Paris

• Wednesday, January 29th: 11:10 - 11:25, Room 1 - Main Arena 1

  Case 26 – PAR 01

  Center:

  Paris

  Case 26 – PAR 01

  Detailed information will be shown in the video itself!
• Wednesday, January 29th: 14:16 - 14:36, Room 2 - Main Arena 2

  Case 37 – FEVAR for type 1a endoleak post EVAR

  Center:

  Paris

  Case 37 – PAR 02: male, 66 years

  Operators:

  • Stéphan Haulon,
  • D. Fabre,
  • A. Girault,
  • P. Charbonneau,
  • A. Schwein

  CLINICAL DATA
  Previous EVAR for AAA
  
  PRESENT STATE
  71 mm AAA
  
  PROCEDURAL STEPS
  1. L: Advance 18F 33cm GORE Dryseal sheath in the LCFA over Lunderquist – 1 x 6F 55 cm and 1 x 7F 55 COOK Ansel sheaths
  100 U/kg Heparin (Target ACT³250)
  L (through one of the 6F): advance long pigtail catheter
  R: 10F sheath/Lunderquist/dilators up to 20
  2. Fluoroscopy to locate fenestrations gold markers
  R: Advanced fenestrated endograft – Aortic angiogram – fusion mask registration – fenestrated endograft deployment
  3. R: Rosen wire advanced through preloaded catheter – Exchange preloaded catheter for a 6F-90cm COOK Ansel Shuttle sheath – Exchange Rosen for a Stealcore 0.018 - 300 cm wire – Retrieve 6F to the level of the fenestration – Retrieve the 6F dilator – Puncture valve – DAV + TERUMO/Roadrunner through 6F for renal artery catheterisation – Renal angiogram – Exchange TERUMO for Rosen – Retrieve Stealcore
  wire – Advance 6F into the renal artery – Advance BENTLEY Begraft bridging stent to parking position
  4. Same for controlateral renal artery
  5. L: Through 6F sheath advance BER + TERUMO to catheterize fenestrated endograft lumen steps (cont.): – Advance 6F below the fenestration (SMA/CT) – USL + TERUMO/ Roadrunner through 6F sheath to catheterise target vessel (SMA/CT) – Vessel angiogram / Exchange TERUMO for Rosen wire – Advance 6F into target vessel – Advance BENTLEY Begraft bridging stent to parking position
  6. R: Release diameter-reducing ties – proximal and distal attachments – Nose retrieval under fluoroscopy
  7. L: SMA/CT stent deployment (3-4 mm protruding in the aortic lumen) after sheath retrieval – Flare the aortic portion of stent with 10-20 mm balloon – Advance the sheath in the SMA/CT stent/angiogram (SMA: exchange Rosen for TERUMO wire)
  8. R: Renal artery stent deployment (3-4 mm protruding in aortic lumen) after 6F retrieval – Flare the aortic portion of stent with 9-20 mm balloon – Advance 6F back into the renal stent – angiogram
  9. R: Remove nose under fluoroscopy / Remove fenestrated device delivery system
  L: Withdraw sheaths in 18F – insert and deploy bifurcated device and iliac limbs
  10. CODA balloon to mold overlaps and distal sealing zones
  Pigtail catheter – Angiogram + non-contrast CBCT

  View image
• Thursday, January 30th: 11:30 - 11:55, Room 2 - Main Arena 2

  Case 63 – PAR 03

  Center:

  Paris

  Case 63 – PAR 03

  Detailed information will be shown in the video itself!
• Thursday, January 30th: 16:15 - 16:40, Room 2 - Main Arena 2

  Case 65 – FEVAR for type 5 thoraco abdominal aortic aneurysm

  Center:

  Paris

  Case 65 – PAR 04: male, 85 years

  Operators:

  • Stéphan Haulon,
  • D. Fabre,
  • P. Charbonneau,
  • A. Girault

  CLINICAL DATA
  Lumbar spine surgery for herniated disc (1993)
  Aorto bi-femoral bypass for an infrarenal AAA (1998)
  Bilateral femoral arteries angioplasty and stenting, L CFA endarterectomy (2012)
  Urothelial cancer resected in 2011, colon polypectomy in 2003
  Chronic kidney disease (GFR 48 ml/min), hypertension, dyslipidemia
  
  PRESENT STATE
  ASA 3, ECG: sinus, TTE: LVEF: 65%, normal
  
  PROCEDURAL STEPS
  1. L: Advance 16F 30 cm GORE Dryseal sheath in the LCFA over Lunderquist – 2x 6F-55 cm COOK Ansel sheaths
  100 U/kg Heparin (Target ACT³250)
  L (through one of the 6F): advance long pigtail catheter
  R: 10F sheath/Lunderquist/ dilators up to 20
  2. R: Deployment of proximal TEVAR, just above the celiac trunk
  3. Fluoroscopy to locate fenestrations gold markers
  R: Advanced fenestrated endograft – Aortic angiogram – fenestrated endograft deployment
  4. R: Rosen wire advanced through preloaded catheter – Exchange preloaded catheter for a 6F-90 cm COOK Ansel Shuttle sheath – Exchange Rosen for a Stealcore 0.018- 300 cm wire – Retrieve 6F to the level of the fenestration – Retrieve the 6F dilator – Puncture valve – DAV + TERUMO/Roadrunner through 6F for renal artery catheterisation – Renal angiogram – Exchange TERUMO for Rosen – Retrieve Stealcore wire – Advance 6F into the renal artery – Advance BENTLEY Begraft bridging stent to parking position
  5. Same for controlateral renal artery
  6. L: Through 6F sheath advance BER + TERUMO to catheterize fenestrated endograft lumen – Advance 6F below the fenestration (SMA/CT) – USL + TERUMO/ Roadrunner through 6F sheath to catheterise target vessel (SMA/CT) – Vessel angiogram – Exchange TERUMO for Rosen wire – Advance 6F into target vessel – Advance BENTLEY Begraft bridging stent to parking position
  7. R: Release diameter-reducing ties – proximal and distal attachments – Nose retrieval under fluoroscopy
  8. L: SMA/CT stent deployment (3-4 mm protruding in the aortic lumen) after 6F retrieval – Flare the aortic portion of stent with 10-20 mm balloon – Advance 6F in the SMA/CT stent/angiogram (SMA: exchange Rosen for TERUMO wire)
  9. R: Renal artery stent deployment (3-4 mm protruding in aortic lumen) after 6F retrieval – Flare the aortic portion of stent with 9-20 mm balloon – Advance 6F back into the renal stent – angiogram
  10. R: Remove nose under fluoroscopy / Remove fenestrated device delivery system
  L: Withdraw 6F sheath in 16F – Insert and deploy bifurcated device and iliac limbs
  11. CODA balloon to mold overlaps and distal sealing zones
  Pigtail catheter – Angiogram + non-contrast CBCT

  View image