Conference day 1

• 8:10 - 8:30, Room 2 - Main Arena 2

  Case 10 – Complex venous intervention of IVC and iliac vein

  Center:

  Bern

  Case 10 – BER 01: male, 37 years, (D-P)

  Operators:

  • Nils Kucher,
  • Torsten Fuß

  CLINICAL DATA
  Iliofemoral DVT right side in 2014
  Currently no anticoagulation therapy
  Moderate renal insufficiency (atrophic left kidney)
  
  RISK FACTORS
  Venous claudication while standing and walking (works as a chef de cuisine)
  Leg swelling right > left
  Hyperpigmentation right lower leg
  
  PROCEDURAL STEPS
  1. Venous access with ultrasound guidance in both femoral and right IJ veins
  - 10F sheath
  
  2. Wire crossage
  - TERUMO 0.035" stiff angled
  
  3. Phlebography, IVUS
  
  4. Predilation
  - Atlas Balloon 14–20 mm (C.R. BARD)
  
  5. Implantation of dedicated Iliac vein stents
  - IVC: Sinus XL 22–24 mm (OPTIMED)
  - Sinus-XL Flex 14 mm (OPTIMED)
  
  6. High-pressure postdilatation of stents
  - Atlas balloon 14–20 mm (C.R. BARD)
  
• 8:14 - 8:49, Room 1 - Main Arena 1

  Case 01 – LEI 01: Severely calcifed SFA-occlusion right

  Center:

  Leipzig, Dept. of Angiology

  Case 01 – LEI 01: male, 68 years

  Operators:

  • Andrej Schmidt,
  • Matthias Ulrich

  CLINICAL DATA
  Severe claudication right calf, walking capacity 60 meters
  ABI right 0.65
  COPD, GOLD B
  Permanent atrial fibrillation
  
  RISK FACTORS
  Arterial hypertension, smoker
  
  ANGIO
  Angiography elsewhere: total occlusion right SFA, calcified
  
  PROCEDURAL STEPS
  1. Left 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 right SFA
  - 4.0/120 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 failure to pass from antegrade:
  3. Retrograde approach via the distal SFA right
  - 21 Gauge 9 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 Nitinol stent (ABBOTT)
  - Stenting of the SFA-ostium: 7.0/40 mm Absolute stent (ABBOTT)
  

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• 9:10 - 9:30, Room 2 - Main Arena 2

  Case 11 – Galway

  Center:

  Galway

  Case 11 – GAL 01: female, 74 years

  Operators:

  • Gerard O'Sullivan

  Information will follow in due time.

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• 9:17 - 9:30, Room 1 - Main Arena 1

  Case 02 – SFA - PRESTO Technique

  Center:

  Dendermonde

  Case 02 – DEN 01: male, 79 years

  Operators:

  • Koen Deloose,
  • Joren Callaert

  Information will follow in due time.

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• 9:28 - 9:53, Room 3 - Technical Forum

  Case 22 – Cotignola

  Center:

  Cotignola

  Case 22 – COT 02: female, 73 years

  Operators:

  • Fausto Castriota,
  • Antonio Micari

  Information will follow in due time.

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• 9:45 - 10:10, Room 2 - Main Arena 2

  Case 12 – Acute on chronic ischemia right leg

  Center:

  Leipzig, Dept. of Angiology

  Case 12 – LEI 05: male, 78 years (M-M)

  Operators:

  • Sven Bräunlich,
  • Matthias Ulrich

  CLINICAL DATA
  Very short walking capacity right since few weeks
  Persistent atrial fibrillation
  Diabetes mellitus, type 2
  Nicotin abuse
  
  IMPORTANT ITEMS
  Angiography: Thrombotic/embolic occlusion right popliteal artery
  Chronic BTK-disease
  
  1. Right antegrade femoral access
  - 6F 55 cm Check-Flo Performer, Raab Modification (COOK)
  
  2. GW-passage and thrombectomy
  - Rotarex 6F (STRAUB MEDICAL)
  
  3. PTA and stenting on indication
  - Lutonix DCB (C.R. BARD)
  

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• 10:30 - 10:55, Room 2 - Main Arena 2

  Case 13 – Treatment of Toskana III ISR popliteal artery with rotarex & DEB

  Center:

  Münster

  Case 13 – MUN 02: male, 84 years

  Operators:

  • Arne Schwindt,
  • Stefan Stahlhoff

  Information will follow in due time.

