LINC
MIDDLE EAST
2016
Grand Hyatt Hotel Dubai
Sheikh Rashid Road
Dubai, United Arab Emirates
April 7 and April 8, 2016
Guide to Live Case
Transmissions
Guide to Live Case Transmissions
During LINC Middle East 2016 19 inter­
ventional and surgical live cases are
scheduled to be performed and transmitted
to the auditorium. The aim of this booklet
is to give you an overview about the live
case schedule and to provide a practical
guide through the procedures.
We hope for your under­standing that
with respect to the clinical needs of the
patients changes of the schedule may occur.
Furthermore, the anticipated procedural
steps are just an outline of the procedure.
Depending on the discretion of the
operator the procedural strategy or the
choice of material may vary.
Thursday
LINC MIDDLE EAST
2016
Procedural
steps
Thursday,
April 7, 2016
1
Thursday, 08:00 – 09:00 Live from University Hospital Leipzig, Germany Case 01 – LEI 01: male, 63 years, (S-F)
Total occlusion left common iliac artery
Operators:
A. Schmidt, M. Ulrich
Clinical data:
Severe claudication left buttock, thigh and calf, walking capacity 50 meters
Rutherford class 3
CAD with PTCA 2008 and 2015
Former smoker
Art. hypertension
Angiography:
During PTCA 2015: calcified total occlusion left common iliac artery
ABI left 0.65
Procedural
steps
1. Femoral access left side
■ 7 F 25 cm sheath (TERUMO)
Left brachial approach:
■ 7 F 90 cm Check-Flo Perfomer Sheath (COOK)
2. Guidewire passage from brachial
■ 5 F 125 cm Judkins Right diagnostic catheter (CARDINAL HEALTH)
■ 0.035" stiff angled glidewire, 260 cm (TERUMO)
3. Guidewire passage from femoral
■ 5 F 80 cm Multipurpose diagnostic catheter (CARDINAL HEALTH)
■0
.035" stiff angled glidewire, 260 cm (TERUMO)
■P
otentially double-balloon-technique with:
Admiral balloon 5.0/40 mm, 135 cm (MEDTRONIC)
4. Stentgraft implantation bilateral after predilatation
■ L ifeStream covered stentgraft (BARD)
2
Thursday, 09:08 – 09:36 Live from University Hospital Leipzig, Germany Case 02 – LEI 02: female, 72 years (E-R)
Chronic total occlusion right SFA
S. Bräunlich, M. Ulrich
Clinical data:
Severe claudication right calf, walking capacity 100 meters
Rutherford class 3
Diabetes mellitus type 2, art. hypertension
Duplex:
Partially calcified SFA-occlusion right
ABI 0.67
Angiography:
SFA-occlusion right, moderately calcified
Procedural
steps
Thursday
Operators:
1. Left groin access and cross-over approach
■ 5 F IMA-cathter (CARDINAL HEALTH)
■ 0.035" soft angled glidewire 180 cm (TERUMO)
■ 0.035" SupraCore Guidewire 180 cm (ABBOTT)
■ 6F 40 cm Balkin Up&Over Sheath (COOK)
2. Guidewire passage
■0
.018" Connect guidewire, 300 cm (ABBOTT)
■4
.0/120 mm Pacific Extreme balloon catheter, 135 cm (MEDTRONIC)
■ In case of thrombus Rotarex thrombectomy before PTA (STRAUB MEDICAL)
3. PTA with drug-coated balloons
■ 5 .0/120 mm In.Pact Pacific (MEDTRONIC)
4. Stenting on indication
■C
omplete selfexpanding nitinol-stent (MEDTRONIC)
3
Thursday, 10:24 – 10:49 Live from University Hospital Leipzig, Germany Case 03 – LEI 03: male, 64 years (W-S)
Chronic total occlusion SFA bilateral
Operators:
Clinical data:
Procedural
steps
A. Schmidt, Y. Bausback
Severe claudication both calves, walking capacity 150 meters; right > left
Rutherford classification 3
Mitral insufficiency II, NYHA II
