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L I N C M I D D L E E A S T
2 0 1 6
Grand Hyatt Hotel Dubai Sheikh Rashid Road Dubai, United Arab EmiratesApril 7 and April 8, 2016
Guide to Live Case Transmissions
Guide to Live Case Transmissions
During LINC Middle East 2016 19 inter-ventional and surgical live cases are scheduled to be performed and transmitted to the auditorium. The aim of this booklet is to give you an overview about the live case schedule and to provide a practical guide through the procedures.
We hope for your under standing that with respect to the clinical needs of the patients changes of the schedule may occur. Furthermore, the anticipated procedural steps are just an outline of the procedure. Depending on the discretion of the operator the procedural strategy or the choice of material may vary.
Procedural steps
L I N C M I D D L E E A S T2 0 1 6
Thursday, April 7, 2016
1
Thur
sday
2
Thursday, 08:00 – 09:00 Live from University Hospital Leipzig, Germany
Case 01 – LEI 01: male, 63 years, (S-F)
Total occlusion left common iliac arteryOperators: A. Schmidt, M. Ulrich
Clinical data: Severe claudication left buttock, thigh and calf, walking capacity 50 meters Rutherford class 3 CAD with PTCA 2008 and 2015 Former smoker Art. hypertension
Angiography: During PTCA 2015: calcified total occlusion left common iliac artery ABI left 0.65
1. Femoral access left side ■ 7F 25 cm sheath (TERUMO) Left brachial approach: ■ 7F 90 cm Check-Flo Perfomer Sheath (COOK)
2. Guidewire passage from brachial ■ 5F 125 cm Judkins Right diagnostic catheter (CARDINAL HEALTH) ■ 0.035" stiff angled glidewire, 260 cm (TERUMO)
3. Guidewire passage from femoral ■ 5F 80 cm Multipurpose diagnostic catheter (CARDINAL HEALTH) ■ 0.035" stiff angled glidewire, 260 cm (TERUMO) ■ Potentially double-balloon-technique with:
Admiral balloon 5.0/40 mm, 135 cm (MEDTRONIC)
4. Stentgraft implantation bilateral after predilatation ■ LifeStream covered stentgraft (BARD)
Procedural steps
3
Thur
sday
Thursday, 09:08 – 09:36 Live from University Hospital Leipzig, Germany
Case 02 – LEI 02: female, 72 years (E-R)
Chronic total occlusion right SFAOperators: S. Bräunlich, M. Ulrich
Clinical data: Severe claudication right calf, walking capacity 100 meters Rutherford class 3 Diabetes mellitus type 2, art. hypertension
Duplex: Partially calcified SFA-occlusion right ABI 0.67
Angiography: SFA-occlusion right, moderately calcified
1. Left groin access and cross-over approach ■ 5F IMA-cathter (CARDINAL HEALTH) ■ 0.035" soft angled glidewire 180 cm (TERUMO) ■ 0.035" SupraCore Guidewire 180 cm (ABBOTT) ■ 6F 40 cm Balkin Up&Over Sheath (COOK)
2. Guidewire passage ■ 0.018" Connect guidewire, 300 cm (ABBOTT) ■ 4.0/120 mm Pacific Extreme balloon catheter, 135 cm (MEDTRONIC) ■ In case of thrombus Rotarex thrombectomy before PTA (STRAUB MEDICAL)
3. PTA with drug-coated balloons ■ 5.0/120 mm In.Pact Pacific (MEDTRONIC)
4. Stenting on indication ■ Complete selfexpanding nitinol-stent (MEDTRONIC)
Procedural steps
4
Thursday, 10:24 – 10:49 Live from University Hospital Leipzig, Germany
Case 03 – LEI 03: male, 64 years (W-S)
Chronic total occlusion SFA bilateralOperators: A. Schmidt, Y. Bausback
Clinical data: Severe claudication both calves, walking capacity 150 meters; right > left Rutherford classification 3 Mitral insufficiency II, NYHA II Art. hypertension, former smoker COPD ABI right 0.66; left 0.67