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• 11:00 - 11:15, Room 2 - Main Arena 2

  Case 14 – Iliofemoral venous intervention

  Center:

  Bern

  Case 14 – BER 02: female, 37 years (E-B)

  Operators:

  • Nils Kucher,
  • Torsten Fuß

  CLINICAL DATA
  Acute left-sided iliofemoral deep vein thrombosis in 04/2008
  
  RISK FACTORS
  Long distance flight, estrogen-containing contraceptives, no known thrombophilia (negative testing)
  Chronic venous insufficiency leg with Villalta Score: 9 points
  
  PROCEDURAL STEPS
  1. Venous access with ultrasound guidance in left popliteal vein
  - 10F sheath
  
  2. Reconstruction of iliac veins
  
  3. Predilation
  - Atlas balloon 12–14 mm (C.R. BARD)
  
  4. Implantation of dedicated iliac vein stents
  - MT stent: Sinus obliquus 14 mm (OPTIMED)
  - Iliac veins: Sinus-XL Flex 14 mm (OPTIMED)
  
  5. High-pressure post-dilation of stents
  - Atlas balloon 14 mm (C.R. BARD)
  
• 11:15 - 11:35, Room 1 - Main Arena 1

  Case 03 – TASC D SFA CTO left

  Center:

  Dendermonde

  Case 03 – DEN 02: male, 78 years

  Operators:

  • Koen Deloose,
  • Joren Callaert,
  • Lieven Maene

  Information will follow in due time.

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• 11:15 - 11:30, Room 2 - Main Arena 2

  Case 15 – Galway

  Center:

  Galway

  Case 15 – GAL 02: male, 50 years

  Operators:

  • Gerard O'Sullivan

  Information will follow in due time.

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• 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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• 11:55 - 12:15, Room 1 - Main Arena 1

  Case 04 – Treatment of 9 cm long SFA CTO with drug eluting stent

  Center:

  Münster

  Case 04 – MUN 01: female, 76 years (K-M)

  Operators:

  • Arne Schwindt,
  • Özgun Sensebat

  CLINICAL DATA
  PAOD Rutherford IV left leg, rest pain at night, walking distance limited to 50 m
  ABI: right leg 0,9; left leg 0,6
  
  RISK FACTORS
  CVRF: hyperlipidemia, hypertension, nicotin
  Carotid surgery 2013
  MR-Angiogram: bilateral iliac stenosis, CTO of left SFA 9 cm long
  
  PROCEDURAL STEPS
  1. Right femoral access and crossover
  - Insertion of 6F 45 cm Destination sheath (TERUMO)
  
  2. Stent PTA
  - Stent PTA common iliac artery bilateral (Dynamic/BIOTRONIK)
  
  3. Recanalization left SFA
  - v18 wire (BOSTON SCIENTIFIC) and Quick-cross catheter (SPECTRANETICS)
  
  4. Predilation
  - 5 x 120 balloon (Advance 18/COOK)
  
  5. Stent implantation
  - Zilver-PTX drug eluting stent (COOK)
  
  6. Puncture site closure with CELT 6F VCD
  

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• 12:00 - 12:15, Room 2 - Main Arena 2

  Case 14 – Iliofemoral venous intervention

  Center:

  Bern

  Case 14 – BER 02: female, 37 years (E-B)

  Operators:

  • Nils Kucher,
  • Torsten Fuß

  CLINICAL DATA
  Acute left-sided iliofemoral deep vein thrombosis in 04/2008
  
  RISK FACTORS
  Long distance flight, estrogen-containing contraceptives, no known thrombophilia (negative testing)
  Chronic venous insufficiency leg with Villalta Score: 9 points
  
  1. Venous access with ultrasound guidance in left popliteal vein
  - 10F sheath
  
  2. Reconstruction of iliac veins
  
  3. Predilation
  - Atlas balloon 12–14 mm (C.R. BARD)
  
  4. Implantation of dedicated iliac vein stents
  - MT stent: Sinus obliquus 14 mm (OPTIMED)
  - Iliac veins: Sinus-XL Flex 14 mm (OPTIMED)
  
  5. High-pressure post-dilation of stents
  - Atlas balloon 14 mm (C.R. BARD)
  
• 12:15 - 12:30, Room 2 - Main Arena 2

  Case 15 – Galway

  Center:

  Galway

  Case 15 – GAL 02

  Operators:

  • Gerard O'Sullivan

  Information will follow in due time.