Art. hypertension, former smoker
COPD
ABI right 0.66; left 0.67
1. Left groin access and cross-over approach
■ 5 F IMA-cathter (CARDINAL HEALTH)
■0
.035" soft angled glidewire 180 cm (TERUMO)
■0
.035" SupraCore guidewire 180 cm (ABBOTT)
■6
F 40 cm Balkin Up&Over Sheath (COOK)
2. Gudewire passage
■0
.035" stiff angled glidewire, 260 cm (TERUMO)
■S
eeker support catheter, 135 cm (BARD)
■E
xchange to a 0.018" SteelCore guidewire, 300 cm (ABBOTT)
3. PTA
■V
ascuTrak balloon 5.0/250 mm (BARD)
■ Lutonix DCB 5.0 or 6.0/150 mm (BARD)
4. Stenting on indication
■ L ifeStent selfexpanding nitinol-stent (BARD)
4
Thursday, 10:57 – 11:22 Live from Rashid Hospital, Dubai, United Arab Emirates Case 04 – RAH 01: male, 61 years (I-A)
Endovascular repair of left CFA and SFA occlusion
Operators:
A. Al-Sibaie, A. Alfalahi
Procedural
steps
Thursday
Clinical data: PAD with intermittent claudication, left leg pain
Rutherford grade I Fontain IIB.
ABI = 0.3
Important items: HTN, IHD, Angioplasty and stenting done for both external iliac arteries
and surgical procedure profundaplasty was done in 2012.
1. Access right groin and cross-over approach
■ 7 F Flexor Check-flo introducer (COOK)
2. Recanalization of left common femoral artery
■T
ERUMO 0.035" with support catheter 4 Fr. glide catheter (TERUMO)
3. Predilation
■ 5 .0 x 60 mm ballon catheter
4. Postdilatation
■D
EB 0.035" 6.0 mm x 80 mm 130 cm In.pact Admiral (MEDTRONIC)
5. Retrograde access to recanalize superficial femoral artery
6. PTA with DEB depends on final angiography
7. Spot stenting in case of dissection or residual stenosis
■D
epending on the location either SUPERA or Zilver PTX (COOK)
5
Thursday, 11:40 – 12:05 Live from University Hospital Leipzig, Germany Case 05 – LEI 04: female, 63 years (S-G)
Reocclusion right SFA
Operators:
M. Ulrich, A. Schmidt
Clinical data:
Severe claudication right SFA, walking capacity 100 meters
PTA left SFA 2/2016
PTA right SFA 2014 elsewhere
CEA right internal carotid artery 2012
Art. hypertension
Diabetes mellitus type 2
Angiography:
Right SFA during PTA left SFA 2/2016
ABI right 0.65
Procedural
steps
1. Left groin access and cross-over approach
■ 5 F IMA cathter (CARDINAL HEALTH)
■ 0.035" soft angled glidewire 180 cm (TERUMO)
■ 0.035" SupraCore guidewire 300 cm (ABBOTT)
■ 6F 40 cm Balkin Up&Over Sheath (COOK)
2. Gudewire passage
■0
.035" stiff angled glidewire, 260 cm (TERUMO)
■C
XC support catheter, 135 cm (COOK)
■E
xchange to a 0.035" SupraCore guidewire, 300 cm (ABBOTT)
3. PTA and stenting
■A
dvance 0.035" balloon 5.0/100 mm (COOK)
■Z
ilver-PTX stents 6.0/120 mm (COOK)
6
Thursday, 13:30 – 14:15 Live from University Hospital Leipzig, Germany Case 06 – LEI 05: male, 58 years (G-N)
Re-occlusion left, partially in-stent
Clinical data:
Procedural
steps
A. Schmidt, S. Bräunlich
Severe claudication left calf, walking capacity 100 meters, restpain during night
Rutherford class 4
Failed antegrade recanalization attempt left SFA 2/2016
PTA and stenting left SFA elsewhere 1/2015
CAD, COPD, art. hypertension, former smoker
ABI left 0.55
Thursday
Operators:
1. Right groin access and cross-over approach
■ 5 F IMA-cathter (CARDINAL HEALTH)
■0
.035" soft angled glidewire 180 cm (TERUMO)
■0
.035" SupraCore guidewire 180 cm (ABBOTT)
■ 7 F 40 cm Balkin Up&Over Sheath (COOK)
