Berlin

• Tuesday, January 24th: 11:20 - 11:45, Room 3 - Technical Forum

  Case 23 – Tripple protection approach in a high-grade left ICA stenosis

  Center:

  Berlin

  Case 23 – BLN 01: female, 80 years (Z-C)

  Operators:

  • Ralf Langhoff,
  • Andrea Behne

  CLINICAL DATA
  Coronary heart disease, aortocoronary bypass
  PAD, PTA left SFA 2011, right SFA 2015
  
  RISK FACTORS
  Hypertension, hyperlipidemia
  
  PROCEDURAL STEPS
  1. Transfemoral retrograde approach
  - 8F short sheath (TERUMO)
  - Diagnostic 5F catheter Weinberg shape (COOK)
  - TERUMO stiff angled 0.035" wire into left ECA
  
  2. Exchange to
  - Vista Brite Tip IG guiding catheter MPA1 shape into left CCA (CORDIS)
  
  3. Distal protection
  - Filter Wire EZ (BOSTON SCIENTIFIC) into distal ICA left
  
  4. Stenting
  - Roadsaver Carotid Micromesh stent (TERUMO) 8 x 25 mm
  
  5. Carotid postdilatation
  - 5 x 20 mm Paladin balloon with integrated embolic protection (40 micron pore size) (CONTEGO-MEDICAL)
  
  6. Paladin filter closure and combined filter/balloon-system removal
  - removal of the distal EPD-Filter Wire EZ
  - removal of guiding catheter (wire controlled)
  
  7. Closure of puncture site
  - Angioseal 8F
  - transfer patient to ICU
  

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• Tuesday, January 24th: 13:54 - 14:14, Room 5 - Global Expert Exchange

  Case 30 – Popliteal reocclusion with impaired single vessel run-off

  Center:

  Berlin

  Case 30 – BLN 03: male, 81 years (HJ-S)

  Operators:

  • Ralf Langhoff,
  • Andrea Behne

  CLINICAL DATA
  PAOD, Rutherford 3–4, ABI 0.63 right, 0.93 left, stenting of the distal SFA and P3-segment 2015, peripheral bBypass surgery left leg
  
  RISK FACTORS
  Art. hypertension, severe atherosclerosis of the aorta, severly impaired walking distance
  
  PROCEDURAL STEPS
  1. Antegrade access right common femoral
  - 5F Terumo Destination 45 cm
  
  2. Recanalisation of the occluded stent in the P3 segment
  
  3. PTA and stenting
  - Cr8 BTK 4 x 38 mm DES (ALVIMEDICA)
  
  4. Recanalisation of the ATA and peroneal, PTA with 2.5 and 3 mm balloon
  
  
  5. Back-up: retrograde access via peroneal artery
  
  6. Closure of puncture site by manual compression
  

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• Tuesday, January 24th: 15:10 - 15:40, Room 3 - Technical Forum

  Case 26 – Long SFA occlusion right

  Center:

  Berlin

  Case 26 – BLN 02: male , 81 years (D-S)

  Operators:

  • Ralf Langhoff,
  • M. Boral

  CLINICAL DATA
  PAOD Rutherford 3, claudication right calf at 50 meters
  Recanalization SFA stent and PTA with DCB for claudication 11/2016
  
  RISK FACTORS
  Coronary heart disease, aortocoronary bypass
  Hypertension, hyperlipidimia, diabetes type II
  ABI 0,6 right, 1,0 left after intervention
  
  ANGIOGRAPHY
  Distal SFA occlusion right side
  
  PROCEDURAL STEPS
  1. Left femoral access and cross-over approach
  - 6F 45 cm cross-over sheath Fortress (BIOTRONIK)
  
  2. Recanalisation right SFA
  - 0.018" Advantage glidewire (TERUMO)
  - 0.018" CXI support catheter (COOK)
  
  Back-up material:
  - Connect 250T CTO-wire (ABBOTT)
  - Outback reentry system (CORDIS)
  
  3. PTA
  - Passeo18 ballon 3 x 150 mm (BIOTRONIK)
  - 5 mm Passeo18 Lux DEB (BIOTRONIK)
  
  4. Stenting
  - Pulsar18 stent 5 x 200 mm (BIOTRONIK)
  
  5. Postdilatation
  - 5 x 200 mm Passeo1 8 balloon (BIOTRONIK)
  
  6. Puncture site closure
  - Angioseal 6F (TERUMO)
  

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