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LINC Asia-Pacific 2018 live case guide

Find all live cases and live centers listed below

 

 

University Hospital Leipzig, Department of Angiology

12 livecase(s)
  • Tuesday, March 13th: - , Room 2 - Technical Forum

    Case 10 – Symptomatic stenosis of the right ICA

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 10 – LEI 04: male, 57 years (O-M)
    Operators:
    • Andrej Schmidt,
    • Yvonne Bausback
    CLINICAL DATA
    TIA 09/17 (left arm palsy)

    RISK FACTORS
    Art. hypertension, nicotin abuse, diabetes mellitus type 2

    PRESENT STATE
    CAD, CABG 2002, ICM (LV-EF 45%)

    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, Mono-Balloon (MEDTRONIC)
    3. Predilatation and stenting
    - 3.5/20 mm MiniTrek Monorail balloon (ABBOTT)
    - Roadsaver Carotid Micromesh stent 8 x 25 mm (TERUMO)
    4. Aspiration of debris (if any) and declamping
    View image
  • Tuesday, March 13th: - , Room 1 - Main Arena

    Case 05 –Chronic total occlusion right SFA

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 05 – LEI 01: male, 56 years (R-T)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication right, walking capacity 50 meters, calf-pain
    TEA both groins 2013; PTA/stent CIA left 2017
    CAD with CABG 2015 and PTCA 2013
    Minor stroke 2008 and 2009

    RISK FACTORS
    Diabetes mellitus, art. hypertension, former smoker

    PROCEDURAL STEPS
    1. Left femoral access and cross-over approach
    - 6F 45 cm cross-over sheath Fortress (BIOTRONIK)
    2. Recanalisation left SFA
    - 0.018" Advantage glidewire (TERUMO)
    - 0.018" CXI support catheter (COOK)
    Back-up material:
    - Connect 250T CTO-wire (ABBOTT)
    - Outback reentry system (CORDIS/CARDINAL HEALTH)
    3. PTA
    - Passeo18 balloon 5 x 150 mm (BIOTRONIK)
    - 5 mm Passeo18 Lux DCB (BIOTRONIK)
    4. Stenting on indication, spot-stenting
    - Pulsar18 stent (BIOTRONIK)
    View image
  • Tuesday, March 13th: - , Room 1 - Main Arena

    Case 08 – Chronic SFA-occlusion right

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 08 – LEI 02: male, 64 years (A-J)
    Operators:
    • Matthias Ulrich,
    • Andrej Schmidt
    CLINICAL DATA
    Severe claudication right calf, walking capacity 150 meters
    CAD, PTCA 2012
    Hemicolectomy 2016
    ABI right 0.63

    RISK FACTORS
    Diabetes mellitus, art. Hypertension

    PROCEDURAL STEPS
    1. Left groin retrograde and cross-over approach
    - 0.035" SupraCore guidewire 190 cm (ABBOTT)
    - 6F–40 cm Balkin Up&Over sheath (COOK)
    2. Guidewire passage
    - 0.035" Radiofocus soft angled guidewire, 260 cm (TERUMO)
    - CXI support catheter, 0.035" 135 cm (COOK)
    In case of failure to pass the CT from antegrade:
    3. Retrograde approach via distal SFA
    - 9 cm 21 Gauge needle (COOK)
    - 0.018" V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
    - 0.018" CXI support catheter 90 cm (COOK)
    4. Angioplasty
    - Advance balloon 5.0/100 mm (COOK)
    - Advance Enforcer 6.0/40 mm in case of focal residual stenosis (COOK)
    5. Stenting
    - Zilver PTX stent 6.0/140 mm (COOK)
    View image
  • Tuesday, March 13th: - , Room 1 - Main Arena

    Case 09 – Critical limb ischemia, restenosis right distal A. pop, and reocclusion right TPT

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 09 – LEI 03: male, 64 years (R-Z)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Recurrent ulceration (mixed venous and arterial) right lower limb
    PTA right popliteal artery 2012; recurrence of symptoms since 10/2017
    Failed recanalization attempt right 1/2018,
    Failure to reenter the posterior and anterior tibial artery
    Art. Hypertension

