Find all live cases and live case centers listed below.
Leipzig, Dept of Angiology
35 livecase(s)
Tuesday, January 26th:
-
,
Room 1 - Main Arena 1
Case 01 – LEI 01:
Highly calcified distal SFA / A. popliteal occlusion left – Part 1
Center:
Leipzig, Dept of Angiology
Case 01 – LEI 01: male, 72 years (H-L)
Operators:
Andrej Schmidt,
Matthias Ulrich
CLINICAL DATA
Rest pain left foot, Rutherford class 4
Severe claudication left, walking capacity 100 meters
Angiography during PTA right iliac arteries after coronary angiography 12/2015
ABI
Left 0.42
RISK FACTORS
CAD with PTCA 12/2015
Carotid TEA bilateral (1999 and 2000)
Permanent atrial fibrillation
Chronic renal insufficiency GFR 62 ml/min
Former smoker, art. hypertension, hyperlipidaemia
PROCEDURAL STEPS 1. Right groin retrograde and cross-over approach
- 0.035" SupraCore Guidewire 190 cm (ABBOTT)
- 7F-40 cm Balkin Up&Over Sheath (COOK)
2. Guidewire-passage and PTA of the occlusion left SFA/Apop
- 4.0/80 mm Armada 35 Balloon (ABBOTT)
- 0.035" Radiofocus soft angled guidewire, 260 cm (TERUMO)
- 6.0/40 mm Armada 35 Balloon (ABBOTT)
- Conquest High Pressure Balloon (C.R.BARD)
In case of antegrade failure: 3. Retrograde approach via the proximal anterior tibial artery
- 21 Gauge 7 cm Micropuncture needle (COOK)
- 0.018" Connect Guidewire 300 cm (ABBOTT)
- 0.018" QuickCross Support-Catheter 90 cm (SPECTRANETICS)
4. Stenting
- 5.0 or 6.0/150 mm Supera Interwoven Selfexpanding Nitinolstent (ABBOTT)
Case 01 – LEI 01:
Highly calcified distal SFA / A. popliteal occlusion left – Part 2
Center:
Leipzig, Dept of Angiology
Case 01 – LEI 01: male, 72 years (H-L)
Operators:
Andrej Schmidt,
Matthias Ulrich
CLINICAL DATA
Rest pain left foot, Rutherford class 4
Severe claudication left, walking capacity 100 meters
Angiography during PTA right iliac arteries after coronary angiography 12/2015
ABI
Left 0.42
RISK FACTORS
CAD with PTCA 12/2015
Carotid TEA bilateral (1999 and 2000)
Permanent atrial fibrillation
Chronic renal insufficiency GFR 62 ml/min
Former smoker, art. hypertension, hyperlipidaemia
PROCEDURAL STEPS 1. Right groin retrograde and cross-over approach
- 0.035" SupraCore Guidewire 190 cm (ABBOTT)
- 7F-40 cm Balkin Up&Over Sheath (COOK)
2. Guidewire-passage and PTA of the occlusion left SFA/Apop
- 4.0/80 mm Armada 35 Balloon (ABBOTT)
- 0.035" Radiofocus soft angled guidewire, 260 cm (TERUMO)
- 6.0/40 mm Armada 35 Balloon (ABBOTT)
- Conquest High Pressure Balloon (C.R.BARD)
In case of antegrade failure: 3. Retrograde approach via the proximal anterior tibial artery
- 21 Gauge 7 cm Micropuncture needle (COOK)
- 0.018" Connect Guidewire 300 cm (ABBOTT)
- 0.018" QuickCross Support-Catheter 90 cm (SPECTRANETICS)
4. Stenting
- 5.0 or 6.0/150 mm Supera Interwoven Selfexpanding Nitinolstent (ABBOTT)
Case 12 – LEI 07:
Acute early reocclusion left SFA after PTA/Stent
Center:
Leipzig, Dept of Angiology
Case 12 – LEI 07: male, 62 years (PMC-L)
Operators:
Sven Bräunlich,
Yvonne Bausback
CLINICAL DATA
Severe claudication left calf, walking capacity 120-150 meters
ABI left 0.63
PTA and stenting of a short distal SFA-stenosis left 11/2015 elsewhere
Acute thrombosis of the SFA
RISK FACTORS
CAD, MI 2003
Art. hypertension, diabetes mellitus type 2, former smoker
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 (ABBOTT)
- 8F Balkin Up&Over Sheath, 40 cm (COOK)
2. Passage of the occlusion and percutaneous thrombectomy
- 0.018" Connect Guidewire 300cm (ABBOTT)
- 0.018" QuickCross Support-Catheter 135 cm (SPECTRANETICS)
- Exchange to Rotarex guidewire (STRAUB MEDICAL)
- 8F Rotarex Thrombectomy Catheter (STRAUB MEDICAL)
3. PTA with DCBs
- In.Pact Pacific 5.0/120 mm (MEDTRONIC)
4. Stenting on indication
- Epic Selfexpanding Nitinol-Stent (BOSTON SCIENTIFIC)
New patient! Information will follow in due time. Thank you for your understanding.
