LINC 2015 live case guide

Heidelberg

• Wednesday, January 28th: 9:50 - 10:05, Technical Forum

  Case 54 – Hepatocellular carcinoma (HCC)

  Center:

  Heidelberg

  Case 54 – HEI 02: male, 83 years

  Operators:

  • Boris Radeleff,
  • Nikolas Kortes,
  • Natalie Tessendorf,
  • Björn Bliesener

  CLINICAL DATA
  Multifocal hepatocellular carcinoma ED: 07/14
  Child A liver cirrhosis
  After 1. DEB-TACE (3 ml 75 μm Tandem loaded with 150 mg doxorubicin
  plus 11 μml unloaded Embozene 250 μm; CELONOVA, USA) 11.12.2014
  Today: 2. DEB-TACE of the first cycle
  
  PROCEDURAL STEPS
  1. Transfemoral approach right groin
  
  2. Short 4F sheath Radifocus (TERUMO)
  
  3. 0.035" 180 cm J-wire
  
  4. 4F 110 cm 4F Sidewinder Typ I (CORDIS)
  
  5. 2,8F Microcatheter Progreat (TERUMO)
  
  6. Embolisation
  - 75μm Tandem DEB-particles (CELONOVA); loaded with 150 mg of doxorubicin

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• Wednesday, January 28th: 13:40 - 14:05, Main Arena 2

  Case 50 – Asymptomatic AAA 5.3 cm

  Center:

  Heidelberg

  Case 50 – HEI 01: male, 76 years (G-Z)

  Operators:

  • Alexander Hyhlik-Dürr,
  • Dittmar Böckler,
  • Drosos Kotelis

  CLINICAL DATA
  Asymptomatic progressive AAA 53 mm
  
  RISK FACTORS
  Art. hypertension, history of smoking
  
  PROCEDURAL STEPS
  1. Fusion imaging (2D-3D registration)
  - Artis Zeego/Leonardo (SIEMENS)
  
  2. Bifemoral cut-down
  
  3. Guidewire positioning
  - Lunderquist GW 180 cm (COOK)
  
  4. Implantation of a bifurcated stentgraft
  - Endurant II (MEDTRONIC)
  
  5. Postdilation
  - Reliant balloon (MEDTRONIC)
  
  6. Contrast enhanced Dyna-CT
  - Artis Zeego/Leonardo (SIEMENS)

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• Wednesday, January 28th: 14:25 - 14:50, Main Arena 2

  Case 50 – Asymptomatic AAA 5.3 cm

  Center:

  Heidelberg

  Case 50 – HEI 01: male, 76 years (G-Z)

  Operators:

  • Alexander Hyhlik-Dürr,
  • Dittmar Böckler,
  • Drosos Kotelis

  CLINICAL DATA
  Asymptomatic progressive AAA 53 mm
  
  RISK FACTORS
  Art. hypertension, history of smoking
  
  PROCEDURAL STEPS
  1. Fusion imaging (2D-3D registration)
  - Artis Zeego/Leonardo (SIEMENS)
  
  2. Bifemoral cut-down
  
  3. Guidewire positioning
  - Lunderquist GW 180 cm (COOK)
  
  4. Implantation of a bifurcated stentgraft
  - Endurant II (MEDTRONIC)
  
  5. Postdilation
  - Reliant balloon (MEDTRONIC)
  
  6. Contrast enhanced Dyna-CT
  - Artis Zeego/Leonardo (SIEMENS)

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• Wednesday, January 28th: 15:30 - 16:00, Technical Forum

  Case 60 – TIPS

  Center:

  Heidelberg

  Case 60 – HEI 03: male, 52 years

  Operators:

  • Boris Radeleff,
  • Ulrike Stampfl,
  • Karl-Heinz Weiss,
  • Nikolas Kortes,
  • Natalie Tessendorf,
  • Björn Bliesener

  CLINICAL DATA
  Pat. on waiting list for LTx
  Cryptogenic liver cirrhosis, child A
  Refractory ascites
  Previous episode of hep. encephalopathy
  
  PROCEDURAL STEPS
  1. Transjugular venous access right side
  - 9F 20 cm sheath (Arrows)
  
  2. Puncture attempt: right liver vein --> right PV
  - TIPS-set (OPTIMED) 30Æ or 60Æ angled
  
  3. 0.035" superstiff wire (BOSTON SCIENTIFIC)
  
  4. Predilatation
  - 8 x 80 mm MARS® balloon (OPTIMED)
  
  5. 10F Sheath (Checkflow, COOK) 38-45 cm, straight / angled
  
  6. Stentgraft implantation
  - Viatorr®-Stentgraft (GORE)
  
  7. Planning
  - Puncture: right LV right PV
  - Needle type: 30Æ angled
  - Shunt: 10 mm Viatorr (GORE) 10/6/2 or 10/7/2

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• Thursday, January 29th: 9:40 - 10:05, Main Arena 2

  Case 75 – Asymptomatic AAA 5.4 cm

  Center:

  Heidelberg

  Case 75 – HEI 04: male, 79 years (G-K)

  Operators:

  • Dittmar Böckler,
  • Alexander Hyhlik-Dürr,
  • Drosos Kotelis

  CLINICAL DATA
  Asymptomatic AAA 54 mm!
  Asymptomatic aneurysm of the left common iliac artery 26 mm
  Left SFA occlusion
  
  RISK FACTORS
  Art. hypertension, history of smoking
  
  PROCEDURAL STEPS
  1. Bifemoral cut-down
  
  2. 8F sheath placement (TERUMO)
  
  3. Fusion imaging for endograft navigation using 2-D – 3-D registration
  
  4. Guidewire insertion (TERUMO)
  - Lunderquist GW 180 cm (COOK)
  
  5. Stentgraft positioning and deployment
  - 2 Nellix systems (ENDOLOGIX)
  
  6. Endobag prefilling with saline, angiography
  
  7. Endobag filling with polymer
  
  8. Optional secondary fill

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• Thursday, January 29th: 10:25 - 10:50, Main Arena 2

  Case 75 – Asymptomatic AAA 5.4 cm

  Center:

  Heidelberg

  Case 75 – HEI 04: male, 79 years (G-K)

  Operators:

  • Dittmar Böckler,
  • Alexander Hyhlik-Dürr,
  • Drosos Kotelis

  CLINICAL DATA
  Asymptomatic AAA 54 mm!
  Asymptomatic aneurysm of the left common iliac artery 26 mm
  Left SFA occlusion
  
  RISK FACTORS
  Art. hypertension, history of smoking
  
  PROCEDURAL STEPS
  1. Bifemoral cut-down
  
  2. 8F sheath placement (TERUMO)
  
  3. Fusion imaging for endograft navigation using 2-D – 3-D registration
  
  4. Guidewire insertion (TERUMO)
  - Lunderquist GW 180 cm (COOK)
  
  5. Stentgraft positioning and deployment
  - 2 Nellix systems (ENDOLOGIX)
  
  6. Endobag prefilling with saline, angiography
  
  7. Endobag filling with polymer
  
  8. Optional secondary fill

  View image