Case 36 – Occlusion of the Posterior Tibial Artery, CLI
Center:
Leipzig
Case 36 – LEI 22: male, 57 years (V-S)
Operators:
Roberto Ferraresi,
Andrej Schmidt
Clinical data
PAOD Rutherford 6, heel-ulceration right
PAOD Rutherford 5 left, PTA 1/2013
Stenting right SFA 2008
Occlusion of the posterior tibial artery
Diabetes mellitus type 2, art. Hypertension
Procedural steps
1. Right antegrade access
- 5F 55 cm Flexor Check-Flo Performer (COOK)
2. PTA and stenting of the anterior tibial artery
- Xience Prime BTK drug-eluting stent (ABBOTT)
3. Passage of the occlusion of the posterior tibial artery
- 0.018" Glidewire Advantage 300 cm (TERUMO)
- 0.035" NaviCross angeled support-catheter 135 cm (TERUMO)
Case 45 – Endovenous Laser Therapy incompetent small saphenous vein
Center:
Leipzig
Case 45 – LEI 27: female, 47 years (I-W)
Operators:
Thomas Schwarz,
Eva von Hodenberg
Clinical data
CVI I (Widmer)
Recurrent oedema and pain right lower leg
Varicose tributaries
Procedural steps
1. Duplex ultrasound of the varicose veins
2. Retrograde access SSV mid lower leg with permanent venous catheter
3. Placement of the ELVeS Radial SLIM fiber (BIOLITEC) into the SSV until 1 cm up to the sapheno-popliteal junction
4. Anesthesia with anesthesia with 200 ml ultracaine, 5 ml sodium carbonate, 5 ml epinephrine diluted in 500 ml cooled saline around the fibre
5. Connecting the fiber to the 1470 nm diode laser (BIOLITEC)
6. Laser treatment from proximal to distal (application of 60 J/cm vein laser energy)
7. Application of 1% polidocanol foam sclerotherapy (KREUSSLER) in tributaries distally with use of ultrasound guidance
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,
Main Arena 1
Case 24 – Occlusion of the popliteal artery and all proximal BTK arteries
Center:
Berlin
Case 24 – BLN 01: female, 77 years (D-R)
Operators:
Ralf Langhoff,
Jens Stegemann
Clinical data
PAOD Rutherford 5, minor tissue loss on the right foot,
walking capacity 20m and rest pain at night
Bilateral diabetic foot syndrome
Recanalization of the left popliteal artery 12/2012,
Diabetes mellitus (IDDM, HbA1c >8,5), art. hypertension
Renal insufficiency (CKD III), CAD, atrial fibrillation with oral anticoagulation
Procedural steps
1. Antegrade access
- 45 cm 6 F braided sheath (TERUMO)
2. Lesion passage into the posterior tibial artery
- Truepath CTO Device (BOSTON SCIENTIFIC)
- Add on wires: Victory 0,014/0,018 and V18 control (BOSTON SCIENTIFIC)
- Add on Support: Rubicon Catheter (BOSTON SCIENTIFIC) and angled CXI support catheter (COOK)
3. PTA
- 3 mm resp. 4 mm Coyote balloon (BOSTON SCIENTIFIC)
4. Stenting on indication
- Promus Element Plus BTK (BOSTON SCIENTIFIC)
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,
Main Arena 2
Case 37
Center:
Mercogliano
Case 37 – MER 07: female, 70 years (DP-A)
Operators:
Marco Manzi,
Luigi Salemme,
Armando Pucciarelli
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,
Technical Forum
Case 46 – Endovenous laser therapie incompetent great saphenous vein
Center:
Leipzig
Case 46 – LEI 28: female, 70 years (R-K)
Operators:
Matthias Ulrich,
Christina Julia Harzendorf
Clinical data
CVI II (Widmer)
Dysaesthesia and chronic oedema both lower leg