Tuesday, January 26th:
-
,
Room 2 - Main Arena 2
Case 13 – LEI 08:
In-stent reocclusion left SFA
Center:
Leipzig, Dept of Angiology
Case 13 – LEI 08: male, 70 years (D-K)
Operators:
Matthias Ulrich,
Michael Moche
CLINICAL DATA
Severe claudication left calf, walking-capacity 150-200 meters since 9/2015
ABI left 0,67
Stenting left SFA 08/2014
Stenting iliac arteries left 2003 and right 12/2015
CAD with PTCA 2003
RISK FACTORS
Art. hypertension, current smoker
ANGIOGRAPHY
During PTA right iliac 12/2015: In-stent reocclusion left SFA
PROCEDURAL STEPS 1. Right groin retrograde and cross-over approach
- IMA diagnostic catheter, 5F (CORDIS / CARDINAL HEALTH)
- 0.035" SupraCore 190 cm Guidewire (ABBOTT)
- 8F-40 cm Balkin Up&Over Sheath (COOK)
2. Passage of the in-stent occlusion left SFA
- Judkins Right 5F-catheter (CORDIS/CARDINAL HEALTH)
- 0.035" Radiofocus angled stiff glidewire, 260 cm (TERUMO)
- Exchange to 0.018" Guidewire (STRAUB MEDICAL)
New patient! Information will follow in due time. Thank you for your understanding.
Tuesday, January 26th:
-
,
Room 1 - Main Arena 1
Case 06 – LEI 04:
Occlusion right popliteal artery
Center:
Leipzig, Dept of Angiology
Case 06 – LEI 04: female, 66 years (I-B)
Operators:
Andrej Schmidt,
Matthias Ulrich
CLINICAL DATA
Severe claudication right calf and restpain during night, Rutherford class 3-4
ABI
Right 0.55
PTA
Right A.poplitea 3/2013
DUPLEX
Moderate stenosis right iliac artery and reocclusion right popliteal artery
RISK FACTORS
Art. hypertension, diabetes mellitus type II, former smoker
PROCEDURAL STEPS 1. Left groin retrograde and cross-over approach
- 7F-55 cm Check-Flow-Performer Sheath (COOK)
2. Passage of the popliteal occlusion right
- 0.018" Victory 18 30 gr 300 cm guidewire (BOSTON SCIENTIFIC)
- 0.018" QuickCross Support-Catheter 135 cm (SPECTRANETICS)
3. Filter-protection placement
- 4F-90 cm Check-Flo Performer sheath (COOK)
- Wirion-Protection system (ALLIUM MEDICAL)
4. Atherectomy
- HawkOne directional atherectomy system, 6 cm tip (MEDTRONIC)
5. PTA with Drug-coated balloons
- In.Pact Pacific 6.0/120 mm (MEDTRONIC)
6. Stenting on indication
- Complete SE-Stent (MEDTRONIC)
Tuesday, January 26th:
-
,
Room 5 - Global Expert Exchange
Case 32 – LEI 10
Center:
Leipzig, Dept of Angiology
Case 32 – LEI 10
Operators:
Andrej Schmidt,
Yvonne Bausback
New patient! Information will follow in due time. Thank you for your understanding.