2. Guidewire passage
■0
.035" stiff angled glidewire, 260 cm (TERUMO)
■Q
uickCross support catheter, 135 cm (SPECTRANETICS)
■E
xchange to a 0.014" Floppy ES Extrasupport guidewire, 300 cm (ABBOTT)
3. In case of failure to pass the guidewire from antegrade
Stent-puncture (proximal or disal stent):
■ 1 8 gauge 7 cm needle proximal and 21 gauge 9 cm needle distally (COOK)
■0
.018" V-18 Control guidewire 300 cm (BOSTON SCIENTIFIC)
■0
.018" QuickCross support catheter 90 cm (SPECTRANETICS)
4. Laser atherectomy and PTA
■ 7 F Tandem Booster-Laser atherectomy (SPECTRANETICS)
■S
tellarex DCB 5.0/120 mm (SPECTRANTICS)
7
Thursday, 14:31 – 14:51 Live from Rashid Hospital, Dubai, United Arab Emirates Case 07 – RAH 02: male, 53 years (N-G)
Right lower limb below knee triple artery segmental stenosis
Operators:
Clinical data:
A. Al-Sibaie, A. Alfalahi
Right leg pain, rutherford grade III Fontain IV.
Right SFA total occlusion balloned and stented.
RT ABI = 0.2
Important items: HTN, DM type II, IHD, CCF
Procedural
steps
1. Right femoral antegrade access
2. Antegrade recanaliztion of anterior and posterior tibial arteries,
in cases not succesful retrograde access will be used
3. Retrograde pedal access
■M
icro puncture set (COOK)
4. Recanalization
■0
.014" wire command ABBOTT with support catheter
5. Snaring of the wire through the femoral access
6. Ballon angioplasty
■O
ver the wire in antegrade direction ballon angioplasty 2.5 mm dilator
0.014" Armada ABBOTT
8
Thursday, 15:32 – 16:11 Live from University Hospital Leipzig, Germany Case 08 – LEI 06: male, 62 years (KH-L)
Severely calcified popliteal occlusion right
S. Bräunlich, A. Schmidt
Clinical data:
Critical limb ischemia with ulceration dig V
Rutherford class 5
CAD, ischemic cardiomyopathy, EF 45%, NYHA II
Diabetes mellitus type 2, former smoker
Angiography:
Distal SFA / Apop P1-segment occlusion right
Anterior and posterior tibial artery occlusion
Severe calcification
ABI right 0.33
Procedural
steps
Thursday
Operators:
1. Right antegrade access
■6
F 55 cm sheath (COOK)
2. Guidewire passage
■0
.035" stiff angled glidewire, 260 cm (TERUMO)
supported by a balloon:
■A
rmada 35 balloon 4.0/80 mm, 90 cm (ABBOTT)
in case of failure to pass the CTO from antegrade
retrograde approach via peroneal artery:
■ 7 cm 21 gauge needle (COOK)
■0
.018" Connect guidewire 300 cm (ABBOTT)
■0
.018" QuickCross support catheter (SPECTRANETICS)
3. PTA and stenting
■A
rmada 5.0 or 6.0/40 mm (ABBOTT)
■ 5 .0 Supera Interwoven nitinol-stent (ABBOTT)
9
Thursday, 16:35 – 17:15 Live from University Hospital Leipzig, Germany Case 09 – LEI 07: male, 65 years (H-G)
Anterior tibial artery occlusion, multiple ulcerations forefoot left
Operators:
M. Ulrich, Y . Bausback
Clinical data: Ulceration Left foot, Rutherford class 5
Failed antegrade recanalization attempt with failure to pass the guidewire
through the ATA-CTO elsewhere
Diabetes mellitus type 2, art. hypertension, former smoker
Angio:
Procedural
steps
ABI right 0.44
Anterior tibial artery occlusion left, high offspring
1. Antegrade access left
■6
F 55 cm sheath (COOK)
2. Retrograde approach via the dorsalis pedis artery left
■P
edal puncture set (COOK)
■4
cm 21 gauge needle (COOK)
■ 2 .9F sheath (COOK)
■0
.018" V-18 Control guidewire 300 cm (BOSTON SCIENTIFIC)
