LINC 2018 live case guide

Zürich

• Tuesday, January 30th: 8:50 - 9:10, Room 2 - Main Arena 2

  Case 10 – Pelvic lymphocele causing post-thrombotic syndrom left leg

  Center:

  Zürich

  Case 10 – ZUE 01: male, 59 years (W-J)

  Operators:

  • Nils Kucher,
  • Dai-Do Do

  CLINICAL DATA
  - Swelling left leg
  - Residual small pelvine lymphocele post sclerotherapy
  
  RISK FACTORS
  Compression left external iliac vein, inactive prostate carcinoma
  
  CT-SCAN
  Lymphocele (post sclerotherapy)
  
  PROCEDURAL STEPS
  1. Retrograde left common femoral vein access
  - 10F sheath
  2. Retrograde recanalization left iliac vein obstruction
  3. IVUS
  4. Vessel preparation
  5. Stenting
  - New generation woven nitinol stent (Blue Flex stent) 10F (14/100 and 14/150)
  6. Post dilatation
  

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• Tuesday, January 30th: 11:00 - 11:15, Room 2 - Main Arena 2

  Case 14 – Postpartal ilio-femoral vein thrombosis left

  Center:

  Zürich

  Case 14 – ZUE 02: female, 27 years, (K-S)

  Operators:

  • Nils Kucher,
  • Dai-Do Do

  CLINICAL DATA
  Post-thrombotic syndrome with leg swelling and claudicatio venosa
  
  RISK FACTORS
  Delivery, postpartum status, May-Thurner anatomy
  
  DUPLEX
  Occlusion left external iliac and common femoral veins; maintained venous inflow by V. femoralis & V. profunda femoris
  
  PROCEDURAL STEPS
  1. Ultrasound-assisted retrograde left common femoral vein access
  - 10F sheath
  2. Passage left iliac vein occlusion
  3. IVUS
  4. Vessel preparation
  5. Stenting
  - VIC: Sinus Obliquus (14/150) (OPTI MED)
  - VIC: Sinus XL Flex (14/100) (OPTI MED)
  - VFC: Sinus XL Flex (14/80) (OPTI MED)
  6. Post-dilatation
  

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• Tuesday, January 30th: 12:00 - 12:15, Room 2 - Main Arena 2

  Case 14 – Postpartal ilio-femoral vein thrombosis left

  Center:

  Zürich

  Case 14 – ZUE 02: female, 27 years, (K-S)

  Operators:

  • Nils Kucher,
  • Dai-Do Do

  CLINICAL DATA CLINICAL DATA
  Post-thrombotic syndrome with leg swelling and claudicatio venosa
  
  RISK FACTORS
  Delivery, postpartum status, May-Thurner anatomy
  
  DUPLEX
  Occlusion left external iliac and common femoral veins; maintained venous inflow by V. femoralis & V. profunda femoris
  
  PROCEDURAL STEPS
  1. Ultrasound-assisted retrograde left common femoral vein access
  - 10F sheath
  2. Passage left iliac vein occlusion
  3. IVUS
  4. Vessel preparation
  5. Stenting
  - VIC: Sinus Obliquus (14/150) (OPTI MED)
  - VIC: Sinus XL Flex (14/100) (OPTI MED)
  - VFC: Sinus XL Flex (14/80) (OPTI MED)
  6. Post-dilatation

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

  Case 16 – Recanalization chronic iliac vein occlusion left

  Center:

  Zürich

  Case 16 – ZUE 03: female, 69 years (R-L)

  Operators:

  • Nils Kucher,
  • Ulrich Frank

  CLINICAL DATA
  Post-partal iliac vein thrombosis (1969) with post-thrombotic syndrome
  
  RISK FACTORS
  APC-resistance, atypical left iliac vein compression
  
  CT-SCAN
  Spontaneous palma, no May-Thurner anatomy but atypical iliac vein compression
  
  PROCEDURAL STEPS
  1. Ultrasound-assisted retrograde left femoral vein access
  - 10F sheath
  2. Passage left iliac vein occlusion
  3. IVUS
  4. Vessel preparation
  5. Stenting
  - VIC: Sinus Obliquus (14/150) (OPTI MED)
  - VIE: Sinus XL Flex (14/100) (OPTI MED)
  - VFC: Sinus XL Flex (14/80) (OPTI MED)
  6. Postdilatation
  

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

  Case 18 – Recanalization vena cava superior occlusion

  Center:

  Zürich

  Case 18 – ZUE 04: female, 65 years, (N-R.M.)

  Operators:

  • Nils Kucher,
  • Dai-Do Do

  CLINICAL DATA
  - PM-associated occlusion of vena cava superior
  - Bi-parietotemporal headache
  - Sick-sinus syndrome with dual-champer PM implantation 2012
  - Persisting pericardial effusion
  
  CLINICAL IMAGE
  Epigastric collateral veins
  
  CT
  Occlusion V. cava superior and innominate vein, insufficient hemiacygos collateral vein,
  atypical mamarian and epigastric veins, PM-electrodes in situ
  
  PROCEDURAL STEPS
  1. Ultrasound-assisted access
  - Left common femoral vein 10F sheath
  - Right internal jugular vein 6F sheath
  2. Passage V. cava superior occlusion
  3. IVUS
  4. Balloon angioplasty
  - Atlas Gold Balloon (up to 16 mm) (BARD)
  

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