Tuesday, January 26th:
-
,
Room 1 - Main Arena 1
Case 07 – LEI 05:
BTK-occlusion right with critical limb ischemia
Center:
Leipzig, Dept of Angiology
Case 07 – LEI 05: male, 81 years (G-P)
Operators:
Andrej Schmidt,
Matthias Ulrich
CLINICAL DATA
Restpain right forefoot and minor gangrene Dig I, Rutherford 5
Recurrent infrainguinal disease right with
PTA right SFA and BTK-arteries 4/2014 and 2/2015
Ischaemic cardiomyopathy, NYHA II-III
CAD with PTCA left main 2/2015
TAVI 2/2015
Permanent atrial fibrillation
PTA right vertebral artery 12/2015
ABI
Right: 0.37
ANGIOGRAPHY
During vertebral artery PTA 12/2015: occlusion of all 3 BTK-arteries right
RISK FACTORS
Arterial hypertension, former smoker, hyperlipidaemia
PROCEDURAL STEPS 1. Right antegrade approach
- 6F 55 cm Flexor Check-Flo Introducer, Raabe Modification (COOK)
2. Passage of the anterior tibial artery occlusion
- CXC 0.018” 90 cm Support-Catheter (COOK)
- 0.018” V-18 Control Guidewire, 300 cm (BOSTON SCIENTIFIC)
Exchange to:
- 0.014" Floppy ES 300 cm guidewire (ABBOTT)
3. PTA and arterial wall-injection of dexamethason
- Armada 14 3.0/120 mm balloon (ABBOTT)
- BullFrog Micro-Infusion-Device (MERCATOR MEDSYSTEMS)
Tuesday, January 26th:
-
,
Room 3 - Technical Forum
Case 30 – LEI 09:
Recurrent stenosis left common carotid artery
Center:
Leipzig, Dept of Angiology
Case 30 – LEI 09: male, 56 years (L-F)
Operators:
Andrej Schmidt,
Matthias Ulrich
CLINICAL DATA
Recurrent stenosis left common carotid artery at the proximal anastomosis
of a prosthesis-interposition left CCA after radical neck dissection
of a parotid cancer left with infiltration of the CCA and radiation therapy 2010
Fogarty-thrombectomy left CCA and stenting left CCA/ICA 2015
Minor stroke 2015
RISK FACTORS
Facial nerve paresis left since 2015
Minor paresis right arm since 2015
Dysarthria
Former smoker, arterial hypertention, diabetes mellitus type II
DUPLEX
High grade recurrent stenosis left proximal common carotid artery
ANGIOGRAPHY
90% proximal CCA-stenosis and 70% recurrent stenosis distal to the ICA-stent
2. Placement of a filter
- Wirion protection device (ALLIUM MEDICAL)
3. Predilatation, stenting and postdilatation
- 3.5/20 mm AngioSculpt RX scoring-balloon (SPECTRANETICS)
- 9.0 or 10/30 mm CGuard carotid embolic prevention system (InspireMD/PENUMBRA)
- 7.0/20 mm Sterling RX-balloon (BOSTON SCIENTIFIC)
Case 09 – LEI 06:
Calcified popliteal artery occlusion
Center:
Leipzig, Dept of Angiology
Case 09 – LEI 06: male, 73 years, (S-W)
Operators:
Sven Bräunlich,
Yvonne Bausback
CLINICAL DATA
Critical limb ischemia with ulceration lateral foot right
Severe claudication right since years
ABI right 0.34, Rutherford class 5
Thrombendartherectomy right groin 2013
RISK FACTORS
Diabetes mellitus type 2, art. hypertension, former smoker
ANGIOGRAPHY
Severely calcified distal SFA and Apop – occlusion right
PROCEDURAL STEPS 1. Right antegrade approach
- 6F 55 cm sheath (COOK)
2. Passage of the occlusion
- Stiff angled Radiofocus guidewire 0.035”, 260cm (TERUMO)
- Armada 35 balloon 4.0/120mm (ABBOTT)
In case of failure form antegrade:
- Retrograde approach vie peroneal or posterior tibial artery
3. PTA
- Armada 5/40 and 6/40 mm balloon (ABBOTT)
- Conquest High Pressure Balloon (C.R.BARD)
Wednesday, January 27th:
-
,
Room 5 - Global Expert Exchange
Case 58 – LEI 21
Center:
Leipzig, Dept of Angiology
Case 58 – LEI 21
Operators:
Andrej Schmidt,
Matthias Ulrich
New patient! Information will follow in due time. Thank you for your understanding.
