewires bilateral and sheaths
    – Lunderquist 0.038"" 260cm Guidewire (COOK)
    – 12 Fr-45cm sheath left groin (GORE)
    – 22Fr-33cm sheath right groin (GORE)

    3. Snaring of a 0.018"" support-guidewire accross the aorto-iliac bifurcation
    – 0.018"" V-18 Control Guidewire 300cm (BOSTON SCIENTIFIC)
    – 10mm Amplatz Goose Neck Snare Kit (MEDTRONIC)

    4. Insertion of the sidebranch device right iliac axis
    – IBD 23mm-14.5mm (GORE)

    5. Cross-over insertion of the sidebranch graft
    – internal iliac ectension 16-14.5-70mm (GORE)

    6. Implantation of the infrarenal bifurcated stentgraft
    – C3 28-14.5-140mm (GORE)

    7. Bridging to the IBD left and extension to the right common iliac artery
    – 16-27-100mm (GORE) right
    – 16-23-120mm (GORE) left
    View image
  • - , Main Arena 1

    BTK/BTA: Long PT/plantar occlusion

    Center:
    Abano Terme
    Case 35 – Abano Terme 02: Male, 61 years (G-F)
    Operators:
    • Salvatore Esposito,
    • Cesare Brigato
    CLINICAL DATA
    – Type 2 DM; ischemic cardiopathy; heart failure; dyslipedemia; obesity; previous controlateral chopart amputation; Fontaine IV; Rutherford 5
    – Deep heel ulcer, moderate ischemia, mild infection
    – WIFI: W3 I2 Fi1

    PROCEDURAL STEPS
    1. US guided antegrade 6F sheath

    2. CO2 angio and 2D perfusion of the foot

    3. Recanalization anterior and posterior tibial arteries CTO 0,018 /0,014 wires

    4. Predilatation if needed and POBA; DEB and dedicated stents discussion

    5. US guided Closure device deployment

    Devices:
    – Ranger (BOSTON SCIENTIFIC) or
    – Lutonix DCB (BD)
    View image
  • - , Main Arena 1

    BTK/BTA: Long PT/plantar occlusion

    Center:
    Abano Terme
    Case 35 – Abano Terme 02: Male, 61 years (G-F)
    Operators:
    • Salvatore Esposito,
    • Cesare Brigato
    CLINICAL DATA
    – Type 2 DM; ischemic cardiopathy; heart failure; dyslipedemia; obesity; previous controlateral chopart amputation; Fontaine IV; Rutherford 5
    – Deep heel ulcer, moderate ischemia, mild infection
    – WIFI: W3 I2 Fi1

    PROCEDURAL STEPS
    1. US guided antegrade 6F sheath

    2. CO2 angio and 2D perfusion of the foot

    3. Recanalization anterior and posterior tibial arteries CTO 0,018 /0,014 wires

    4. Predilatation if needed and POBA; DEB and dedicated stents discussion

    5. US guided Closure device deployment

    Devices:
    – Ranger (BOSTON SCIENTIFIC) or
    – Lutonix DCB (BD)
    View image
  • - , 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
    View image
  • - , Main Arena 1

    Pedal recanalization for limb threatenting ischemia

    Center:
    Leipzig, Universitätsklinikum, Abt. Angiologie
    Case 36 – LEI 12: Male, 71 years (J-S)
    Operators:
    • Sandra Düsing
    CLINICAL DATA
    – Ulceration right forefoot, acute worsening 6 weeks ago,
    – Recanalization of an acute occlusion of the popliteal artery right 4/2022
    – Unsuccessful guidewire-passage into pedal arteries (posterior tibial artery)

    RISK FACTORS
    – Angiography 6 weeks before showing the popliteal artery occlusion, recanalization and remaining distal tibial artery occlusions, and angiography after additional thrombolysis showing chronic distal tibial and pedal occlusions
    – ABI right 0

    PROCEDURAL STEPS
    1. Antegrade access right groin
    – 6Fr 50cm sheath (COOK)

    2. Guidewire-passage of the posterior tibial artery occlusion
    – 0.014"" Command ES 300cm (ABBOTT)
    – 0.014"" Winn 200T 300cm (ABBOTT)
    – Command 18, 300cm (ABBOTT)

    3. Atherectomy / thrombectomy (peroneal artery and posterior artery occlusion)
    – Excimer-laser 1.4mm (PHILIPS)

    4. Balloon-Angioplasty /DCB-PTA
    – Armada 14 2.5/120mm (ABBOTT)
    – Litos Drug-Coated Balloon 3.0/120mm (ACOTEC)
    View image
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