History of erysipelas right lower leg
Night Cramps in the calf
Procedural steps
1. Duplex ultrasound of the varicose veins
2. Retrograde access GSV upper right lower leg calf with a 6F sheath
3. Placement of the ELVeS Radial fiber (BIOLITEC) into the GSV until 1 cm up to the sapheno-femoral junction
4. Anesthesia with 25 ml ultracaine diluted in 500 ml cooled saline around the fiber
5. Connecting the fiber to the 1470 nm diode laser (BIOLITEC)
6. Laser treatment from proximal to distal (application of 60 J/cm vein laser energy)
7. Application of 1% polidocanol foam sclerotherapy (KREUSSLER) in tributaries distally with use of ultrasound guidance
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,
Main Arena 1
Case 25 – Complex SFA-occlusion left
Center:
Leipzig
Case 25 – LEI 14: male, 55 years (G-R)
Operators:
Andrej Schmidt,
Sven Bräunlich
Clinical data
PAOD Rutherford 3, painfree walking-capacity 100 meters
ABI left 0.67
Asymptomatic Internal carotid artery stenosis
Small abdominal aneurysm (35 mm)
Diabetes mellitus type 2, art. hypertension, hyperlipidemia
Procedural steps
1. Right femoral access and cross-over approach
- 6F Balkin Up & Over Contralateral Flexor Check-Flo Performer 40 cm (COOK)
2. Attempt to pass intraluminally
- TruePath-system (BOSTON SCIENTIFIC)
- Rubicon 18 Support-Catheter, 135 mm (BOSTON SCIENTIFIC)
3. In case of subintimal passage and inability to reenter distal
- V-18 Control Guidewire 300 cm (BOSTON SCIENTIFIC)
- OffRoad Reentry System (BOSTON SCIENTIFIC)
Case 47 – Persistent Type II endoleak with aneurysm growth
Center:
Münster
Case 47 – MÜN 01: male, 82 years (B-S)
Operators:
Arne Schwindt,
Konstantinos Donas
Clinical data
3/2013 EVAR (main body Zenith Flex, iliac extensions Zenith spiral COOK)
CT-control 11/12: axial diameter increase from initially 53 mm to 58 mm
Procedural steps
1. Right femoral approach
- 5F 10 cm sheath (TERUMO)
3. Cannulation Endoleak
- 0.014" Choice PT II (BOSTON SCIENTIFIC) and
- 0.014" Echelon™ Microcatheter (COVIDIEN)
4. Embolisation inflow and outflow vessel with Ethylene-Vinyl-Alcohol
5. Copolymer Onyx® 34 (COVIDIEN)
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,
Main Arena 1
Case 26 – Calcified Apop-Occlusion right, CLI
Center:
Leipzig
Case 26 – LEI 15: 66 years (G-R)
Operators:
Andrej Schmidt,
Michael Piorkowski
Clinical data
PAOD Rutherford 5, heel-ulceration right
SFA-Angioplasty bilateral 2011 and 2012
Arterial hypertension
Procedural steps
1. Antegrade Access right groin
- 6F 55 cm Flexor Check-Flo Introducer (COOK)
2. Antegrade passage of the occlusion
- Connect 250 T Guidewire (ABBOTT)
- QuickCross Support-Catheter 0.018” 90 cm (SPECTRANETICS)
3. In case of antegrade failure retrograde puncture of the proximal ATA
- Quick-Access Needle Holder (SPECTRANETICS)
- 21 Gauge / 7 cm needle (COOK)
- V-18 Control 300 cm guidewire (BOSTON SCIENTIFIC)
- QuickCross Support-Catheter 0.018” 90 cm (SPECTRANETICS)
4. After retrograde passage of the guidewire snaring from antegrade
- Quick Cross Capture-Wire Connector (SPECTRANETICS)
Clinical data
PAOD Rutherford 5 impaired wound healing and minor tissue loss right foot after amputation D1 11/2012
Recanalisation of the right SFA and right TPT