Wednesday, January 27th:
-
,
Room 2 - Main Arena 2
Case 44 – LEI 15:
Abdominal aortic aneurysm – Part 1
Center:
Leipzig, Dept of Angiology
Case 44 – LEI 15: male, (R-E)
Operators:
Andrej Schmidt,
Daniela Branzan
CLINICAL DATA
Incidental finding of an eccentric AAA, 5.3 cm diameter
RISK FACTORS
CAD with NSTEMI 10/2015, PTCA LAD
Chronic renal insufficiency (GFR 72 ml/min)
Art. hypertention, former smoker
PROCEDURAL STEPS 1. Percutaneous access both groins in local anaesthesia
- 5F-10 cm Radifocus-sheaths (TERUMO)
- 0.035" SupraCore guidewire 190 m (ABBOTT)
- Preloading of 2 Proglide-systems per groin (ABBOTT)
- 0.035" Lunderquist 260 cm guidewires bilateral (COOK)
2. Graft implantation
- Implantation of the Altura Stentgraft system and extension to the hypogastric artery bilateral (LOMBARD MEDICAL)
3. Postdilatation of the whole graft
- Exchange to 12F-12 cm sheath bilateral (COOK)
- Reliant balloons both sides (MEDTRONIC)
Wednesday, January 27th:
-
,
Room 5 - Global Expert Exchange
Case 60 – LEI 22
Center:
Leipzig, Dept of Angiology
Case 60 – LEI 22
Operators:
Sven Bräunlich,
Matthias Ulrich
New patient! Information will follow in due time. Thank you for your understanding.
Wednesday, January 27th:
-
,
Room 2 - Main Arena 2
Case 44 – LEI 15:
Abdominal aortic aneurysm – Part 2
Center:
Leipzig, Dept of Angiology
Case 44 – LEI 15: male, (R-E)
Operators:
Andrej Schmidt,
Daniela Branzan
CLINICAL DATA
Incidental finding of an eccentric AAA, 5.3 cm diameter
RISK FACTORS
CAD with NSTEMI 10/2015, PTCA LAD
Chronic renal insufficiency (GFR 72 ml/min)
Art. hypertention, former smoker
PROCEDURAL STEPS 1. Percutaneous access both groins in local anaesthesia
- 5F-10 cm Radifocus-sheaths (TERUMO)
- 0.035" SupraCore guidewire 190 m (ABBOTT)
- Preloading of 2 Proglide-systems per groin (ABBOTT)
- 0.035" Lunderquist 260 cm guidewires bilateral (COOK)
2. Graft implantation
- Implantation of the Altura Stentgraft system and extension to the hypogastric artery bilateral (LOMBARD MEDICAL)
3. Postdilatation of the whole graft
- Exchange to 12F-12 cm sheath bilateral (COOK)
- Reliant balloons both sides (MEDTRONIC)
Wednesday, January 27th:
-
,
Room 1 - Main Arena 1
Case 35 – LEI 11:
Reocclusion right SFA
Center:
Leipzig, Dept of Angiology
Case 35 – LEI 11: male, 50 years (R-D)
Operators:
Andrej Schmidt,
Matthias Ulrich
CLINICAL DATA
Severe claudication right calf, painfree walking capacity 50 meters
Rutherford class 3
ABI right 0.63
PTA left SFA 12/2015, PTA right SFA with DCBs 12/2012
RISK FACTORS
Art. hypertension, current smoker
PROCEDURAL STEPS 1. Left groin retrograde and cross-over approach
- 7F–40 cm Balkin Up&Over Sheath
2. Guidewire passage
- 0.035" stiff angled Radiofocus guidewire, 260 cm (TERUMO)
- 0.035" Seeker Support-catheter, 135 cm (BARD)
In case of failure to redirect the guidewire back into the true lumen retrograde approach via the distal SFA:
- 21 Gauge 9 cm puncture needle (COOK)
- 0.018" V-18 Control guidewire 90 cm (BOSTON SCIENTIFIC)