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• 13:30 - 15:00, Room 2 - Main Arena 2

  Case 16 – Removal of tilted IVC filter (aortic penetration) and reconstruction of the IVC and iliac veins

  Center:

  Bern

  Case 16 – BER 03: female, 48 years (T-B)

  Operators:

  • Nils Kucher,
  • T. Gregory Walker

  CLINICAL DATA
  Protein S deficiency and factor V Leiden mutation
  Ongoing anticoagulation therapy
  Recurrent ilio-femoral thrombosis despite medical therapy
  Implantation of permanent Simon™ filter (2004/USA)
  
  RISK FACTORS
  Chronic venous insufficiency both legs with:
  venous claudication, varicose veins, hyperpigmentation, leg swelling
  Villalta-score: 6 points
  
  PROCEDURAL STEPS
  1. Venous access
  - Venous access with ultrasound guidance in both femoral veins (10F sheath)
  - Venous access IJ (18F sheath)
  
  2. Filter extraction with endobronchial forceps from IJ access
  - Forceps Alligator 2.5 mm x 55 cm hard foreign body double action (KARL STORZ)
  
  3. Reconstruction of IVC and iliac veins
  
  4. Predilatation
  - Atlas balloon 14–20 mm (C.R. BARD)
  
  5. Implantation of dedicated IVC and Iliac vein stents
  - IVC: Sinus XL 22 mm (OPTIMED)
  - Iliac veins: Sinus-XL Flex 14 mm (OPTIMED)
  
  6. High-pressure postdilatation of stents
  - Atlas balloon 14–20 mm (C.R. BARD)
  

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• 13:30 - 15:00, Room 2 - Main Arena 2

  Case 17 - Galway

  Center:

  Galway

  Case 17 – GAL 03: female, 82 years

  Operators:

  • Gerard O'Sullivan

  Information will follow in due time.

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• 13:30 - 15:00, Room 3 - Technical Forum

  Case 24 – Flush-occlusion right SFA after CEA right groin

  Center:

  Leipzig, Dept. of Angiology

  Case 24 – LEI 06: male, 57 years (H-F)

  Operators:

  • Andrej Schmidt,
  • Sven Bräunlich

  CLINICAL DATA
  Severe claudication right calf, walking capacity 50 meters
  CEA and patch-plastic 9/2014 right groin
  Stenting right SFA 2009
  PTA left SFA (Lithoplasty)
  CAD, MI and PTCA 2009
  Art. hypertension, former smoker
  
  ANGIO
  Flush-occlusion right SFA, stent within the SFA-occlusion right
  ABI right 0,57
  
  PROCEDURAL STEPS
  1. Left groin retrograde and cross-over approach
  - IMA-diagnostic 5F-catheter (CORDIS/CARDINAL HEALTH)
  - 0.035" angled soft Radiofocus guidewire, 190 cm (TERUMO)
  - 0.035" SupraCore guidewire, 190 cm (ABBOTT)
  - 7F Balkin Up&Over Sheath, 40 cm (COOK)
  
  2. Right SFA CTO-puncture (stent-puncture)
  - 18 Gauge 7 cm needle
  - 0.035" stiff angled Glidewire, 190 cm (TERUMO)
  - 6F – 10 cm Radiofocus-Introducer (TERUMO)
  
  3. Passage of the CTO
  Retrograde passage into the right CFA:
  - Pioneer-Plus Reentry-system (VOLCANO)
  - 0.014" Floppy ES Guidewire, 300cm (ABBOTT)
  - Snaring if the retrograde guidewire into the the cross-over-sheath
  
  Final guidewire-passage into the popliteal artery from antegrade:
  - 0.035" siff angled Glidewire 260 cm (TERUMO)
  
  4. PTA/stenting
  - Armada 35 5.0/100 mm balloon (ABBOTT)
  - Supera Interwoven Nitinol stent (ABBOTT)
  - SFA-ostium: Viabahn 7.0/50 mm (GORE) or Absolute stent (ABBOTT)
  

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• 13:30 - 15:00, Room 3 - Technical Forum

  Case 25 – Severe left iliac and femoropopliteal disease in a critical limb ischaemia patient

  Center:

  Cotignola

  Case 25 – COT 03: female, 74 years

  Operators:

  • Antonio Micari

  Information will follow in due time.

