Conference day 3

• 8:14 - 8:59, Room 1 - Main Arena

  Case 22 – Juxt-renal AAA

  Center:

  Beijing PLA Hospital

  Case 22 – BPH 04: male, 76 years (LCB)

  Operators:

  • Wei Guo,
  • Xin Jia

  CLINICAL DATA
  Abdominal mass found one month ago
  
  RISK FACTORS
  Hypertension, smoker
  
  PROCEDURAL STEPS
  1. Bilateral femoral access
  - Proglide preclose techniques (ABBOTT)
  2. Angiography and planning
  3. Fenestrated stentgrafts (COOK)
  4. Stenting of renal artery (GORE)
  5. Closure of femoral access

  View image
• 10:28 - 11:22, Room 1 - Main Arena

  Case 23 – Type B aortic dissection

  Center:

  Beijing PLA Hospital

  Case 23 – BPH 05: male, 46 years (ZJH)

  Operators:

  • Wei Guo,
  • Xin Jia

  CLINICAL DATA
  Acute chest pain for two weeks
  
  RISK FACTORS
  Hypertension
  
  PROCEDURAL STEPS
  1. Right femoral access
  - Proglide (ABBOTT)
  2. Left brachial access for angiography
  3. Stentgraft implantation in thoracic aorta
  - Ankura-Stentgraft (LIFETECH)
  4. In-situ fenestration
  - Viabahn (GORE)
  5. Femoral access closure

  View image
• 13:30 - 16:00, 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
• 13:30 - 16:00, 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
• 13:30 - 16:00, 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