3. PTA and stenting
- Armada 35 5.0/120mm (ABBOTT)
- 6.0/250 mm Viabahn (W.L.GORE)
- 7.0/80 mm GORE Tigris Stent across the collateral distal to the occlusion (W.L.GORE)
Wednesday, January 27th:
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,
Room 1 - Main Arena 1
Case 37 – LEI 12:
Chronic SFA-Occlusion right
Center:
Leipzig, Dept of Angiology
Case 37 – LEI 12: male, 74 years (G-W)
Operators:
Andrej Schmidt,
Matthias Ulrich
CLINICAL DATA
Severe claudication right calf, Rutherford class 3
ABI right 0.62
Angiography during PTCA 11/2015:
Long SFA-occlusion right and popliteal artery stenosis right
RISK FACTORS
CAD with NSTEMI 11/2015 and PTCA RCX
Moderate aortic valve stenosis
Former smoker, art. hypertension, diabetes mellitus Type 2
PROCEDURAL STEPS 1. Left groin retrograde and cross-over approach
- 6F-40cm Balkin Up&Over Sheath (COOK)
2. Passage of the CTO
- 0.035" Radiofocus glidewire, stiff, angled, 260 cm (TERUMO)
- 0.035" Seeker support-catheter, 135 cm (BARD)
- Exchange to a 0.018" SteelCore guidewire 300 cm (ABBOTT)
Wednesday, January 27th:
-
,
Room 3 - Technical Forum
Case 57 – LEI 20:
Infrarenal aortic stenosis and bilateral iliac occlusions, Leriche-Syndrome
Center:
Leipzig, Dept of Angiology
Case 57 – LEI 20: male, 68 years (K-A)
Operators:
Andrej Schmidt,
Holger Staab,
Daniela Branzan
CLINICAL DATA
Claudication intermittens, walking capacity 50 meters
Weakness and pain buttock, thigh and calf bilateral
ABI bilateral 0.67
CAD, PTCA 2012 and 2013, cardiomyopathy, EF 45%
Adipositas
Gastric surgery due to perforation 2001
RISK FACTORS
Art. hypertension, hyperlipidemia
PROCEDURAL STEPS 1. Transbrachial approach
- 6F 90 cm Check-Flo performer sheath (COOK)
- 5F 125 cm diagnostic Judkins Right catheter (CORDIS / CARDINAL HEALTH)
- SupraCore 300 cm 0.035" guidewire (ABBOTT)
2. Passage of the occlusions
- Stiff angled 0,035" guidewire, 260 cm (TERUMO)
- Together with 5F-125 cm Judkins Right Catheter
3. Bilateral groin access
- 7F 10 cm Radiofocus sheath (TERUMO)
- Snaring of the antegrade guidewire form above into the groin-sheath or
- Into 6F-Judkins-Right guiding catheter (CORDIS), inserted form below
4. PTA via the groin access bilateral
- SupraCore 300 cm 0,035" guidewire (ABBOTT)
- Admiral balloon 6.0/120 mm bilateral (MEDTRONIC)
5. Stenting
- Aorta: Sinus XL Aortic Stent (OPTIMED)
- Common iliac arteries: 8.0/59 mm LifeStream covered Stentgrafts in Kissing technique (C.R.BARD)
- External iliac artery bilateral: 8.0/120 mm Absolute Pro Stent bilateral (ABBOTT)
Wednesday, January 27th:
-
,
Room 1 - Main Arena 1
Case 41 – LEI 14:
Diffuse restenosis left SFA
Center:
Leipzig, Dept of Angiology
Case 41 – LEI 14: male, 73 years (P-S)
Operators:
Sven Bräunlich,
Matthias Ulrich
CLINICAL DATA
Severe claudication left calf, walking capacity 200-300 meters
Rutherford class 3, ABI left 0.68
PTA with plane balloon angioplasty left 7/2015
(POBA-arm of a DCB randomized controlled trial)
PTA right SFA 1/2016
CAD
Minor stroke without residual symptoms 2012