    PROCEDURAL STEPS
    1. Right groin antegrade access
    - 6F 55 cm sheath (COOK)
    2. Guidewire passage antegrade
    - 0.018" Command-18 guidewire, 300 cm (ABBOTT)
    - Seeker 0.018" support catheter, 90 cm (BARD)
    In case of repeat failure to pass from antegrade: retrograde access via PTA
    - Pedal 2.9F sheath (pedal puncture set) (COOK)
    - 0.014" CTO-Approach 25 gramm guidewire, 300 cm (COOK)
    - 0.018" CXI support catheter 90 cm (COOK)
    3. PTA
    - VascuTrak scoring balloon 4.0/120 mm (BARD)
    - Lutonix 4.0/150 mm DCB (BARD)
    4. Stenting on indication
    - Supera Interwoven Nitinol Stent (ABBOTT)
    View image
  • Wednesday, March 14th: - , Room 1 - Main Arena

    Case 16 – Reocclusion of the right popliteal and BTK-arteries

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 16 – LEI 05: female, 78 years (G-H)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication right leg and restpain at night, Rutherford class 4
    ABI right 0.6
    Renal impairment, atrial fibrillation

    IMPORTANT ITEMS
    PTA of right SFA 01/18
    PTA of right popliteal artery, ATA and peroneal artery 07/2017
    Angiography during PTA right 01/18:
    High-grade stenosis right SFA and reocclusion of the right popliteal arteries
    and of proximal BTK-arteries

    PROCEDURAL STEPS
    1. Left groin retrograde and cross-over approach
    - 6F 55 cm Check-Flo Performer, Raabe Modification (COOK)
    2. Guidewire passage of the occlusion
    - 0.035" stiff, angled glidewire, 260 cm (TERUMO)
    - 0.035" Seeker support catheter, 135 cm (BARD)
    - 0.018" Command 18 guidewire, 300 cm (ABBOTT)
    3. In case of failure antegrade approach via anterior tibial artery
    - 0.018" Command 18 guidewire, 300 cm (ABBOTT)
    - 0.018" Seeker support catheter (BARD)
    4. PTA with scoring balloons and DCBs
    - Vascutrak 3.0/150 mm and 4.0/120 mm (BARD)
    - Lutonix-BTK DCB (BARD)
    View image
  • Wednesday, March 14th: - , Room 1 - Main Arena

    Case 17 – Reocclusion of right SFA, in-stent-reocclusion

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 17 – LEI 06: male, 64 years (J-H)
    Operators:
    • Matthias Ulrich,
    • Axel Fischer
    CLINICAL DATA
    PAOD Rutherford 3, painfree walking distance 50 m, ABI right 0.67
    PTA/Stent right SFA 2010

    RISK FACTORS
    Smoker, arterial hypertension, diabetes mellitus type 2

    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)
    - 8F Balkin Up&Over sheath, 40 cm (COOK)
    2. Guidewire passage and thrombectomy
    - Rotarex 8F (STRAUB MEDICAL)
    3. PTA with DCBs
    - 5.0 and 6.0 mm In.Pact Admiral drug-eluting balloons (MEDTRONIC)
    View image
  • Wednesday, March 14th: - , Room 1 - Main Arena

    Case 18 – Extremely calcified distal SFA-occlusion left

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 18 – LEI 07: male, 66 years (B-A)
    Operators:
    • Andrej Schmidt,
    • Yvonne Bausback
    CLINICAL DATA
    Critical limb ischemia left, ulceration lateral forefoot, restpain during night
    Rutherford class 5
    Severe claudication left calf, walking capacity 50 meters
    ABI left 0.37
    PTA both iliac arteries 2/2018
    CAD, MI and PTCA 2010