Diabetes mellitus with diabetic foot syndrome
Renal insufficiency (CKD III)
Left ventricular dysfunction, oral anticoagulation
Current smoker, stroke in the past
Procedural steps
1. Right antegrade access
- 4F Fortress 45 cm Sheath (BIOTRONIK)
2. Passing the lesion
- XT-14 or a Cruiser-18 guide wire (BIOTRONIK)
3. Predilation
- 2mm Passeo-14 or Passeo-18 (BIOTRONIK)
4. PTA
- Passeo-18 Lux drug coated balloon 2.5 mm (BIOTRONIK)
5. Stenting on indication
- Orsiro 3 x 40 mm coronary DES or Pulsar-18 self-epxanding stent system (BIOTRONIK)
6. Prepare for a retrograde pedal access via ATA as a backup option
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,
Global Expert Exchange
Case 54 – Asymptomatic high grade stenosis of the left internal carotid artery
Center:
Leipzig
Case 54 – LEI 31: male, 75 years (W-D)
Operators:
Dierk Scheinert,
Sven Bräunlich
Clinical data
Bilateral stenosis of the internal carotid arteries
Left ICA (80%): vmax = 3,5 m/s; ED vmax = 120 cm/s
Right ICA (60%): vmax = 2,5 m/s; ED vmax = 60 cm/s
Arterial hypertension, hyperlipidemia, adipositas (BMI 32 kg/m2)
Procedural steps
1. Femoral access right groin
- 8F 10 cm sheath (TERUMO)
- 8F Sidewinder II Guiding-Catheter (CORDIS)
2. Distal protection
- Filterwire EZ (BOSTON SCIENTIFIC)
4. Post Dilatation
- 5.0/30 mm Sterling (BOSTON SCIENTIFIC)
5. Closure of the access site
- Perclose Proglide (ABBOTT)
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,
Main Arena 2
Case 39 – Calcified SFA-Occlusion Left
Center:
Leipzig
Case 39 – LEI 23: male, 74 years (G-U)
Operators:
Andrej Schmidt,
Sven Bräunlich,
Martin Werner
Clinical data
PAOD Rutherford 3, painfree walking-capacity 20 meters
ABI left 0.57
CAD, NSTEMI 12/2012, COPD
Atrial fibrillation with oral anticoagulation
Chronic renal failure (GFR 65 ml/min)
Diabetes mellitus type 2, art. hypertension, hyperlipidemia
Procedural steps
1. Right femoral access and cross-over approach
- 6F Balkin Up & Over Contralateral Flexor Check-Flo Performer 40 cm (COOK)
2. Passage of the lesion
- Passeo 18 Balloon 5.0/170 mm (BIOTRONIK)
- Cruiser S 0.018" Guidewire 300 cm (BIOTRONIK)
- Exchange for XT-14 Guidewire (BIOTRONIK)
3. Lesion preparation
- AngioSculpt XL Scoring-Balloon 5/80 mm (BIOTRONIK)
4. Exchange to 0.035" guidewire
- SupraCore (ABBOTT)
Case 55 – High grade symptomatic left ICA stenosis
Center:
Berlin
Case 55 – BLN 03: male, 60 years (H-W)
Operators:
Ralf Langhoff,
Brigitte Bäsell
Clinical data
2nd transient blindness in 2012 left eye
Bilateral ICA Stenosis L>R, PSV ICA left >300cm/s, EDV 90 cm/sec
CAD with stenting left main 12/2012
PAOD with bilateral EIA stenosis
Arterial hypertension, former smoker (till 12/2012), hyperlipidemia
Premedication
Aspirin 100 mg, Clopidogrel 75 mg since 12/2012, Simvastatin 40 mg
Ramipril 5 mg and HCT 12,5 mg
Procedural steps
1. Femoral access right groin
2. Stenting of the right EIA
(Dynamic Balloon-Expandable Stent System 7 x 38 mm, BIOTRONIK)
3. 260 cm stiff angeled Radiofocus guide wire (TERUMO)
4. Weinberg Catheter for left CCA (COOK)
5. Vista Brite Tip IG Guiding Catheter 8F MP Shape (CORDIS)
6. Filterwire EZ Protection System (BOSTON SCIENTIFIC)
7. 9/30 mm Wallstent (BOSTON SCIENTIFIC)