RISK FACTORS
Art. hypertension, former smoker
Angiography during PTA right SFA: diffuse restenosis left SFA
PROCEDURAL STEPS 1. Right groin retrograde and cross-over approach
- IMA 5F diagnostic catheter (CORDIS / CARDINAL HEALTH)
- 0.035" soft angled Radiofocus guidewire, 190 cm (TERUMO)
- 0.035" SupraCore Guidewire 190 cm (ABBOTT)
- 6F-40 cm Balkin Up&Over Sheath (COOK)
2. Guidewire-passage and preparation of the lesion
- 0.018" SteelCore Guidewire, 300 cm (ABBOTT)
- FLEX Plaque Modification Catheter (VENTURE MED GROUP)
3. PTA and stenting on indication
- Luminor DCB 5.0/120 mm (iVASCULAR)
- VascuFlex Multi-LOC (B.BRAUN)
Wednesday, January 27th:
-
,
Room 2 - Main Arena 2
Case 49b – LEI 17:
Amplatzer Plug implantation for an Endoleak via subclavian artery
Center:
Leipzig, Dept of Angiology
Case 49b – LEI 17: female 73 years (M-K)
Operators:
Andrej Schmidt,
Matthias Ulrich
CLINICAL DATA
Type II Endoleak after thoracoabdominal Stentgraft via left subclavian artery
Surgical repair of an aneurysm of the ascending aorta 2015
Bypass surgery from right to left common carotid and from left common carotid to left subclavian artery to prepare a landing-zone for a thoracoabdominal stentgraft
No proximal bending / clipping to occlude the left subclavian artery
RISK FACTORS
Art. Hypertension
ANGIOGRAPHY LEFT
Via left brachial artery: large endoleak into the descending thoracic aorta
PROCEDURAL STEPS 1. Left brachial approach
- 6F 55 cm sheath (COOK)
2. Implantation of an Amplatzer Plug 16 mm (ST JUDE MEDICAL) into the proximal left subclavian artery
DUPLEX
Duplex-sonographic surveillance for a few years
Progression from < 5.0 cm to 5.5 cm within a year
PROCEDURAL STEPS 1. Percutaneous approach with local anaesthesia both groins
- Preloading of 2 Proglide-Systems per groin (ABBOTT)
- 0.035" LunderQuist 200 cm guidwires via both groins (COOK)
- Calibration angiography to estimate the graft-length
2. Bilateral insertion of the Nellix-systems (ENDOLOGIX)
- Implantation of the 10 mm-diameter stentgrafts with integrated balloons
- Pre-filling of Nellix Endobags with pressure-monitoring (ENDOLOGIX)
- After aspiration of the pre-fill injection of the Polymer-filling
- Postdilatation with integrated 10 mm balloons
DUPLEX
Duplex-sonographic surveillance for a few years
Progression from < 5.0 cm to 5.5 cm within a year
PROCEDURAL STEPS 1. Percutaneous approach with local anaesthesia both groins
- Preloading of 2 Proglide-Systems per groin (ABBOTT)
- 0.035" LunderQuist 200 cm guidwires via both groins (COOK)
- Calibration angiography to estimate the graft-length
2. Bilateral insertion of the Nellix-systems (ENDOLOGIX)
- Implantation of the 10 mm-diameter stentgrafts with integrated balloons
- Pre-filling of Nellix Endobags with pressure-monitoring (ENDOLOGIX)
- After aspiration of the pre-fill injection of the Polymer-filling
- Postdilatation with integrated 10 mm balloons
New patient! Information will follow in due time. Thank you for your understanding.