1. Left groin access and cross-over approach ■ 5F IMA-cathter (CARDINAL HEALTH) ■ 0.035" soft angled glidewire 180 cm (TERUMO) ■ 0.035" SupraCore guidewire 180 cm (ABBOTT) ■ 6F 40 cm Balkin Up&Over Sheath (COOK)
2. Gudewire passage ■ 0.035" stiff angled glidewire, 260 cm (TERUMO) ■ Seeker support catheter, 135 cm (BARD) ■ Exchange to a 0.018" SteelCore guidewire, 300 cm (ABBOTT)
3. PTA ■ VascuTrak balloon 5.0/250 mm (BARD) ■ Lutonix DCB 5.0 or 6.0/150 mm (BARD)
4. Stenting on indication ■ LifeStent selfexpanding nitinol-stent (BARD)
Procedural steps
Procedural steps
Thursday, 10:57 – 11:22 Live from Rashid Hospital, Dubai, United Arab Emirates
Case 04 – RAH 01: male, 61 years (I-A)
Endovascular repair of left CFA and SFA occlusionOperators: A. Al-Sibaie, A. Alfalahi
Clinical data: PAD with intermittent claudication, left leg pain Rutherford grade I Fontain IIB. ABI = 0.3 Important items: HTN, IHD, Angioplasty and stenting done for both external iliac arteries
and surgical procedure profundaplasty was done in 2012.
1. Access right groin and cross-over approach ■ 7 F Flexor Check-flo introducer (COOK)
2. Recanalization of left common femoral artery ■ TERUMO 0.035" with support catheter 4 Fr. glide catheter (TERUMO)
3. Predilation ■ 5.0 x 60 mm ballon catheter
4. Postdilatation ■ DEB 0.035" 6.0 mm x 80 mm 130 cm In.pact Admiral (MEDTRONIC)
5. Retrograde access to recanalize superficial femoral artery
6. PTA with DEB depends on final angiography
7. Spot stenting in case of dissection or residual stenosis ■ Depending on the location either SUPERA or Zilver PTX (COOK)
5
Thur
sday
6
Thursday, 11:40 – 12:05 Live from University Hospital Leipzig, Germany
Case 05 – LEI 04: female, 63 years (S-G)
Reocclusion right SFAOperators: M. Ulrich, A. Schmidt
Clinical data: Severe claudication right SFA, walking capacity 100 meters PTA left SFA 2/2016 PTA right SFA 2014 elsewhere CEA right internal carotid artery 2012 Art. hypertension Diabetes mellitus type 2
Angiography: Right SFA during PTA left SFA 2/2016 ABI right 0.65
1. Left groin access and cross-over approach ■ 5F IMA cathter (CARDINAL HEALTH) ■ 0.035" soft angled glidewire 180 cm (TERUMO) ■ 0.035" SupraCore guidewire 300 cm (ABBOTT) ■ 6F 40 cm Balkin Up&Over Sheath (COOK)
2. Gudewire passage ■ 0.035" stiff angled glidewire, 260 cm (TERUMO) ■ CXC support catheter, 135 cm (COOK) ■ Exchange to a 0.035" SupraCore guidewire, 300 cm (ABBOTT)
3. PTA and stenting ■ Advance 0.035" balloon 5.0/100 mm (COOK) ■ Zilver-PTX stents 6.0/120 mm (COOK)
Procedural steps
7
Thursday, 13:30 – 14:15 Live from University Hospital Leipzig, Germany
Case 06 – LEI 05: male, 58 years (G-N)
Re-occlusion left, partially in-stentOperators: A. Schmidt, S. Bräunlich
Clinical data: Severe claudication left calf, walking capacity 100 meters, restpain during night Rutherford class 4 Failed antegrade recanalization attempt left SFA 2/2016 PTA and stenting left SFA elsewhere 1/2015 CAD, COPD, art. hypertension, former smoker ABI left 0.55
1. Right groin access and cross-over approach ■ 5F IMA-cathter (CARDINAL HEALTH) ■ 0.035" soft angled glidewire 180 cm (TERUMO) ■ 0.035" SupraCore guidewire 180 cm (ABBOTT) ■ 7F 40 cm Balkin Up&Over Sheath (COOK)