8. PTA with 5 x 30 mm Sterling Balloon Dilatation Catheter (BOSTON SCIENTIFIC)
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,
Main Arena 1
Case 27 – Occlusion of the left SFA
Center:
Leipzig
Case 27 – LEI 16: male, 62 years (R-S)
Operators:
Michael Piorkowski,
Johannes Schuster
-
,
Technical Forum
Case 48 – Radiofrequency ablation therapy GSV
Center:
Leipzig
Case 48 – LEI 29: female, 49 years (L-A)
Operators:
Karin Brachmann,
Daniela Branzan
-
,
Main Arena 2
Case 40 – Occlusion of the left superficial femoral artery
Center:
Leipzig
Case 40 – LEI 24: male, 53 years (P-K)
Operators:
Matthias Ulrich,
Johannes Schuster
Clinical data
PAOD Rutherford 3, claudication left calf 50 m
ABI left 0.7
Arterial hypertension, current smoker (15 py)
Procedural steps
1. Right femoral access and cross-over approach
- 6 Fr Balkin Up & Over Contralateral Flexor Check-Flo Performer 40cm (COOK)
2. Intra-luminal passage of the lesion
- 0.018" Connect guide wire, 300 cm (abbott)
4. PTA
- Three Lutonix Drug-Coated-Balloons 5/100 (C. R. BARD)
5. Stent implantation (spot stenting)
- 6/170 mm LifeStent (C. R. BARD)
-
,
Main Arena 1
Case 28 – Severe restenosis of calcific superficial femoral artery
Center:
Mercogliano
Case 28 – MER 06: male, 70 years (M-A)
Operators:
Angelo Cioppa,
Luigi Salemme,
Grigor Popusoi
Clinical data
PAOD Rutherford 3, claudication right leg
PTA right SFA with DEB 2011
PTA/Stent left ICA 10/12
Hypertension, COPD, former smoker, hyperlipidaemia,
Diabetes mellitus
Duplex
Fibroclacific plaque determining severe restenosis PSV: 4.9 m/sec
Procedural steps
1. Contralateral access and placement of a cross-over sheath
- 5F JR4 Radiofocus Angiographic Catheter (TERUMO)
- 0.035" Radiofocus angled soft guide-wire M, 180 cm (TERUMO)
- 0.035" Supra Core guide-wire, 300 cm (ABBOTT)
- 6F–45 cm Destination Guiding Sheath (TERUMO)
2. Passage of the lesions and predilation
- 0.018" V-18™ Control Wire® Guide Wire 300 cm (BOSTON)
- 5/100 mm Pacific Balloon Catheter (Medtronic)
3. Endovascular graft implantation
- 6/150 mm 6 F VIABAHN® Endoprosthesis (GORE)
- 6/120 mm Pacific Balloon Catheter (Medtronic)
-
,
Main Arena 1
Case 29 – Total occlusion of the abdominal artery and both common iliac arteries
Center:
Leipzig
Case 29 – LEI 17: male, 56 years (J-M)
Operators:
Peter Goverde,
Andrej Schmidt
Clinical data
PAOD Rutherford 3-4
Severe claudication both sides (hip, buttock, thigh)
Restpain / paraesthesia during night both feet
Risk factors: Diabetes mellitus type 2, former smoker, hyperlipidaemia
Left ventricular cardiomyopathy, EF 45%
Procedural steps
1. Left brachial approach
- 7F-90 cm Destination guiding sheath (TERUMO)
2. Passage of the occlusion from brachial
- 5F Multipurpose 125 cm diagnostic catheter (CORDIS)
- 0.035" angled stiff Terumo 260 cm (TERUMO)
3. Snaring of the Terumo via 7F groin sheath bilateral
- 7F and 11F 25 cm Introducer Sheath (TERUMO)
4. Exchange to
- 0.035" SupraCore 300cm guidewires via groin-access (ABBOTT)
5. Implantation of
- Advanta 12 7/38 mm-Covered Stents (ATRIUM/Maquet Getinge Group) in both renal arteries
6. PTA of the occlusion
- Admiral 5/80 mm (MEDTRONIC)
8. Postdilation of the abdominal stent
- Maxi LD 15/40 mm (CORDIS)