    RISK FACTORS
    Art. hypertension, smoker

    PROCEDURAL STEPS
    1. Right groin and cross-over approach
    - 7F 55 cm sheath (COOK)
    2. Guidewire passage
    Antegrade:
    - 0.018" Command 18 or Connect 250 T guidewire, 300 cm (ABBOTT)
    - 4.0/40 mm Pacific balloon (MEDTRONIC)
    Retrograde in case of antegrade failure via proximal ATA left:
    - 0.018" Command 18, 300 cm (ABBOTT)
    - 0.018" Seeker 90 cm support catheter (BARD)
    3. PTA and stenting
    - 4.0, 5.0 and 6.0/40 mm Pacific balloon (MEDTRONIC)
    - Potentially Conquest high pressure balloon (BARD)
    - Supera Interwoven Nitinol Stent (ABBOTT)
    View image
  • Wednesday, March 14th: - , Room 1 - Main Arena

    Case 19 – Long occlusion of the right SFA, CLI

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 19 – LEI 08: male, 72 years (J-H)
    Operators:
    • Matthias Ulrich,
    • Axel Fischer
    CLINICAL DATA
    CLI with ulceration dig 2 and 3 right, severe claudication right leg
    Rutherford class 5, ABI right 0.3
    Minor stroke 2013

    RISK FACTORS
    Smoker (30PY), arterial hypertension, hyperlipidemia

    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 right SFA
    - 0.018" Advantage guidewire (TERUMO)
    - 0.018" CXI support catheter (COOK)
    3. Vessel preparation right SFA
    - Sterling 5.0/100 mm balloon (BOSTON SCIENTIFIC)
    4. Primary stenting
    - Eluvia DES (BOSTON SCIENTIFIC)
    View image
  • Wednesday, March 14th: - , Room 1 - Main Arena

    Case 20 – ATA recanalization and dexamethason injection with a Bullfrog-device

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 20 – LEI 09: male, 80 years (N-M)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    PAOD Rutherford 5 left, forefeet ulcerations, ABI 0.35 left
    PTA left peroneal artery 01/2018, failled recanlisaton attempt left ATA 01/2018
    CAD, AMI 2008 and 2009, PTCA

    RISK FACTORS
    Diabetes mellitus type 2, arterial hypertension, hyperlipidemia, former smoker

    ANGIOGRAPHY
    During PTA left: distal occlusion of left ATA

    PROCEDURAL STEPS
    1. Left antegrade access
    - 6F 55 cm Flexor Check-Flo Introducer, Raabe Modification (COOK)
    2. Guidewire passage of the ATA-CTO
    - 0.014" Command ES guidewire, 300 cm (ABBOTT)
    - 3.5/120 mm Armada 14 balloon (ABBOTT)
    3. Arterial wall injection of dexamethason
    - BullFrog Micro-Infusion-Device (MERCATOR MEDSYSTEMS)
    View image
  • Thursday, March 15th: - , Room 1 - Main Arena

    Case 24 – Calcified occlusion left common iliac artery

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 24 – LEI 10: female, 60 years (M-D)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication left leg, walking capacity 50 meters, ABI left 0.26
    Liver cirrhosis CHILD A

    RISK FACTORS
    Former smoker, diabetes mellitus, art. Hypertension

    ANGIOGRAPHY
    Preinterventional angiography: severely calcified iliac arteries,
    total occlusion left CIA, stenosis right CIA

    PROCEDURAL STEPS
    1. Left retrograde groin-access
    - 7F 20 cm sheath (TERUMO)
    2. Left brachial access
    - 7F 90 cm Shuttle sheath (COOK)
    3. Guidewire-passage left common iliac artery occlusion
    antegrade:
    - 5F 125 cm Judkins Right diagnostic catheter (CORDIS/CARDINAL HEALTH)
    - 0.035" stiff angled glidewire, 260 cm (TERUMO)
    retrograde:
    - 5F 80 cm Multipurpose catheter (CORDIS/CARDINAL HEALTH)
    - 0.035" stiff angled glidewire, 190 cm (TERUMO)
    - Potentially CART-technique
    4. Balloon dilatation and stenting in kissing technique
    - Admiral 6/40 mm balloon (MEDTRONIC) bilateral
    - LifeStream 8/38 mm and 8/57 mm covered stent (BARD)
    View image
  • Thursday, March 15th: - , Room 1 - Main Arena

