LINC 2018 live case guide

New York

• Tuesday, January 30th: 13:45 - 14:05, Room 1 - Main Arena 1

  Case 05 – Right superficial femoral diffuse severe disease

  Center:

  New York

  Case 05 – NY 01: female, 66 years (E-M)

  Operators:

  • Prakash Krishnan,
  • Karthik Gujja,
  • S. Singla,
  • Rheoneil Lascano

  CLINICAL DATA
  - Patient presents with 2 block life-style limiting lower extremity claudication
  - over last 6 months. Progressively worsening. Rutherford Category 3.
  - No history of ulcer. Failed maximal medical therapy.
  - ABI: right 0.71, left 0.92
  
  RISK FACTORS
  - Hypertension, ex smoker, dyslipidemia
  - CAD s/p CABG
  - PVD - s/p left fempop bypass
  
  PROCEDURAL STEPS
  1. Left groin access with retrograde cross over approach
  - UF 4F diagnostic catheter (ANGIO DYNAMICS)
  - 0.035" SupraCore guidewire, 300 cm (ABBOTT VASCULAR)
  - 7F–45 cm Pinnacle sheath (TERUMO)
  2. Passage through the right SFA stenosis
  - 0.035" Tempo Aqua Vert support catheter, 125 cm (CORDIS)
  - 0.014" Fielder guidewire, 300 cm (ABBOTT VASCULAR)
  - Exchange to 0.014" Spartacore guidewire, 300 cm (ABBOTT VASCULAR)
  3. Filter placement
  - Exchange to a Barewire through the support catheter (ABBOTT VASCULAR)
  - Emboshield Nav 6 filter placement (ABBOTT VASCULAR)
  4. Plaque modification
  - Chocolate balloon 5 x 120 mm (MEDTRONIC)
  5. PTA with drug-coated balloon
  - In.Pact Admiral 6.0 x 150 mm DCB (MEDTRONIC)
  

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• Tuesday, January 30th: 16:41 - 17:02, Room 1 - Main Arena 1

  Case 08 – Right superficial femoral artery occlusion – calcified

  Center:

  New York

  Case 08 – NYo2: male, 80 years, (H-P)

  Operators:

  • Prakash Krishnan,
  • Vishal Kapur,
  • Karthik Gujja,
  • S. Singla,
  • Rheoneil Lascano

  CLINICAL DATA
  - Progressively worsening right leg claudication x 1 year
  - No history of rest pain or ulceration
  - Has failed maximal medical therapy
  - Current claudication distance <1 block (Rutherford stage 3)
  - ABI: right 0.82, left 0.94
  
  RISK FACTORS
  - Type 2 diabetes mellitus, hypertension, dyslipidemia, ex smoker
  - History of CAD s/p CABG
  
  PROCEDURAL STEPS
  1. Left groin access with retrograde cross over approach
  - UF 4F diagnostic catheter (ANGIO DYNAMICS)
  - 0.035" SupraCore guidewire, 300 cm (ABBOTT VASCULAR)
  - 6F–45 cm Pinnacle sheath (TERUMO)
  2. Passage through the right SFA occlusion
  - 0.035" Tempo Aqua Vert support catheter, 125 cm (CORDIS)
  - 0.018" Connect 250 T guidewire, 300 cm (ABBOTT VASCULAR)
  - If unable to cross with 0.018" guidewire, switch to an 0.035" stiff angled glidewire (TERUMO)
  3. Filter placement
  - Exchange to a Barewire through the support catheter (ABBOTT VASCULAR)
  - Emboshield Nav 6 filter placement (ABBOTT VASCULAR)
  4. Jetstream atherectomy of the right SFA calcified disease
  - Jetstream 2.4/3.4 mm atherectomy (BOSTON SCIENTIFIC)
  5. PTA with drug-coated balloon
  - In.Pact Admiral 6.0 x 120 mm DCB (MEDTRONIC)
  6. PTA with a non-compliant balloon
  - Dorado 6 x 100 mm balloon (BARD)
  7. Stenting and post-dilatation
  - 5.5 x 150 mm Supera interwoven self-expanding Nitinol stent (ABBOTT)
  - Dorado 6 x 100 mm balloon (BARD)
  

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