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• 13:48 - 14:08, Room 1 - Main Arena 1

  Case 05 – Chronic total occlusion right SFA, CLI

  Center:

  Leipzig, Dept. of Angiology

  Case 05 – LEI 02: male, 64 years (P-S)

  Operators:

  • Sven Bräunlich,
  • Johannes Schuster

  CLINICAL DATA
  Critical limb ischemia right, ulceration dig 4, Rutherford class 5
  Severe claudication right calf, walking capacity 50 meters, PTA/stenting left SFA 12/2015 for CLI left
  Diabetes mellitus, type 2, art. hypertension, former smoker
  ABI right: 0.2
  
  ANGIO
  Angiography (during PTA left):
  long CTO right SFA, minimal calcification
  
  PROCEDURAL STEPS
  1. Left groin retrograde and cross-over approach
  - IMA-diagnostic 5F catheter (CORDIS/CARDINAL HEALTH)
  - 0.035" angled soft Radiofocus guidewire, 190 cm (TERUMO)
  - 0.035" SupraCore guidewire, 190 cm (ABBOTT)
  - 6F Balkin Up&Over Sheath, 40 cm (COOK)
  
  2. Passage of the occlusion left SFA
  - 0.035" Radiofocus angled stiff guidewire, 260 cm (TERUMO)
  - 0.035" TrailBlazer supportcatheter, 135 cm (MEDTRONIC)
  - Exchange to 0.018" SteelCore guidewire (ABBOTT)
  
  3. PTA
  - 5.0/120mm Pacific Plus PTA catheter, 130 cm (MEDTRONIC)
  - 6.0/120 mm In.Pact Pacific DCB (MEDTRONIC)
  
  4. Stenting on indication
  - In case of dissections: provisional placement of nitinol Tacks (INTACT VASCULAR)
  - In case of residual stenosis: Complete-Stent (MEDTRONIC)
  

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• 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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• 14:26 - 14:46, Room 5 - Global Expert Exchange

  Case 31 – Calcified SFA-CTO right

  Center:

  Leipzig, Dept. of Angiology

  Case 31 – LEI 08: male, 64 years (F-B)

  Operators:

  • Sven Bräunlich,
  • Johannes Schuster

  CLINICAL DATA
  Severe claudication right calf, walking capacity 100 meters
  PTA/stent left SFA 12/2015
  Diabetes mellitus, type 2, insulin-dependent
  Art. hypertension, former smoker
  
  ANGIO
  Angiography right SFA during PTA/stent left SFA:
  short, moderately calcified SFA-CTO right
  ABI right 0.61
  
  PROCEDURAL STEPS
  1. Left groin retrograde and cross-over approach
  - IMA-diagnostic 5F catheter (CORDIS/CARDINAL HEALTH)
  - 0.035" angled soft Radiofocus guidewire, 190 cm (TERUMO)
  - 0.035" SupraCore guidewire, 190 cm (ABBOTT)
  - 6F 55 cm Flexor Check-Flo Introducer, Raabe Modifcation (COOK)
  
  2. Guidewire passage and PTA of the occlusion right SFA
  - 4.0/40 mm Pacific Plus balloon (MEDTRONIC)
  - 0.018" Connect 250 T guidewire, 300 cm (ABBOTT)
  
  3. Stenting
  - NitiDES drug-eluting stent (ALVIMEDICA)
  

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• 14:34 - 14:55, Room 1 - Main Arena 1

  Case 06 – Long segment left SFA occlusion - directional atherectomy and DCB therapy

  Center:

  New York

  Case 06 – NY 01: female, 83 years

  Operators:

  • Prakash Krishnan,
  • Vishal Kapur,
  • Karthik Gujja,
  • Farhan Majeed,
  • Rheoneil Lascano

  Information will follow in due time.

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• 15:10 - 15:35, Room 2 - Main Arena 2

  Case 18 – Carotid artery stenting in high grade asymptomatic right ICA stenosis

  Center:

  Münster

  Case 18 – MUN 03: male, 87 years (S-W)

  Operators:

  • Arne Schwindt,
  • Özgun Sensebat

  CLINICAL DATA
  CVRF: hypertension
  CHD, RCA-PTCA 2016 with DES
  Aortic valve stenosis
  
  RISK FACTORS
  In CC-Duplex high grade right ICA stenosis with vmax of 290 cm/sec.
  MR-Angiogram: Type II aortic arch, 90% right ICA stenosis
  
  PROCEDURAL STEPS
  - Right femoral access, aortic arch angiogram, canulation of right common carotid artery with 0,035 Advantage wire (TERUMO) and insertion of 6F 90cm shuttle-sheath (COOK)
  