    Case 25 – Long occlusion of the left SFA and popliteal artery, CLI

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 25 – LEI 11: male, 60 years (HJ-S)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication left leg, walking capacity 20 meters, and restpain at night, ABI left 0.3
    Femoro-popliteal bypass left 02/2014, bypass thrombectomy 04/2014 (now occluded)
    TEA of the left CFA 02/16

    RISK FACTORS
    Current smoker (60PY), diabetes mellitus, art. Hypertension

    PROCEDURAL STEPS
    1. Right groin retrograde and cross-over approach
    - IMA 5F diagnostic catheter (CORDIS/CARDINAL HEALTH)
    - 0.035" soft angled Radiofocus guidewire, 190 cm (TERUMO)
    - 0.035" SupraCore guidewire 190 cm (ABBOTT)
    - 7F 55 Check-Flo Performer sheath, Raabe Modification (COOK)
    2. Antegrade guidewire passage
    - 0.035" stiff angled glidewire, 260 cm(TERUMO)
    - CXC 0.035" support catheter, 135 cm (COOK)
    3. Retrograde guidewire passage
    Access via puncture of the occluded SFA
    - 7 cm 21 Gauge needle (COOK)
    - 0.018" V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
    - 4F 10 cm Radiofocus introducer (TERUMO)
    - Pacific Plus 4.0/40 and 5.0/40 mm balloon, 90 cm (MEDTRONIC)
    4. Antegrade GW passage and vessel preparation
    - Command 18 and Armada 18 balloon (ABBOTT) or
    - 0.035" Radiofocus soft angled guidewire, 260 cm (TERUMO) and 4.0/120 mm Armada 35 balloon (ABBOTT)
    - 6.0/40 mm Armada 35 balloon (ABBOTT)
    - Conquest high pressure balloon on indication (BARD)
    5. Stenting
    - proximal: Zilver-PTX DES (COOK)
    - mid and distal: Supera Interwoven Nitinol Stent (ABBOTT)
    View image
  • Thursday, March 15th: - , Room 1 - Main Arena

    Case 26 – Calcified BTK CTO left, CLI

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 26 – LEI 12: male, 69 years (R-T)
    Operators:
    • Andrej Schmidt,
    • Yvonne Bausback
    CLINICAL DATA
    POAD Rutherford 5, heel ulcerations and restpain at night
    Walking capacity 20 m, ABI left 0.4
    PTA left SFA 02/18, multiple interventions boths legs
    Infrarenal AAA, bifurcated stentgraft 05/2015
    CAD, atrial fibrillation

    RISK FACTORS
    Current smoker (40PY), diabetes mellitus, art. hypertension, renal impairment

    PROCEDURAL STEPS
    1. Left groin antegrade approach
    - 6F 55 cm Flexor Check-Flo introducer, Raabe Modifcation (COOK)
    2. Guidewire passage from antegrade
    In case of failure retrograde approach via distal posterior tibial/plantar artery
    - 2.9F sheath (pedal puncture set) (COOK)
    - 0.014" CTO-Approach Hydro guidewire, 300 cm (COOK)
    - 0.018" CXI support catheter 90 cm (COOK)
    - Advance Micro-Balloon 3.0/120 mm, 90 cm (COOK)
    3. PTA
    - 2.5/100 m Amphirion Deep ballon catheter (MEDTRONIC)
    View image

Live case transmission centers

 

During LINC Asia-Pacific 2018 several live cases will be performed from 4 international centers. All live case transmissions are coordinated, filmed, and produced by the mediAVentures crew, using the latest in high definition television and wireless technology.

• Beijing PLA Hospital, Beijing, China with Wei Guo, Xin Jia, and Xiaohui Ma 
• Seoul National University Hospital, Seoul, Republic of Korea with Hwan Jun Jae, Jae Kyu Kim, Saebeom Hur, and Sang Hyun Ahn
• The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong with Bryan Yan, Steven Kum, Skyi Yin Chun Pang, and Sven Bräunlich
• University Hospital Leipzig, Department of Angiology, Leipzig, Germany with Andrej Schmidt, Matthias Ulrich, Yvonne Bausback, and Axel Fischer

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