2. Guidewire passage ■ 0.035" stiff angled glidewire, 260 cm (TERUMO) ■ QuickCross support catheter, 135 cm (SPECTRANETICS) ■ Exchange to a 0.014" Floppy ES Extrasupport guidewire, 300 cm (ABBOTT)
3. In case of failure to pass the guidewire from antegrade Stent-puncture (proximal or disal stent): ■ 18 gauge 7 cm needle proximal and 21 gauge 9 cm needle distally (COOK) ■ 0.018" V-18 Control guidewire 300 cm (BOSTON SCIENTIFIC) ■ 0.018" QuickCross support catheter 90 cm (SPECTRANETICS)
4. Laser atherectomy and PTA ■ 7F Tandem Booster-Laser atherectomy (SPECTRANETICS) ■ Stellarex DCB 5.0/120 mm (SPECTRANTICS)
Thur
sday
Procedural steps
8
Thursday, 14:31 – 14:51 Live from Rashid Hospital, Dubai, United Arab Emirates
Case 07 – RAH 02: male, 53 years (N-G)
Right lower limb below knee triple artery segmental stenosisOperators: A. Al-Sibaie, A. Alfalahi
Clinical data: Right leg pain, rutherford grade III Fontain IV. Right SFA total occlusion balloned and stented. RT ABI = 0.2
Important items: HTN, DM type II, IHD, CCF
1. Right femoral antegrade access
2. Antegrade recanaliztion of anterior and posterior tibial arteries, in cases not succesful retrograde access will be used
3. Retrograde pedal access ■ Micro puncture set (COOK)
4. Recanalization ■ 0.014" wire command ABBOTT with support catheter
5. Snaring of the wire through the femoral access
6. Ballon angioplasty ■ Over the wire in antegrade direction ballon angioplasty 2.5 mm dilator
0.014" Armada ABBOTT
Procedural steps
9
Thursday, 15:32 – 16:11 Live from University Hospital Leipzig, Germany
Case 08 – LEI 06: male, 62 years (KH-L)
Severely calcified popliteal occlusion rightOperators: S. Bräunlich, A. Schmidt
Clinical data: Critical limb ischemia with ulceration dig V Rutherford class 5 CAD, ischemic cardiomyopathy, EF 45%, NYHA II Diabetes mellitus type 2, former smoker
Angiography: Distal SFA / Apop P1-segment occlusion right Anterior and posterior tibial artery occlusion Severe calcification ABI right 0.33
1. Right antegrade access ■ 6F 55 cm sheath (COOK)
2. Guidewire passage ■ 0.035" stiff angled glidewire, 260 cm (TERUMO) supported by a balloon: ■ Armada 35 balloon 4.0/80 mm, 90 cm (ABBOTT) in case of failure to pass the CTO from antegrade
retrograde approach via peroneal artery: ■ 7 cm 21 gauge needle (COOK) ■ 0.018" Connect guidewire 300 cm (ABBOTT) ■ 0.018" QuickCross support catheter (SPECTRANETICS)
3. PTA and stenting ■ Armada 5.0 or 6.0/40 mm (ABBOTT) ■ 5.0 Supera Interwoven nitinol-stent (ABBOTT)
Thur
sday
Procedural steps
10
Thursday, 16:35 – 17:15 Live from University Hospital Leipzig, Germany
Case 09 – LEI 07: male, 65 years (H-G)
Anterior tibial artery occlusion, multiple ulcerations forefoot left Operators: M. Ulrich, Y . Bausback
Clinical data: Ulceration Left foot, Rutherford class 5 Failed antegrade recanalization attempt with failure to pass the guidewire
through the ATA-CTO elsewhere Diabetes mellitus type 2, art. hypertension, former smoker
Angio: ABI right 0.44 Anterior tibial artery occlusion left, high offspring
1. Antegrade access left ■ 6F 55 cm sheath (COOK)
2. Retrograde approach via the dorsalis pedis artery left ■ Pedal puncture set (COOK) ■ 4 cm 21 gauge needle (COOK) ■ 2.9F sheath (COOK) ■ 0.018" V-18 Control guidewire 300 cm (BOSTON SCIENTIFIC) ■ 0.018" CXI support catheter 90 cm (COOK) ■ Exchange to 0.014" Hydro-ST guidewire 300 cm (COOK) ■ Advance Micro balloon 3.0/120 mm, 90 cm (COOK)
