LINC 2015 live case guide

Bad Krozingen

• Thursday, January 29th: 8:40 - 9:00, Main Arena 1

  Case 64 – Occlusion of the posterior tibial artery

  Center:

  Bad Krozingen

  Case 64 – BK 01: male, 82 years (R-S)

  Operators:

  • Aljoscha Rastan,
  • Elias Noory

  CLINICAL DATA
  Claudication (foot) Rutherford-Becker class 3
  Recanalisation of the femoro-popliteal bypass (P I) 12/2014
  Femoro-popliteal bypass (PTFE) 2008
  
  RISK FACTORS
  Hypertension, tobacco use
  
  ABI AT REST
  0.6/1.0
  
  DUPLEX
  Occlusion of the PTA/ATA
  
  PROCEDURAL STEPS
  1. Antegrade femoral access right groin
  - 6F 11cm sheath (CORDIS)
  - 5F STR guiding catheter (CORDIS)
  
  2. Recanalisation of the posterior tibial artery
  - 0.014" Pilot 150 wire (ABBOTT), 0.014" Extra-Support wire (ABBOTT)
  - 0.014" Advantage (TERUMO), 2.0x120mm OTW Amphirion balloon (MEDTRONIC)
  
  3. Atherectomy
  - Phoenix 1.8 mm (VOLCANO)
  
  4. (DE-) Postdilatation and stenting on indication
  - 2.5x120 mm Lutonix 14 (BARD)
  
  5. Optional: tibial access

  View image
• Thursday, January 29th: 9:45 - 10:10, Main Arena 1

  Case 65 – Occlusion of the right SFA

  Center:

  Bad Krozingen

  Case 65 – BK 02: male, 76 years old (P. W.)

  Operators:

  • Thomas Zeller
• Thursday, January 29th: 10:20 - 10:45, Main Arena 1

  Case 66 – Occlusion of the left SFA

  Center:

  Bad Krozingen

  Case 66 – BK 03 b: male, 67 years old
• Thursday, January 29th: 11:05 - 11:40, Technical Forum

  Case 82 – Occlusion (in-stent) of the left SFA

  Center:

  Bad Krozingen

  Case 82 – BK 05: male, 65 years (E-G)

  Operators:

  • Aljoscha Rastan,
  • Elias Noory

  CLINICAL DATA
  Claudication Rutherford-Becker class 3
  Recanalization and stenting of the left EIA and SFA 06/2013
  Stenting of the right SFA 09/2013
  
  RISK FACTORS
  Tobacco use, hypertension, hypercholesterolemia
  
  ABI AT REST
  Right/left: 0.6/0.3
  
  DUPLEX
  Left leg: CIA, EIA, CFA, DFA without stenosis.
  Origin of the SFA occluded. Detectable blood flow in the PA (I).
  
  PROCEDURAL STEPS
  1. Retrograde femoral access (cross-over)
  - 6F and 8F Cross-over sheath Balkin (CORDIS)
  - 0.035" stiff wire (TERUMO)
  
  2. Recanalization of the SFA
  - 0.018" Advantage (TERUMO), Quick-Cross support-catheter (SPECTRANETICS)
  
  3. Laser procedure
  - 2.0mm Elite Laser, Turbo-Tandem (SPECTRANETICS)
  - Wirion filter (GARDIA MEDICAL)
  
  4. DEB postdilatation
  - 5 mm and 6 mm x 120 mm PacificInpact balloon
  
  5. Stenting on indication

  View image
• Thursday, January 29th: 11:20 - 11:45, Main Arena 1

  Case 67 – Occlusion of the left SFA/PA

  Center:

  Bad Krozingen

  Case 67 – BK 03: male, 81 years (G-S)

  Operators:

  • Thomas Zeller

  CLINICAL DATA
  Claudication (left calf) Rutherford-Becker class 3
  Coronary heart disease: DES RCX 02/2005; PCI RCA 09/2001
  
  RISK FACTORS
  Tobacco, hypertension, diabetes hypercholesterolemia
  
  ABI AT REST
  Right/left: 0.9/0.4
  
  DUPLEX
  Left leg: CIA, EIA, DFA without stenosis, distal part of the SFA incl. PA occluded
  Detectable blood flow in the middle part of the PA and the tibio-peroneal trunc
  
  PROCEDURAL STEPS
  1. Antegrade femoral access
  - 7F sheath (CORDIS)
  
  2. Recanalization of the SFA/PA
  - 4F vertebralis catheter (CORDIS)
  - 0.035" wire (TERUMO)
  
  3. Atherectomy
  - Jetstream (BOSTON SCIENTIFIC)
  
  4. Postdilatation
  - 4/5 mm 120 mm DE-balloon angioplasty, Ranger (BOSTON SCIENTIFIC)
  
  5. Stenting on indication
• Thursday, January 29th: 13:30 - 16:30, Technical Forum

  Case 86A – Occlusion of the right PTA

  Center:

  Bad Krozingen

  Case 86A – BK 07A: male, 54 years (F-D)

  Operators:

  • Thomas Zeller

  CLINICAL DATA
  Claudication Rutherford-Becker class 3
  Femoro-popliteal Bypass surgery 2005, re-occlusion of the Bypass 2006+2014
  Recanalization+DEB+Stent of the SFA/PA 12/2014
  
  RISK FACTORS
  Tobacco use
  
  ABI AT REST
  Right/left: 0.5/1.1
  
  DUPLEX
  Bypass and PA without stenosis, occlusion of the PTA and ATA.
  
  PROCEDURAL STEPS
  1. Antegrade femoral access (cross-over)
  - 6F sheath (TERUMO)
  
  2. Recanalization of PTA
  - 5F STR-catheter (CORDIS), 0.014" Pilot 50/150 wire (ABBOTT), 0.014" Advantage (TERUMO)
  - 2.0 x 120 mm Amphirion-OTW (MEDTRONIC)
  
  3. Predilatation
  - 2.0 x 120 mm Amphirion-RX (MEDTRONIC)
  
  4. Dilatation
  - 2.5/3 x 120 mm Lutonix (DE-) balloon (BARD)
  
  5. Optional
  - DES, retrograde access, re-entry device

  View image
• Thursday, January 29th: 16:38 - 17:08, Main Arena 1

  Case 71 – Calcified stenosis of the left CFA

  Center:

  Bad Krozingen

  Case 71 – BK 04: male, 70 years old (E. S.)

  Operators:

  • Elias Noory,
  • Aljoscha Rastan