■0
.018" CXI support catheter 90 cm (COOK)
■E
xchange to 0.014" Hydro-ST guidewire 300 cm (COOK)
■A
dvance Micro balloon 3.0/120 mm, 90 cm (COOK)
3. PTA from antegrade with DCBs
After predilatation from retrograde
■ Lutonix DCBs from antegrade (BARD)
10
Thursday, 17:15 – 18:00 Live from University Hospital Leipzig, Germany Case 10 – LEI 08: male, 72 years (R-F)
Progressive, highgrade stenosis left internal carotid artery
Clinical data:
A. Schmidt, S. Bräunlich
90% stenosis left ICA
Minor stroke 1/2015
Art. hypertension, diabetes mellitus type 2
CAD with NSTEMI 11/2015, PTCA
Thursday
Operators:
Risk factors: Left ICA flow-velocity progression
1/2015: 2.5m/sec
11/2015: 4.8m/sec
Procedural
Angiography during PTCA 11/2015: 90% stenosis left ICA
steps
1. Right groin access
■9
F 25 cm sheath (TERUMO)
2. Cannulation of the left external carotid artery
■ 5 F Judkins right diagnostic catheter (CARDINAL HEALTH)
■0
.035" soft angled glidewire, 190 cm (TERUMO)
■E
xchange to 0.035" SupraCore guidewire, 190 cm (ABBOTT)
3. Cerebral protection
■M
OMA endovascular clamping device (MEDTRONIC)
4. Predilatation, stenting and postdilatation
■ 3 .5/20 mm MiniTrek RX balloon (ABBOTT)
■R
oadsaver carotid artery stent system (TERUMO)
■ 5 .0/20 mm Sterling RX balloon (BOSTON SCIENTIFIC)
5. Aspiration of potential plaque-debris before declamping of the MOMA-system
6. Final angiography
11
12
LINC MIDDLE EAST
2016
Friday
Friday,
April 8, 2016
13
Friday, 08:00 – 08:45 Live from University Hospital Leipzig, Germany Case 11 – LEI 09: male, 59 years (P-R)
Severely calcified distal SFA / Apop-CTO right
Operators:
A. Schmidt, M. Ulrich
Clinical data:
Restpain right foot, walking capacity 50 meters, claudication right calf
Rutherford class 4
PTA and stenting iliac arteries 2012 and 2/2016
Failure to recanalize the SFA / Apop-occlusion right from antegrade
TEA right groin 2014, PTA / Supera-stent left popliteal artery 3/2015
End stage renal failure with chronic dialysis
CAD, PTCA 2012, ICD
Risk factors:
ABI: > 1.4 (mediasclerosis)
Severely calcified total occlusion of the distal SFA and Apop right
Procedural
steps
1. Right groin antegrade access
■ 7 F 40 cm Balkin Up&Over Sheath (COOK)
2. Second attempt to pass the CTO from antegrade
■0
.035" stiff angled glidewire, 260 cm (TERUMO)
■4
.0/80 mm Armada 35 balloon, 90 cm (ABBOTT)
3. In case of failure retrograde approach via the proximal anterior tibial artery
■ 7 cm 21 gauge needle (COOK)
■ 0.018" Connect guidewire, 300 cm (ABBOTT)
■ 0.018" CXC support catheter, 90 cm (SPECTRANETICS)
potentially sheath-insertion:
■ 4F 10 cm Radiofocus Sheath, 0.025" GW-compatible (TERUMO)
4. PTA and stenting
■ 5 .0/40 mm and 6.0/40 mm Armada 35 balloon (ABBOTT)
■ 5 .0 or 6.0 mm Supera interwoven nitinol-stent (ABBOTT)
14
Friday, 09:01 – 09:26 Live from Rashid Hospital, Dubai, United Arab Emirates Case 12 – RAH 03: male, 55 years (M-A)
AAA with extension to common iliac arteries
modified implantation technique of IBD
Operators:
A. Al-Sibaie, A. Alfalahi
Clinical data:Infrarenal AAA measuring 5.7 cm extending over the aortic bifurcation
to common iliac arteries
Risk factors:-Short common iliac arteries, the internal iliac artery bilaterally
are seen originating approx. 1 cm distal to the orgin of common iliac arteries.