3. PTA from antegrade with DCBs After predilatation from retrograde ■ Lutonix DCBs from antegrade (BARD)
Procedural steps
11
Thursday, 17:15 – 18:00 Live from University Hospital Leipzig, Germany
Case 10 – LEI 08: male, 72 years (R-F)
Progressive, highgrade stenosis left internal carotid arteryOperators: A. Schmidt, S. Bräunlich
Clinical data: 90% stenosis left ICA Minor stroke 1/2015 Art. hypertension, diabetes mellitus type 2 CAD with NSTEMI 11/2015, PTCA
Risk factors: Left ICA flow-velocity progression 1/2015: 2.5m/sec 11/2015: 4.8m/sec Angiography during PTCA 11/2015: 90% stenosis left ICA
1. Right groin access ■ 9F 25 cm sheath (TERUMO)
2. Cannulation of the left external carotid artery ■ 5F Judkins right diagnostic catheter (CARDINAL HEALTH) ■ 0.035" soft angled glidewire, 190 cm (TERUMO) ■ Exchange to 0.035" SupraCore guidewire, 190 cm (ABBOTT)
3. Cerebral protection ■ MOMA endovascular clamping device (MEDTRONIC)
4. Predilatation, stenting and postdilatation ■ 3.5/20 mm MiniTrek RX balloon (ABBOTT) ■ Roadsaver carotid artery stent system (TERUMO) ■ 5.0/20 mm Sterling RX balloon (BOSTON SCIENTIFIC)
5. Aspiration of potential plaque-debris before declamping of the MOMA-system
6. Final angiography
Thur
sday
Procedural steps
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Frid
ay
L I N C M I D D L E E A S T2 0 1 6
Friday, April 8, 2016
13
14
Friday, 08:00 – 08:45 Live from University Hospital Leipzig, Germany
Case 11 – LEI 09: male, 59 years (P-R)
Severely calcified distal SFA / Apop-CTO rightOperators: A. Schmidt, M. Ulrich
Clinical data: Restpain right foot, walking capacity 50 meters, claudication right calf Rutherford class 4 PTA and stenting iliac arteries 2012 and 2/2016 Failure to recanalize the SFA / Apop-occlusion right from antegrade TEA right groin 2014, PTA / Supera-stent left popliteal artery 3/2015 End stage renal failure with chronic dialysis CAD, PTCA 2012, ICD
Risk factors: ABI: > 1.4 (mediasclerosis) Severely calcified total occlusion of the distal SFA and Apop right
1. Right groin antegrade access ■ 7F 40 cm Balkin Up&Over Sheath (COOK)
2. Second attempt to pass the CTO from antegrade ■ 0.035" stiff angled glidewire, 260 cm (TERUMO) ■ 4.0/80 mm Armada 35 balloon, 90 cm (ABBOTT)
3. In case of failure retrograde approach via the proximal anterior tibial artery ■ 7 cm 21 gauge needle (COOK) ■ 0.018" Connect guidewire, 300 cm (ABBOTT) ■ 0.018" CXC support catheter, 90 cm (SPECTRANETICS) potentially sheath-insertion: ■ 4F 10 cm Radiofocus Sheath, 0.025" GW-compatible (TERUMO)
4. PTA and stenting ■ 5.0/40 mm and 6.0/40 mm Armada 35 balloon (ABBOTT) ■ 5.0 or 6.0 mm Supera interwoven nitinol-stent (ABBOTT)
Procedural steps
15
Friday, 09:01 – 09:26 Live from Rashid Hospital, Dubai, United Arab Emirates
Case 12 – RAH 03: male, 55 years (M-A)
AAA with extension to common iliac arteries modified implantation technique of IBDOperators: A. Al-Sibaie, A. Alfalahi
Clinical data: Infrarenal AAA measuring 5.7 cm extending over the aortic bifurcation to common iliac arteries
Risk factors: -Short common iliac arteries, the internal iliac artery bilaterally are seen originating approx. 1 cm distal to the orgin of common iliac arteries.