Thursday, January 28th:
-
,
Room 1 - Main Arena 1
Case 68 – LEI 24:
Retrograde approach using a 2.9F pedal sheath in CLI
Center:
Leipzig, Dept of Angiology
Case 68 – LEI 24: male 76 years (H-H)
Operators:
Andrej Schmidt,
Matthias Ulrich
CLINICAL DATA
Critical limb ischemia with forefoot gangrene left
Rutherford class 5, ABI > 1.3
Failed recanalization attempt 01/2016 of an occluded anterior tibal artery
RISK FACTORS
Diabetes mellitus type 2, art. Hypertension
ANGIOGRAPHY
During recanalization attempt:
Left: SFA, Apop and peroneal artery patent, posterior and anterior tibial artery occluded
Guidewire-perforation in the mid segment of the anterio tibial artery
PROCEDURAL STEPS 1. Antegrade left access
- 5F-55 cm sheath (COOK)
2. Retrograde approach via the dorsalis pedis artery
- Pedal puncture kit (COOK)
- 21 Gauge 4 cm needle (COOK)
- 2.9F ID pedal sheath (COOK)
3. Retrograde passage of the ATA-occlusion left
- 0.018" straight CXI support-catheter, 90 cm (COOK)
- 0.014" Hydro-ST guidewire, 300 cm (COOK)
- 0.014" CTO-Approach 25 gramm 300 cm guidewire (COOK)
4. PTA from retrograde
- Advance Micro balloon 2.5/120 mm (COOK)
Case 71 – LEI 25:
Popliteal occusion right, previous unsuccessful recanalization attempt
Center:
Leipzig, Dept of Angiology
Case 71 – LEI 25: male, 76 years (W-K)
Operators:
Andrej Schmidt,
Sven Bräunlich
CLINICAL DATA
Restpain and severe claudication right foot and calf
11/2015 unsuccessful recanalization attempt elsewhere with
inability to redirect the guidewire into the true lumen distally
ABI
Right 0.47
RISK FACTORS
Art. hypertension, former smoker, hyperlipidaemia
PROCEDURAL STEPS 1. Right antegrade approach
- 6F-55 cm Check-Flo Performer sheath (COOK)
2. Second attempt to pass the occlusion from antegrade
- 0.018" Connect 250 T guidewire, 300 cm (ABBOTT)
- Pacific balloon 3.0/80 mm (MEDTRONIC)
3. In case of failure retrograde approach via the peroneal artery
- 21 gauge 7 cm puncture needle (COOK)
- 0.018" V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
- 0.018" TrailBlazer support-catheter, 90 cm (MEDTRONIC / COVIDIEN)
- Snaring of the guidewire from antegrade after passage of the CTO
4. Vessel preparation and PTA from antegrade
- FLEX Plaque-Modification catheter (VENTUREMEDGROUP)
- Lutonix DCB (C.R.BARD)
5. Stenting on indication
- Multi-LOC Multiple-Stent-Delivery-System (B.BRAUN) or
- Supera Interwoven Nitinol-Stent (ABBOTT)
Case 81 – LEI 28:
Fenestrated EVAR for a juxtarenal aortic aneurysm
Center:
Leipzig, Dept of Angiology
Case 81 – LEI 28: male
Operators:
Andrej Schmidt,
Daniela Branzan,
Holger Staab
CLINICAL DATA
Progressive juxtarenal aneurysm
Incidental finding during an episode of abdominal pain
CAD, PTCA 20120
RISK FACTORS
Art. hypertension, former smoker
PROCEDURAL STEPS 1. General anaesthesia
Percutaneous approach via both groins and left axillary artery
- Preloading of 2 Proglide-systems per groin and left axillary artery (ABBOTT)
- 12F-45 cm Sheath via left brachial artery (COOK)
- 0.035" Lunderquist 300 cm (COOK) pullthrough left groin to axillary artery using a
- Snare-kit 10 mm (COVIDIEN / MEDTRONIC)
2. Precannulation of the visceral arteries before stentgraft implantation
- 16F-30 cm sheath via right groin (COOK)