-Standard devices can't provide long term distal sealing.
-Modified implantation technique of IBD is required as the right common iliac artery
is too short to do it according to IFU.
1. MAIN BODY (ZENITH COOK) insertion through left femoral access
2. Through and through wire from left brachial access
through the main body to right femoral access
3. Insertion IBD (ZENITH COOK) through the right femoral access
using the through and through wire as an access to the Internal iliac artery branch
4. Periphral stent graft 7F BENTLEY InnoMED will be inserted
through the left brachial access through the IBD into right internal iliac artery
5. Connecting IBD with main body
6. Extending left iliac limb into the external iliac artery
covering the left internal iliac artery
Friday
Procedural
steps
15
Friday, 09:34 – 09:59 Live from University Hospital Leipzig, Germany Case 13 – LEI 10: male, 72 years (M-W)
Percutaneous EVAR
Operators:
Clinical data:
A. Schmidt, D. Branzan
Progressive infrarenal abdominal aortic aneurysm
Art. hypertension, former smoker
Prostatic cancer surgery 2015
Duplex: Duplex-sonographic measurement
12/2012: 32 mm max. diameter
12/2015: 51 mm max. diameter, excentric infrarenal aneurysm
1. Percutaneous access in local anaesthesia both groins
Procedural
■P
reloading of 2 Proglide-systems per groin (ABBOTT)
steps
■9
F 10 cm Radiofocus sheath (TERUMO)
■ L underquist guidewire 180 cm (COOK)
2. Implantation of the stentgraft
■O
vation stentgraft (ENDOLOGIX / TRIVASCULAR)
■P
olymere filling of the graft
■C
annulation of the contralateral limb
■ 5 F Amplatz left diagnostic catheter (CARDINAL HEALTH)
■0
.035" soft angled guidewire, 190 cm (TERUMO)
■ Implantation of both limb-extensions (ENDOLOGIX / TRIVASCULAR)
3. PTA
■P
roximal seal: Reliant balloon (MEDTRONIC)
■G
raft-bifurcation: 12/40 mm Admiral balloon in kissing-technique (MEDTRONIC)
4. Closure of the groins
■P
reloaded Proglide-systems (ABBOTT)
16
Friday, 10:43 – 11:08 Live from University Hospital Leipzig, Germany Case 14 – LEI 11: female, 28 years (L-M)
Iliofemoral venous intervention
A. Schmidt, Y. Bausback, D. Branzan
Clinical data:
Iliac vein left side and distal inferior vena cava thrombosis 6/2013
Venous claudication left (painfree walking capacity 500 meters)
Swelling left leg despite compression therapy
No skin changes, groin varicosis left
Present state:
Phlebography via popliteal vein:
postthrombotic residuum left common femoral vein,
total occlusion iliac vein left, varicous groin-veins.