-Standard devices can't provide long term distal sealing. -Modified implantation technique of IBD is required as the right common iliac artery
is too short to do it according to IFU.
1. MAIN BODY (ZENITH COOK) insertion through left femoral access
2. Through and through wire from left brachial access through the main body to right femoral access
3. Insertion IBD (ZENITH COOK) through the right femoral access using the through and through wire as an access to the Internal iliac artery branch
4. Periphral stent graft 7F BENTLEY InnoMED will be inserted through the left brachial access through the IBD into right internal iliac artery
5. Connecting IBD with main body
6. Extending left iliac limb into the external iliac artery covering the left internal iliac artery
Frid
ay
Procedural steps
16
Friday, 09:34 – 09:59 Live from University Hospital Leipzig, Germany
Case 13 – LEI 10: male, 72 years (M-W)
Percutaneous EVAROperators: A. Schmidt, D. Branzan
Clinical data: Progressive infrarenal abdominal aortic aneurysm Art. hypertension, former smoker Prostatic cancer surgery 2015
Duplex: Duplex-sonographic measurement 12/2012: 32 mm max. diameter 12/2015: 51 mm max. diameter, excentric infrarenal aneurysm
1. Percutaneous access in local anaesthesia both groins ■ Preloading of 2 Proglide-systems per groin (ABBOTT) ■ 9F 10 cm Radiofocus sheath (TERUMO) ■ Lunderquist guidewire 180 cm (COOK)
2. Implantation of the stentgraft ■ Ovation stentgraft (ENDOLOGIX / TRIVASCULAR) ■ Polymere filling of the graft ■ Cannulation of the contralateral limb ■ 5F Amplatz left diagnostic catheter (CARDINAL HEALTH) ■ 0.035" soft angled guidewire, 190 cm (TERUMO) ■ Implantation of both limb-extensions (ENDOLOGIX / TRIVASCULAR)
3. PTA ■ Proximal seal: Reliant balloon (MEDTRONIC) ■ Graft-bifurcation: 12/40 mm Admiral balloon in kissing-technique (MEDTRONIC)
4. Closure of the groins ■ Preloaded Proglide-systems (ABBOTT)
Procedural steps
17
Friday, 10:43 – 11:08 Live from University Hospital Leipzig, Germany
Case 14 – LEI 11: female, 28 years (L-M)
Iliofemoral venous interventionOperators: A. Schmidt, Y. Bausback, D. Branzan
Clinical data: Iliac vein left side and distal inferior vena cava thrombosis 6/2013 Venous claudication left (painfree walking capacity 500 meters) Swelling left leg despite compression therapy No skin changes, groin varicosis left
Present state: Phlebography via popliteal vein: postthrombotic residuum left common femoral vein, total occlusion iliac vein left, varicous groin-veins.