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,
Main Arena 1
Case 30 – In-stent occlusion left SFA
Center:
Leipzig
Case 30 – LEI 18: female, 70 years (R-P)
Operators:
Matthias Ulrich,
Johannes Schuster
Clinical data
PAOD Rutherford 3, claudication left calf at 100 meters
PTA left SFA and stenting for claudication 11/2011
Elsewhere failed recanalization-attempt 12/2012 left SFA
Inability to direct the guidewire into the stent
Diabetes mellitus type 2, art. hypertension, hyperlipidaemia
Procedural steps
1. Right femoral access and cross-over approach
- 2.6F Balkin Up & Over Contralateral Flexor Check-Flo Performer 40 cm (COOK)
2. Retrograde puncture of the SFA-stent
- 18 Gauge 7cm needle (COOK)
- Quick-Access Needle Holder (SPECTRANETICS)
- 0.035" stiff, angled Terumo, 300 cm (BOSTON SCIENTIFIC)
3. Retrograde passage of the stent and snaring from antegrade
- Quick Cross Capture-Wire Connector (SPECTRANETICS)
Clinical data
Arterial Hypertension, insufficiently controlled by 5 antihypertensive drugs, hyperlipidemia, former smoker
PAOD, thrombectomy and PTA Stent left SFA 01/2012
Procedural steps
1. Retrograde access right groin and guiding catheter
- 6F Radiofocus Introducer II Sheath, 25 cm (TERUMO)
- 6F MACH 1 Guiding Catheter (BOSTON SCIENTIFIC)
2. Passing of the lesion, Pre-dilation and Stenting
- 0.014" Galeo ES guide-wire, 175 cm (BIOTRONIK)
- 3.0/20 mm Falcon Bravo RX PTA Balloon Catheter (MEDTRONIC)
- 6.0/18 mm ArchStent Ostial System (Ostial Inc.)
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,
Main Arena 2
Case 41 – Juxtarenal aortic aneurysm 55 mm
Center:
Ludwigsburg
Case 41 – LUD 01: male, 77 years (L-W)
Operators:
Johannes Gahlen,
Wilko Staiger,
Pirkko Hettrich
Clinical data
Progressive juxtarenal aortic aneurysm
Arterial hypertension, hyperlipidemia, coronary heart disease
Atrial fibrillation with oral anticoagulation
Procedural steps
1. Placement of a Zenith Endograft (2 fenestrations, 1 scallop, COOK)
2. 3D Dyna CT run (Siemens Artis Zeego)
3. Cannulation of the renal arteries with Virtual Guidance
4. Implantation of the bridging stentgrafts
(Advanta V12, ATRIUM/Maquet Getinge Group)
5. Implantation of the distal bifurcated Endograft (COOK)
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,
Global Expert Exchange
Case 56 – Right critical limb ischemia due to anterior tibial artery occlusion and tibioperoneal trunk stenosis
Center:
Mercogliano
Case 56 – MER 10: male, 75 years (DP-C)
Operators:
Luigi Salemme,
Vittoro Ambrosini,
Linda Cota
Clinical data
PAOD Rutherford 4, rest pain right limb
Hypertension, former smoker, hyperlipidaemia, diabetes mellitus
Duplex
Fibrotic plaque determining severe stenosis of the tibioperoneal trunk and occlusion of the posterior tibial artery
Procedural steps
1. Contralateral access and placement of a cross-over sheath
- 5F JR4 Radiofocus Angiographic Catheter (TERUMO)
- 0.035" Radiofocus angled soft guide-wire M, 180 cm (TERUMO)
- 0.035" Supra Core guide-wire, 300 cm (ABBOTT)
- 6F-90 cm Destination Guiding Sheath (TERUMO)
2. Passage of the lesions and distal embolic protection positioning
- 0.014" Balance Middle Weight guide-wire, 300 cm (ABBOTT)
- 4.0 Spider Fx Embolic Protection Sysytem (COVIDIEN)