Procedural
steps
1. Prone position of the patient in general anaesthesia
2. Duplex-guided access left popliteal vein
■ 1 1F 10 cm Radiofocus sheath (TERUMO)
3. Guidewire passage of the left iliac veins
■0
.035" stiff straight glidewire, 260 cm (TERUMO)
■ 4F 100 cm Judkins Right diagnostic catheter (CARDINAL HEALTH) or
■ 0.018" V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
■ 3.0/120 mm Pacific Extreme balloon (MEDTRONIC)
Friday
Operators:
4. PTA
■A
tlas high pressure balloon 14/60 mm (BARD)
5. Implantation of dedicated iliac vein stents
■S
inus-Obliquus 14-16 mm (OPTIMED)
■S
inus-XL Flex 14-16 mm (OPTIMED) or
■Z
ilver Vena venous self-expanding stent (COOK)
6. Postdilatation
■A
tlas high pressure balloon 14/60 mm (BARD)
17
Friday, 11:45 – 12:30 Live from University Hospital Leipzig, Germany Case 15 – LEI 12: male, 62 years (S-D)
Acute reocclusion left SFA after PTA / stent
Operators:
S. Bräunlich, M. Ulrich
Clinical data:
Severe claudication left calf, walking capacity 150 meters
Rutherford class 3
PTA left SFA 1/2016 elsewhere with an acute reocclusion 2 days post PTA
CAD, MI 2012
Diabetes mellitus type 2, art. hypertension, current smoker
Current state:
Procedural
steps
ABI left 0.70
Angiography of the left SFA-stenosis before PTA and after stenting
Angiography of the acute reocclusion of the SFA 2 days later
PTA / stent SFA-Stenosis left 11/2015
Acute occlusion early after PTA
1. Right groin retrograde and cross-over approach
■ IMA diagnostic 5F catheter (CORDIS / CARDINAL HEALTH)
■0
.035" angled soft Radiofocus glidewire, 190 cm (TERUMO)
■0
.035" SupraCore guidewire, 190 cm (ABBOOTT)
■8
Fr Balkin Up&Over Sheath, 40 cm (COOK)
2. Passage of the occlusion and percutaneous thrombectomy
■0
.018" Connect guidewire 300 cm (ABBOTT)
■0
.018" QuickCross support catheter 135 cm (SPECTRANETICS)
■E
xchange to Rotarex guidewire (STRAUB MEDICAL)
■8
F Rotarex thrombectomy catheter (STRAUB MEDICAL)
3. PTA with DCBs
■ In.Pact Pacific 5.0/120 mm (MEDTRONIC)
4. Stenting on indication
■C
omplete selfexpanding nitinol-stent (MEDTRONIC)
18
Friday, 13:30 – 14:00 Live from University Hospital Leipzig, Germany Case 16 – LEI 13: male, 76 years (M-P)
Restpain left leg, unsuccessful recanalization attempt
A. Schmidt, M. Ulrich
Clinical data:
Restpain left foot, claudication left calf, walking capacity 20 meters
Rutherford class 4
Fem-pop bypass surgery left 2012 with early failure
PTA and stent left distal SFA 1/2013
Reocclusion 12/2015 and failure to recanalize from antegrade and retrograde elsewhere
Art. hypertension
Surgery of a colon-carcinoma 2012
Angiography:
Left: total occlusion of the SFA to the popliteal segment
ABI left 0.2
Procedural
steps
1. Right groin retrograde and cross-over approach
■ IMA diagnostic 5F catheter (CORDIS / CARDINAL HEALTH)
■0
.035" angled soft Radiofocus glidewire, 190 cm (TERUMO)
■0
.035" SupraCore guidewire, 190 cm (ABBOOTT)
■6
F Balkin Up&Over Sheath, 40 cm (COOK)
2. Retrograde approach via the occluded SFA
■ 1 8 gauge 7 cm needle (COOK)
■0
.035" stiff angled glidewire 190 cm (TERUMO)
■4
F 12 cm Sheath (St. JUDE)
■0
.018" Connect 250 T guidewire, 300 cm (ABBOTT)
■4
F Judkins right diagnostic catheter (CARDINAL HEALTH)