1. Prone position of the patient in general anaesthesia
2. Duplex-guided access left popliteal vein ■ 11F 10 cm Radiofocus sheath (TERUMO)
3. Guidewire passage of the left iliac veins ■ 0.035" stiff straight glidewire, 260 cm (TERUMO) ■ 4F 100 cm Judkins Right diagnostic catheter (CARDINAL HEALTH) or ■ 0.018" V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC) ■ 3.0/120 mm Pacific Extreme balloon (MEDTRONIC)
4. PTA ■ Atlas high pressure balloon 14/60 mm (BARD)
5. Implantation of dedicated iliac vein stents ■ Sinus-Obliquus 14-16 mm (OPTIMED) ■ Sinus-XL Flex 14-16 mm (OPTIMED) or ■ Zilver Vena venous self-expanding stent (COOK)
6. Postdilatation ■ Atlas high pressure balloon 14/60 mm (BARD)
Frid
ay
Procedural steps
18
Friday, 11:45 – 12:30 Live from University Hospital Leipzig, Germany
Case 15 – LEI 12: male, 62 years (S-D)
Acute reocclusion left SFA after PTA / stentOperators: S. Bräunlich, M. Ulrich
Clinical data: Severe claudication left calf, walking capacity 150 meters Rutherford class 3 PTA left SFA 1/2016 elsewhere with an acute reocclusion 2 days post PTA CAD, MI 2012 Diabetes mellitus type 2, art. hypertension, current smoker
Current state: ABI left 0.70 Angiography of the left SFA-stenosis before PTA and after stenting Angiography of the acute reocclusion of the SFA 2 days later
1. Right groin retrograde and cross-over approach ■ IMA diagnostic 5F catheter (CORDIS / CARDINAL HEALTH) ■ 0.035" angled soft Radiofocus glidewire, 190 cm (TERUMO) ■ 0.035" SupraCore guidewire, 190 cm (ABBOOTT) ■ 8Fr Balkin Up&Over Sheath, 40 cm (COOK)
2. Passage of the occlusion and percutaneous thrombectomy ■ 0.018" Connect guidewire 300 cm (ABBOTT) ■ 0.018" QuickCross support catheter 135 cm (SPECTRANETICS) ■ Exchange to Rotarex guidewire (STRAUB MEDICAL) ■ 8F Rotarex thrombectomy catheter (STRAUB MEDICAL)
3. PTA with DCBs ■ In.Pact Pacific 5.0/120 mm (MEDTRONIC)
4. Stenting on indication ■ Complete selfexpanding nitinol-stent (MEDTRONIC)
Procedural steps
PTA / stent SFA-Stenosis left 11/2015 Acute occlusion early after PTA
19
Friday, 13:30 – 14:00 Live from University Hospital Leipzig, Germany
Case 16 – LEI 13: male, 76 years (M-P)
Restpain left leg, unsuccessful recanalization attemptOperators: A. Schmidt, M. Ulrich
Clinical data: Restpain left foot, claudication left calf, walking capacity 20 meters Rutherford class 4 Fem-pop bypass surgery left 2012 with early failure PTA and stent left distal SFA 1/2013 Reocclusion 12/2015 and failure to recanalize from antegrade and retrograde elsewhere Art. hypertension Surgery of a colon-carcinoma 2012
Angiography: Left: total occlusion of the SFA to the popliteal segment ABI left 0.2
1. Right groin retrograde and cross-over approach ■ IMA diagnostic 5F catheter (CORDIS / CARDINAL HEALTH) ■ 0.035" angled soft Radiofocus glidewire, 190 cm (TERUMO) ■ 0.035" SupraCore guidewire, 190 cm (ABBOOTT) ■ 6F Balkin Up&Over Sheath, 40 cm (COOK)
2. Retrograde approach via the occluded SFA ■ 18 gauge 7 cm needle (COOK) ■ 0.035" stiff angled glidewire 190 cm (TERUMO) ■ 4F 12 cm Sheath (St. JUDE) ■ 0.018" Connect 250 T guidewire, 300 cm (ABBOTT) ■ 4F Judkins right diagnostic catheter (CARDINAL HEALTH)