3. Lesion debulking
- Turbo-Hawk small vessel Peripheral Plaque Excision System Catheter (COVIDIEN)
4. Drug Eluting Balloon Dilation, Intravascular Ultrasound Assessment and Bail-Out Stenting
- 4/80 mm Amphirion IN.PACT Balloon Catheter (MEDTRONIC)
- Eagle Eye Platinum RX digital IVUS Catheter (VOLCANO)
- Stenting on indication Inperia Advance (CID)
-
,
Main Arena 1
Case 31 – CLI, long occlusion of ATA, failed antegrade recanalization
Center:
Leipzig
Case 31 – LEI 19: male, 82 years, E-S
Operators:
Andrej Schmidt,
Michael Piorkowski
Clinical data
PAOD Rutherford 5, ulceration D2 left
ABI left 0.4
Failed antegrade recanalization of the ATA 01/2013
Diabetes mellitus type 2, art. Hypertension
Renal failure, on dialysis for 3 years
Amputation right lower limb after car accident
CAD, PTCA/Stent LAD/D1, RIM 02/2012
Procedural steps
1. Antegrade Access left groin
- 6F 55 cm Flexor Check-Flo Introducer (COOK)
2. Retrograde puncture of the anterior tibial artery
- Quick-Access Needle Holder (SPECTRANETICS)
- Micropuncture Pedal Access Set (COOK)
- 21 Gauge / 4 cm needle (COOK)
- 3 French pedal sheath (COOK)
- 0.014" Hydro ST 300 cm guidewire (COOK)
- 0.018" CXI Supportcatheter 90 cm (COOK)
PTA via the 3F sheath:
- Advance Micro 14 Ultra Low-Profile PTA Balloon-Catheter (COOK)
3. After retrograde angioplasty guidewire-passage from antegrade
- 0.014" Hydro ST 300 cm guidewire (COOK)
4. Antegrade angioplasty with DEBs
- In.Pact Deep 2.5/120 mm and 3.0/120 mm (MEDTRONIC)
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,
Main Arena 2
Case 41 – Juxtarenal aortic aneurysm 55 mm
Center:
Ludwigsburg
Case 41 – LUD 01: male, 77 years (L-W)
Operators:
Johannes Gahlen,
Wilko Staiger,
Pirkko Hettrich
Clinical data
Progressive juxtarenal aortic aneurysm
Arterial hypertension, hyperlipidemia, coronary heart disease
Atrial fibrillation with oral anticoagulation
Procedural steps
1. Placement of a Zenith Endograft (2 fenestrations, 1 scallop, COOK)
2. 3D Dyna CT run (Siemens Artis Zeego)
3. Cannulation of the renal arteries with Virtual Guidance
4. Implantation of the bridging stentgrafts
(Advanta V12, ATRIUM/Maquet Getinge Group)
5. Implantation of the distal bifurcated Endograft (COOK)
-
,
Global Expert Exchange
Case 57 – In-Stent Occlusion of the right superficial femoral artery
Center:
São Paulo
Case 57 – SAO 02: male, 64 years
Operators:
Armando Lobato,
Dino Felli Colli
-
,
Main Arena 2
Case 42 – EVAR of an abdominal aortic aneurysm
Center:
Leipzig
Case 42 – LEI 25: male, 53 years (J-R)
Operators:
Andrej Schmidt,
Daniela Branzan,
Bernd-Michael Harnoss
Clinical data
Screening for an abdominal aortic aneurysm
Diameter 5.4 mm
Arterial hypertension, current smoker
Renal insufficiency, GFR 55
Procedural steps
1. Preclosing with Proglide Closure Devices both groins (ABBOTT)
2. 9F 10 cm Radiofocus Introducer II both groins (TERUMO)
3. 0.035" Archer Guide Wire, 200 cm (MEDTRONIC)
4. Ovation Main Body (TRIVASCULAR) via right groin
5. Bilateral implantation of limb-extensions
6. Post-dilatation with Reliant-Balloon (MEDTRONIC)
-
,
Main Arena 1
Case 32 – Posterior tibial artery occlusion left
Center:
Dallas
Case 32 – DAL 01: male, 84 years
Operators:
