LINC 2018 live case guide


Find all live cases and live case centers listed below.

 

 

Frankfurt/Main

3 livecase(s)
  • Wednesday, January 31st: - , Room 3 - Technical Forum

    Case 43 – Microwave ablation-HCC

    Center:
    Frankfurt/Main
    Case 43 – FRA 01: female, 76 years (K-M)
    Operators:
    • K. Eichler,
    • P. Panahi
    CLINICAL DATA
    - HCC-lesion in liver segment 3 in alcoholic liver cirrhosis
    - BCLC B
    - 12/2014 atypical liver resection Seg 7 (G2,pT3a, R0)
    - 09/2016 microwave ablation seg 6
    - 10/2016 microwave ablation seg 8

    PRESENT STATE
    - MELD score:6
    - CHILD-PUGH: A
    - No ascites

    PROCEDURAL STEPS
    1. Pre-ablation imaging like CT (contrast enhanced)
    2. Local anesthesia, analgosedation
    3. One antenna is placed directly into the lesion
    - EMPRINT CA15L2, Short percutaneous Antenna with thermosphere technology (COVIDIEN)
    - Generator: EMPRINT (COVIDIEN)
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  • Wednesday, January 31st: - , Room 3 - Technical Forum

    Case 46 – Conventional transarterial chemoembolization (cTACE) of hepatocellular carcinoma (HCC)

    Center:
    Frankfurt/Main
    Case 46 – FRA 02: female, 54 years (T-C)
    Operators:
    • T. Gruber-Rouh,
    • B. Bodelle
    CLINICAL DATA
    - 54 year old patient with HCC lesions in liver segments 8, 8/5 and 6
    - 12/2017: TACE

    RISK FACTORS
    liver cirrhosis, hepatitis B, BCLC-Stage-B, Type 2 diabetes mellitus, hypertension

    PROCEDURAL STEPS
    1. Right retrograde access
    - 5F sheath Introducer 2® (TERUMO)
    2. Catheterization and DSA of celiac trunk plus indirect porotgraphy
    - 5 F Side-Winder catheter (TERUMO)
    - 0.035'' angled guidewire (TERUMO)
    3. Selective catheterization of segmental and subsegmental branches of the hepatic artery in depending on location, size, and arterial feeding vessel of the target tumor
    - 2.8F coaxial microcatheter system Progreat (TERUMO)
    4. Chemoembolization with mitomycin C and lipiodol
    5. Puncture site closure with a percutaneous closure device
    - 6F Angio-Seal™ VIP (ST. JUDE Medical)
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  • Wednesday, January 31st: - , Room 3 - Technical Forum

    Case 50 – Transjugular intrahepatic portosystemic shunt (TIPSS)

    Center:
    Frankfurt/Main
    Case 50 – FRA 03: female, 59 years (B-H)
    Operators:
    • A. Thalhammer,
    • M. Nour Eldin,
    • S. Fischer
    CLINICAL DATA
    Alcoholic liver cirrhosis with portal hypertension, including refractory ascites and variceal bleeding

    RISK FACTORS
    Type 2 diabetes mellitus, hypertension

    PROCEDURAL STEPS
    1. Insertion of 10F sheath into the right jugular vein
    - 10F x 17-3%4'' sheath super Arrow-Flex® Psi Set, 45 cm, and tisue dilatator (Arrow International)
    - 0.035'' angled guide wire (TERUMO)
    2. Access to the a hepatic vein (right or middle) by inserting a 5F multi-purpose catheter
    - 5F MP A1 (CORDIS)
    - 0.035'' angled guide wire (TERUMO)
    3. Puncture of the portal vein under ultrasound or fluoroscopic control using a Tips puncture set
    - Tips puncture set with a spezial nitinol guide wire; needle size: ø 1.8 mm x 580 mm, 60° curved (OPTI MED)
    - 0.035'' straight guide wire (stiff type) (TERUMO)
    4. Placement of stiff guide wire and a catheter into the portal venous system to produce a direct portogram and to measure the direct portal pressure
    - 4F Berenstein catheter (ANGIO DYNAMICS)
    - Haemofix-Monitorin Kit Art/Ven BSS
    5. Dilatation of the parenchymateous tract using an angioplasty balloon
    - 0.035'' Supra Core 35 (ABBOTT VASCULAR)
    - 6F Armada 35 PTA catheter (ABBOTT VASCULAR)
    - Inflation device (MERIT MEDICAL)
    6. Placement of the 10F sheath into the portal mainstem
    - 10 F Check Flo Performer® introducer (COOK)
    7. Implantation the portovenous PTFE covered stent under fluoroscopic control
    - VIATORR 10 mm x 8 cm/2 cm; 10F (GORE)
    8. Dilatation of stent using an angioplasty balloon
    - 0.035'' Supra Core 35 (ABBOTT VASCULAR)
    - 6F Armada 35 PTA catheter (ABBOTT VASCULAR)
    - Inflation device (MERIT MEDICAL)
    9. Direct portography and measure the pressure gradients between the portal vein and the inferior vena cava
    - 5F- MP A1 (CORDIS)
    - F Check Flo Performer® introducer (COOK)
    10. Placement of a central venous catheter in the superior vena cava or right atrium
    - Mahurkar acute dual lumen catheter, 11.5F x 19.5 cm (COVIDIEN)

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