  - Angiogram of lesion, placement of 0,014 Choice PT wire (BOSTON SCIENTIFIC) distal to lesion
  
  - Delivery of Nanoparasol filter (TERUMO) distal to lesion
  
  - Implantation of Roadsaver micromesh stent (TERUMO)
  
  - Postdilation of stent (Sterling RX, BOSTON SCIENTIFIC)
  
  - Filter capture and final angiogram
  

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• 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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• 15:27 - 16:01, Room 1 - Main Arena 1

  Case 07 – Leipzig

  Center:

  Leipzig, Dept. of Angiology

  Case 07 – LEI 03: female, 72 years

  Operators:

  • Andrej Schmidt,
  • Matthias Ulrich

  CLINICAL DATA
  Restpain left foot, Rutherford class 4
  Severe claudication, walking capacity 50 m
  ABI left 0.42
  CAD, PTCA 10/16
  TAVI 03/16
  
  RISK FACTORS
  Arterial hypertension
  
  PROCEDURAL STEPS
  - Right croin retrograde and cross-over approach
  - Passage and predilatation of the SFA-occlusion left
  - PTA/Stenting SFA left (ELUVIA)
  

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• 15:49 - 16:19, Room 3 - Technical Forum

  Case 27 – Dendermonde

  Center:

  Dendermonde

  Case 27 – DEN 03

  Operators:

  • Koen Deloose,
  • Joren Callaert,
  • Lieven Maene

  Information will follow in due time.

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• 15:55 - 16:20, Room 2 - Main Arena 2

  Case 19 – Rapid progression of asymptomatic right carotid artery disease

  Center:

  Cotignola

  Case 19 – COT 01: male, 66 years

  Operators:

  • Antonio Micari,
  • Fausto Castriota

  Information will follow in due time.

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• 16:30 - 18:00, Room 2 - Main Arena 2

  Case 20 – Thoracic inlet syndrome with instent thrombosis

  Center:

  Bern

  Case 20 – BER 04: female, 46 years (D-C)

  Operators:

  • Nils Kucher,
  • Torsten Fuß

  CLINICAL DATA
  Primary (spontaneous) upper extremity deep vein thrombosis 06/15
  (Paget-Schroetter syndrome) --> lysis and anticoagulant therapy
  Known bony exostosis of the first rib and the clavicula --> resection the the first rib and stenting of the subclavian vein in 12/15
  Recurrent swelling of the right arm --> thrombus aspiration in a tertiary care hospital (11/16)
  
  PRESENT STATE
  Swelling of the right arm since several weeks
  
  PROCEDURAL STEPS
  1. Venous access with ultrasound guidance in right femoral vein
  - 10F sheath
  
  2. Wire crossage
  - Terumo 0.035" stiff angled
  
  3. Phlebography
  
  4. Predilatation
  - Dorado balloon 10 mm (C.R. BARD)
  
  5. Implantation of dedicated vein stent (stent-in-stent)
  
  6. High pressure postdilatation of stent
  - Atlas balloon 12 mm (C.R. BARD)
  

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• 16:30 - 18:00, Room 2 - Main Arena 2

  Case 21 – Galway

  Center:

  Galway

  Case 21 – GAL 04: female, 36 years

  Operators:

  • Gerard O'Sullivan

  Information will follow in due time.

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• 16:30 - 18:00, Room 3 - Technical Forum

  Case 28 – Symptomatic left ICA disease in a patient with challenging access routes

  Center:

  Cotignola

  Case 28 – COT 04: male

  Operators:

  • Fausto Castriota

  Information will follow in due time.

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• 16:30 - 18:00, Room 3 - Technical Forum

  Case 29 – Progressive, asymptomatic internal carotid stenosis right

  Center:

  Leipzig, Dept. of Angiology

  Case 29 – LEI 07: male, 71 years (M-Z)

  Operators:

  • Andrej Schmidt,
  • Sven Bräunlich

  CLINICAL DATA
  Progressive ICA-stenosis right, peak systolic velocity 5.8 m/sec.
  CAD with CABG 2000
  PTCA stent 12/2016
  Recurrent supraventricular arrythmia, left atrial ablations 2014/2015
  CEA left ICA 2010
  Former smoker
  
  ANGIOGRAPHY
  Angiography during PTCA 12/2016, short, high-grade stenosis right ICA
  