3. In case of failure to reenter
from retrograde into the
common femoral artery
■E
xchange to a 6F 10 cm
sheath (TERUMO)
■O
utback reentry device
from retrograde
(CARDINAL HEALTH)
■0
.014 Stabilizer
300 cm guidewire
(CARDINAL HEALTH)
Friday
Operators:
4. PTA and stenting
■A
dvance 18 balloon
5.0/100 mm (COOK)
■ Zilver-PTX stent (COOK)
19
Friday, 13:30 – 14:00 Live from University Hospital Leipzig, Germany Case 17 – RAH 04
Please consult website for case information:
www.linc-around-the-world.com
20
Friday, 14:45 – 15:30 Live from University Hospital Leipzig, Germany Case 18 – LEI 14: male, 56 years (J-H)
Restpain with popliteal occlusion left
S. Bräunlich, M. Ulrich
Clinical data:
Restpain left foot, claudication left calf, walking capacity 20 meters
Rutherford class 4
Failure to recanalize from antegrade elsewhere
Art. Hypertension
Angiography:
Chronic occlusion of the left popliteal artery (P1-P3)
ABI left: 0.4
Procedural
steps
1. Left antegrade approach
■6
F 55 cm sheath (COOK)
2. Second attempt to pass the occlusion from antegrade
■C
onnect 250 T guidewire, 300 cm (ABBOTT)
■4
.0/80 mm Pacific Extreme balloon, 90 cm (MEDTRONIC)
Friday
Operators:
3. In case of failure: retrograde approach via the proximal anterior tibial artery
■ 7 cm 21 gauge needle (COOK)
■C
onnect guidewire, 300 cm (ABBOTT)
■Q
uickCross support catheter (SPECTRANETICS)
4. PTA and stenting
■ 5 .0 and 6.0/40 mm Pacific Extreme balloon (MEDTRONIC)
■ 5 .0 and 6.0 Supera interwoven nitinol stent (ABBOTT)
21
Friday, 15:30 – 16:00 Live from University Hospital Leipzig, Germany Case 19 – LEI 15: female, 82 years (H-L)
Restpain with multilevel disease right
Operators:
A. Schmidt, Y. Bausback
Clinical data:
Restpain right foot, claudication left calf, walking capacity 50 meters
Rutherford class 4
Art. Hypertension
Angiography:
Right: Proximal SFA-stenosis, occlusion of the P1-segment and tibioperoneal trunk
ABI left: 0.44
Procedural
steps
1. Left groin retrograde and cross-over approach
■ IMA diagnostic 5F catheter (CARDINAL HEALTH)
■ 0.035" angled soft Radiofocus glidewire, 190 cm (TERUMO)
■ 0.035" SupraCore guidewire, 190 cm (ABBOOTT)
■ 7F Balkin Up&Over Sheath, 40 cm (COOK)
2. Guidewire passage
■C
onnect 250 T guidewire, 300 cm (ABBOTT)
■C
XC support catheter, 135 cm (COOK)
3. Filter protection and atherectomy
■S
pider-filter 4 mm into the posterior tibial artery (MEDTRONIC)
■H
awkOne 6.6 cm tip (MEDTRONIC)
4. PTA with drug-coated balloons
■ In.Pact Pacific 5.0 and 4.0 mm (MEDTRONIC)
22
Live case transmission performing centres and operators
University Hospital Leipzig,
Division of Interventional Angiology, Leipzig, Germany
Operators:
Andrej Schmidt
Matthias Ulrich
Sven Bräunlich,
Yvonne Bausback
Daniela Branzan
Rashid Hospital, Dubai,
United Arab Emirates
Operator:
Ayman Al-Sibaie
Afra Muesem Alfalahi
23
For your notes
24
The venue
Grand Hyatt Hotel Dubai
Sheikh Rashid Road
Dubai
United Arab Emirates
Congress production:
Provascular GmbH
Sonnenleite 3
91336 Heroldsbach, Germany
www.provascular.de
Congress organisation
Congress Organisation and More GmbH
Antonie Jäger
Ruffinistrasse 16
80637 Munich
Germany
Phone: +49 89 23 75 74–65
Fax:
+49 89 23 75 74–70
E.mail: [email protected]
www.cong-o.com