3. In case of failure to reenter from retrograde into the common femoral artery
■ Exchange to a 6F 10 cm sheath (TERUMO)
■ Outback reentry device from retrograde (CARDINAL HEALTH)
■ 0.014 Stabilizer 300 cm guidewire (CARDINAL HEALTH)
4. PTA and stenting ■ Advance 18 balloon
5.0/100 mm (COOK) ■ Zilver-PTX stent (COOK)
Frid
ay
Procedural steps
20
Friday, 13:30 – 14:00 Live from University Hospital Leipzig, Germany
Case 17 – RAH 04
Please consult website for case information: www.linc-around-the-world.com
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Frid
ay
Friday, 14:45 – 15:30 Live from University Hospital Leipzig, Germany
Case 18 – LEI 14: male, 56 years (J-H)
Restpain with popliteal occlusion leftOperators: S. Bräunlich, M. Ulrich
Clinical data: Restpain left foot, claudication left calf, walking capacity 20 meters Rutherford class 4 Failure to recanalize from antegrade elsewhere Art. Hypertension
Angiography: Chronic occlusion of the left popliteal artery (P1-P3) ABI left: 0.4
1. Left antegrade approach ■ 6F 55 cm sheath (COOK)
2. Second attempt to pass the occlusion from antegrade ■ Connect 250 T guidewire, 300 cm (ABBOTT) ■ 4.0/80 mm Pacific Extreme balloon, 90 cm (MEDTRONIC)
3. In case of failure: retrograde approach via the proximal anterior tibial artery ■ 7 cm 21 gauge needle (COOK) ■ Connect guidewire, 300 cm (ABBOTT) ■ QuickCross support catheter (SPECTRANETICS)
4. PTA and stenting ■ 5.0 and 6.0/40 mm Pacific Extreme balloon (MEDTRONIC) ■ 5.0 and 6.0 Supera interwoven nitinol stent (ABBOTT)
Procedural steps
22
Friday, 15:30 – 16:00 Live from University Hospital Leipzig, Germany
Case 19 – LEI 15: female, 82 years (H-L)
Restpain with multilevel disease rightOperators: A. Schmidt, Y. Bausback
Clinical data: Restpain right foot, claudication left calf, walking capacity 50 meters Rutherford class 4 Art. Hypertension
Angiography: Right: Proximal SFA-stenosis, occlusion of the P1-segment and tibioperoneal trunk ABI left: 0.44
1. Left groin retrograde and cross-over approach ■ IMA diagnostic 5F catheter (CARDINAL HEALTH) ■ 0.035" angled soft Radiofocus glidewire, 190 cm (TERUMO) ■ 0.035" SupraCore guidewire, 190 cm (ABBOOTT) ■ 7F Balkin Up&Over Sheath, 40 cm (COOK)
2. Guidewire passage ■ Connect 250 T guidewire, 300 cm (ABBOTT) ■ CXC support catheter, 135 cm (COOK)
3. Filter protection and atherectomy ■ Spider-filter 4 mm into the posterior tibial artery (MEDTRONIC) ■ HawkOne 6.6 cm tip (MEDTRONIC)
4. PTA with drug-coated balloons ■ In.Pact Pacific 5.0 and 4.0 mm (MEDTRONIC)
Procedural steps
23
Live case transmission performing centres and operators
University Hospital Leipzig, Division of Interventional Angiology,Leipzig,Germany
Operators: Andrej SchmidtMatthias UlrichSven Bräunlich,Yvonne BausbackDaniela Branzan
Rashid Hospital, Dubai, UnitedArabEmirates
Operator: Ayman Al-SibaieAfra Muesem Alfalahi
24
For your notes
Congress production:
Provascular GmbHSonnenleite 391336 Heroldsbach, Germany
www.provascular.de
Congress organisation
Congress Organisation and More GmbHAntonie Jäger
Ruffinistrasse 1680637 MunichGermany
Phone: +49 89 23 75 74–65Fax: +49 89 23 75 74–70E.mail: [email protected]
www.cong-o.com
The venue
Grand Hyatt Hotel Dubai Sheikh Rashid Road Dubai United Arab Emirates