Tony Das,
Huey McDaniel
Clinical data
PAOD Rutherford 5, non-healing ulcer left heel
ABI left 0.4; right 0.7
CAD, PVD
Risk factors: Diabetes mellitus type 2, art. Hypertension
Procedural steps
1. Contralateral access
2. Left pedal access by ultrasound
3. Recanalization and CSI Stealth DB atherectomy (CSI Inc.)
4. PTA with 3.0mm Chocolate balloon (TriReme)
5. Provisional stenting
-
,
Global Expert Exchange
Case 58 – Calcified stenosis right CFA, distal SFA stenosis
Center:
Münster
Case 58 – MÜN 02: female, 75 years (W-M)
Operators:
Arne Schwindt
-
,
Main Arena 2
Case 42 – EVAR of an abdominal aortic aneurysm
Center:
Leipzig
Case 42 – LEI 25: male, 53 years (J-R)
Operators:
Andrej Schmidt,
Daniela Branzan,
Bernd-Michael Harnoss
Clinical data
Screening for an abdominal aortic aneurysm
Diameter 5.4 mm
Arterial hypertension, current smoker
Renal insufficiency, GFR 55
Procedural steps
1. Preclosing with Proglide Closure Devices both groins (ABBOTT)
2. 9F 10 cm Radiofocus Introducer II both groins (TERUMO)
3. 0.035" Archer Guide Wire, 200 cm (MEDTRONIC)
4. Ovation Main Body (TRIVASCULAR) via right groin
5. Bilateral implantation of limb-extensions
6. Post-dilatation with Reliant-Balloon (MEDTRONIC)
-
,
Main Arena 1
Case 33 – Aorto-Iliac Occlusion
Center:
Mountain View
Case 33 – MOU 01: female, 73 years
Operators:
James Joye,
Chad Rammohan
Clinical data
PAOD Rutherford 3,
Debiliating hip, buttock and thigh-claudication
Risk factors:
Remote smoker, hyperlipidemia,
Art. hypertension, familiy-history of CAD
4. Balloon-expandable stent graft delivered in kissing fashion
5. Hemodynamic assessment of results
-
,
Main Arena 2
Case 43 – Complex isolated iliac artery aneurysm
Center:
São Paulo
Case 43 – SAO 01: male, 68 years
Operators:
Armando Lobato,
Dino Felli Colli,
Robert Guimaraes
-
,
Technical Forum
Case 50 – Non healing ulcer of R AKA stump
Center:
Dallas
Case 50 – DAL 02: male, 85 years
Operators:
Tony Das,
Huey McDaniel
-
,
Main Arena 1
Case 34 – Chronic total occlusion left SFA
Center:
Leipzig
Case 34 – LEI 20: male, 52 years (W-K)
Operators:
Matthias Ulrich,
Michael Piorkowski
Clinical data
PAOD Rutherford 3, severe claudication left calf
ABI left 0.68
Arterial hypertension, nicotine abuse
Procedural steps
1. Right groin cross-over access
- 6F 40 cm Balkin Up & Over Contralateral Check-Flo Introducer (COOK)
2. Guidewire-passage
- 0.035" stiff angled Terumo 260cm (TERUMO)
- Supported by a Judkins Right 5F-diagnostic catheter (CORDIS)
- Exchange to 0.018" Steel Core Guidewire 300 cm (ABBOTT)
3. Predilatation
- 4.0/100 mm Mustang Balloon (BOSTON SCIENTIFIC)
4. DEB-angioplasty
- 3 x 6/100 mm Lutonix drug-coated-balloon (C.R. BARD)
5. Stenting on indication
- Spot-stenting with the Tack-IT Endovascular Stapler SystemTM (INTACT VASCULAR)
-
,
Main Arena 1
Case 35 – Chronic occlusion of the left superficial femoral artery
Center:
Leipzig
Case 35 – LEI 21: male, 68 years (W-L)
Operators:
Sven Bräunlich,
Martin Werner
-
,
Main Arena 2
Case 44 – Aneurysm of infrarenal aorta and common iliac artery
Center:
Leipzig
Case 44 – LEI 26: male, 69 years (D-V)
Operators:
Andrej Schmidt,
Daniela Branzan,
Bernd-Michael Harnoss
-
,
Technical Forum
Case 51 – Critical limb ischemia
Center:
Mountain View
Case 51 – MOU 02: female, 93 years
Operators:
James Joye,
Chad Rammohan
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