  PROCEDURAL STEPS
  1. Right groin access
  - 9F 25 cm Radiofocus Introducer (TERUMO)
  - 5F Judkins Right diagnostic catheter (CORDIS/CARDINAL HEALTH)
  - 0.035" soft angled Glidewire, 190 cm (TERUMO)
  - 0.035" SupraCore 190 cm guidewire (ABBOTT)
  
  2. Cerebral protection
  - MoMa proximal protection system (MEDTRONIC)
  
  3. Predilatation and stenting
  - 3.5/20 mm MiniTrek Monorail balloon (ABBOTT)
  - 8/30 mm CGuard stent (InspireMD)
  
  4. Postdilatation
  - Paladin® Carotid Post-Dilatation balloon with integrated embolic protection (CONTEGO MEDICAL)
  
  5. Aspiration and declamping with the Paladin-filter in place
  
  6. Retrieval of the Paladin-system
  

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• 16:44 - 17:04, Room 1 - Main Arena 1

  Case 08 – Severely calcified SFA-CTO right

  Center:

  Leipzig, Dept. of Angiology

  Case 08 – LEI 04: male, 69 years (R-P)

  Operators:

  • Andrej Schmidt,
  • Matthias Ulrich

  CLINICAL DATA
  Severe claudication right calf, walking capacity 150 meters
  Thromendartherectomy both groins 2014
  Stenting/PTA left SFA 11/2016
  CAD, PTCA 2000, CABG 2000
  Art. hypertension, former smoker
  
  ANGIOGRAPHY
  Severely calcified distal SFA-CTO right
  ABI right 0.51
  
  PROCEDURAL STEPS
  1. Left groin retrograde and cross-over approach
  - IMA-diagnostic 5F catheter (CORDIS/CARDINAL HEALTH)
  - 0.035" angled soft Radiofocus guidewire, 190 cm (TERUMO)
  - 0.035" SupraCore guidewire, 190 cm (ABBOTT)
  - 7F 55cm Flexor Check-Flo Introducer, Raabe Modifcation (COOK)
  
  2. Passage of the distal SFA-CTO
  - 0.018" Connect 250 T guidewire, 300 cm (ABBOTT)
  - 0.018" QuickCross support catheter 135 cm (SPECTRANETICS)
  
  3. Angioplasty
  - 6.0/60 mm Lithoplasty balloon (SHOCKWAVE MEDICAL)
  
  4. Stenting only on indication
  - Supera Interwoven Nitinol stent (ABBOTT)
  

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• 17:35 - 17:55, Room 1 - Main Arena 1

  Case 09 – Heavily calcified severe right SFA disease

  Center:

  New York

  Case 09 – NY 02: female, 78 years old (S-P)

  Operators:

  • Prakash Krishnan,
  • Vishal Kapur,
  • Karthik Gujja,
  • Farhan Majeed,
  • Rheoneil Lascano

  CLINICAL DATA
  Patient presents with right lower extremity ischemic rest pain
  Rutherford grade 2, category 4
  Fontaine stage III
  Symptoms have been getting progressively worse over the last few weeks
  No ischemic ulcers noted.
  ABI: Right ABI 0.38.
  
  RISK FACTORS
  Hypertension, hyperlipidemia, diabetes mellitus, previous history of tobacco use
  
  PROCEDURAL STEPS
  1. Left groin access with retrograde cross over approach
  - UF 4F diagnostic catheter (ANGIODYNAMICS)
  - 0.035" SupraCore guidewire, 300 cm (ABBOTT)
  - 7 F – 45 cm Pinnacle Sheath (TERUMO)
  
  2. Passage through the right SFA calcified stenosis
  - 0.018" Trailblazer Vert support catheter, 135 cm (MEDTRONIC)
  - 0.014" Fielder guidewire, 300 cm (ASAHI)
  
  3. Filter placement
  - Exchange to a Barewire through the support catheter (ABBOTT)
  - Emboshield Nav 6 filter placement (ABBOTT)
  
  4. Jetstream atherectomy of the right SFA calcified disease
  - Jetstream 2.4/3.4 mm atherectomy (BOSTON SCIENTIFIC)
  
  5. PTA with a non-compliant balloon
  - Dorado 6 x 200 mm balloon (C.R. BARD)
  
  6. Stenting and postdilatation
  - 5.5 x 150 mm Supera interwoven self-expanding Nitinol stent (ABBOTT)
  - Dorado 6 x 150 mm balloon (C.R. BARD)
  

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