- SOS Omni-Selective 5F-catheter (ANGIODYNAMICS)
- Stabilization with guidewires: Galeo Pro (BIOTRONIK)
3. Stentgraft implantation
- Implantation of the 4-vessl branched CMD-stentgraft (JOTEC) via left groin
- Removal of the stentgraft delivery system and partiall closure left groin
4. Cannulation of the visveral arteries
- Puncture of the valve of the 12F-45 cm sheath axillary artery and insertion of a 7F-55 cm sheath (COOK)
- Judkins Right Diagnostic Catheter (CORDIS)
- 0.018" V-18-Control Guidewire 300 cm (BOSTON SCIENTIFIC)
5. Implantation of covered stents to the visceral arteries
- E-ventus BX stentgrafts (JOTEC)
Friday, January 29th:
-
,
Room 3 - Technical Forum
Case 89 – LEI 30:
Complex SFA-occlusion right
Center:
Leipzig, Dept of Angiology
Case 89 – LEI 30: male, 54 years (G-M)
Operators:
Andrej Schmidt,
Matthias Ulrich
CLINICAL DATA
Severe claudication bilateral, right > left, restpain right foot, Rutherford 4
walking capacity 60 meters
ABI right 0.55
PTA of iliac stenosis bilateral 11/2015
Persistent symptoms
CLINICAL DATA
Art. hypertension, current smoker
PROCEDURAL STEPS 1. Left groin retrograde and cross-over approach
- 7F 55 cm Check-Flow-Performer sheath (COOK)
2. Atherectomy of the profunda femoris stenosis right
- HawkOne directional atherectomy system, 9 cm tip (MEDTRONIC)
3. Passage of the SFA-occlusion and filter placement
- 0.018" Connect guidewire 300 cm (ABBOTT)
- 0,018" QuickCross Support-Catheter, 135 cm (SPECTRANETICS)
- 4F 90 cm sheath (COOK)
- Wirion-Protection system (ALLIUM-MEDICAL)
4. Atherectomy of the superficial femoral artery
- HawkOne directional atherectomy system, 9 cm tip (MEDTRONIC)
5. PTA with drug-coated balloons
- Ranger DCB 5.0/120 mm (BOSTON SCIENTIFIC)
Friday, January 29th:
-
,
Room 3 - Technical Forum
Case 90 – LEI 31:
High grade stenosis brachiocphalic trunk
Center:
Leipzig, Dept of Angiology
Case 90 – LEI 31: male, 62 years (R-K)
Operators:
Andrej Schmidt,
Matthias Ulrich
CLINICAL DATA
Minor stroke right hemispheric 2011, no residual symptoms
Intermittent vertigo
Intermittent atrial fibrillation
CAD, MI 2012
COPD
RISK FACTORS
Art. hypertension, former smoker, diabetes mellitus type 2
DUPLEX
Retrograde flow right vertebral artery
MR-ANGIOGRAPHY
High grade stenosis origin of the brachiocephalic trunk
PROCEDURAL STEPS
1. Right groin access
- 5F-Judkins Right diagnostic catheter (CORDIS / CARDINAL HEALTH)
- 0.035" SupraCore guidewire 300 cm (ABBOTT)
- 7F 90 cm Check-Flo Performer sheath (COOK)
- Guidewire-position into the subclavian artery
2. Potentially cerebral protection with a filter via a right brachial access
- 6F 25 cm Radiofocus sheath (TERUMO)
- 6F IMA guiding catheter (MEDTRONIC)
- Filterwire EZ (BOSTON SCIENTIFIC) from brachial to the internal carotid artery
3. Predilatation and stenting
- 5.0/40 mm Admiral balloon, 135 cm (MEDTRONIC)
- BeGraft 10/27 mm Covered Stent (BENTLEY INNOMED)
New case! Information will follow in due time. Thank you for your understanding.
Friday, January 29th:
-
,
Room 1 - Main Arena 1
Case 93 – LEI 34
Center:
Leipzig, Dept of Angiology
Case 93 – LEI 34: female, 60 years
New case! Information will follow in due time. Thank you for your understanding.
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