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LINC Asia-Pacific 2019 live case guide

Find all live cases and live centers listed below

University Hospital Leipzig, Department of Angiology

8 livecase(s)
  • Tuesday, March 12th: - , Room 1 - Main Arena

    Case 05 – SFA-CTO in a patient with severe claudication

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 05 – LEI 01: female, 65 years (I-S)
    Operators:
    • Andrej Schmidt,
    • Axel Fischer
    CLINICAL DATA
    Severe claudication left, walking capacity 150 meters
    ABI left 0.67, Rutherford class 3
    PTA / Stenting of the distal SFA 2016 elsewhere
    Aorto-iliac bifurcational stenting 2015, elsewhere
    CAD, PTCA 2012
    Art. hypertension, diabetes mellitus Type 2

    PROCEDURAL STEPS
    1. Antegrade access left
    – 5F 10 cm Radiofocus Introducer sheath (TERUMO)
    2. Guidewire passage
    – 0.018“ Command 18 Guidewire, 300 cm (ABBOTT)
    – Passeo 18 5.0/120 mm balloon (BIOTRONIK)

    In case of failure from antegrade:
    3. Retrograde approach via the distal SFA or stent-puncture
    – 9 cm 20 gauge needle (B. BRAUN)
    – V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
    4. Angioplasty, DCB-treatment and stenting
    – Passeo 18 Lux DCB 5.0/120 mm (BIOTRONIK)
    – Pulsar 18-T3 stent (BIOTRONIK)
    View image
  • Tuesday, March 12th: - , Room 1 - Main Arena

    Case 06 – Distal SFA-CTO left

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 06 – LEI 02: male, 62 years (F-F)
    Operators:
    • Matthias Ulrich,
    • Manuela Matschuck
    CLINICAL DATA
    Disabeling claudication left, walking capacity 100 meters
    ABI left 0.56, Rutherford class 3
    COPD, CAD

    RISK FACTORS
    Art. hypertension, diabetes mellitus Type 2, smoker

    PROCEDURAL STEPS
    1. Left antegrade access
    – 6F 55 cm sheath, Ansel-modification (COOK)
    2. Antegrade guidewire passage
    – Command 18 guidewire, 300 cm (ABBOTT)
    – CXI support catheter (COOK)

    In case of antegrade failure:
    3. Retrograde access to the proximal anterior tibial artery
    – 7 cm 21 Gauge needle (COOK)
    – Command 18 guidewire, 300 cm (ABBOTT)
    – CXI support catheter (COOK)
    4. Angioplasty and stenting
    – Advance 18 balloon 5.0/100
    View image
  • Tuesday, March 12th: - , Room 1 - Main Arena

    Case 07 – Long chronic total occlusion right SFA

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 07 – LEI 03: male, 63 years (F-H)
    Operators:
    • Andrej Schmidt,
    • Axel Fischer
    CLINICAL DATA
    Severe claudication right, walking capacity 150 meters
    ABI right 0.67, Rutherford class 3
    CAD, PTCA 2016
    Moderate renal insufficiency (GFR 58 ml/min)

    RISK FACTORS
    Art. hypertension

    PROCEDURAL STEPS
    1. Left retrograde and cross-over access
    – 6F 40 cm Balkin Up&Over sheath (COOK)
    2. Antegrade guidewire passage Zilver-PTX stents (COOK)
    – 6F Judkins-Right guiding catheter (MEDTRONIC)
    – CXC 0.035“ support catheter, 130 cm (COOK)
    3. Angioplasty and stenting Zilver-PTX stents (COOK)
    – Advance 35 balloon 5.0/100 mm (COOK)

    In case of residual stenosis:
    – Advance Enforcer balloon
    – Zilver-PTX stents (COOK)
    View image
  • Tuesday, March 12th: - , Room 1 - Main Arena

    Case 08 – CLI with total occlusion of the anterior tibial artery left

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 08 – LEI 04: male, 76 years (F-F)
    Operators:
    • Matthias Ulrich,
    • Manuela Matschuck
    CLINICAL DATA
    Critical limb ischemia left, ulcerations dig II and III
    ABI left 0.25, Rutherford class 5
    Renal insufficiency, GFR 40ml/min
    CAD, CABG 2012
    Heart failure, EF 35%

    RISK FACTORS
    Art. hypertension, former smoker

    PROCEDURAL STEPS
    1. Left antegrade approach
    – 5F 50 cm sheath, Ansel Modification (COOK)
    2. Guidewire passage
    – Command ES guidewire, 300 cm (ABBOTT)
    – 0.018“ Seeker support catheter, 130 cm (BARD/BD)

    In case of antegrade failure:
    3. Retrograde approach
    – Transpedal kit (COOK)
    – 21 Gauge 4 cm needle, 2.9F pedal sheath
    – CXI 0.018“ support catheter (COOK)
    4. PTA
    – VascuTrak scoring balloon 2.5–250 mm (BARD/BD)
    – Lutonix DCB 3.0/150 mm (BARD/BD)
    View image
  • Tuesday, March 12th: - , Room 1 - Main Arena

    Case 09 – Severely calcified occlusion right popliteal artery

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 09 – LEI 05: male, 58 years (V-D)
    Operators:
    • Andrej Schmidt,
    • Axel Fischer
    CLINICAL DATA
    Critical limb ischemia right, minor ulcerations dig 1 right
    ABI right 0.44, Rutherford class 5
    CAD, CABG 2011
    COPD
    Renal insufficiency, GFR 65 ml/min

    PROCEDURAL STEPS
    1. Right antegrade approach
    – 7F 55 cm sheath, Ansel Modification (COOK)
    2. Guidewire passage antegrade
    – 0.018“ Connect 250 T guidewire, 300 cm (ABBOTT)
    – 0.018“ TrailBlazer support catheter, 90 cm (MEDTRONIC)
    3. Angioplasty
    Stepwise balloon-angioplasty:
    – 5.0/40 mm Armada 18 balloon (ABBOTT)
    – 6.0/40 mm Armada 18 balloon (ABBOTT)
    – 7.0/20 mm Conquest high pressure balloon (BARD/BD) (optional)
    4. Stenting
    – 5.5 or 6.5 mm Supera Interwoven Nitinol stent (ABBOTT)
    View image
  • Wednesday, March 13th: - , Room 1 - Main Arena

    Case 14 – Complex aortoiliac occlusion

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 14 – LEI 06: male, 58 years (G-R)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication (right >> left), pain-free walking capacity 150 meters
    ABI right 0.67, left 0.72, Rutherford class 3

    RISK FACTORS
    Art. hypertension, nicotine abuse

    PROCEDURAL STEPS
    1. Left brachial access
    – 7F 90 cm Check-Flo Performer sheath 90 cm (COOK)
    2. Right femoral approach
    – 9F 10 cm Radiofocus Introducer sheath (TERUMO)
    3. Guidewire passage from brachial
    – 6F Judkins Right coronary guiding catheter (MEDTRONIC)
    – 0.035“ Seeker support catheter, 125 cm (BARD/BD)
    – 0.035“ stiff angled glidewire, 260 cm (TERUMO)

    In case of failure:
    4. Additional retrograde guidewire access to the CTO right iliac
    – 4.0/40 mm Admiral balloon for support (MEDTRONIC)
    – 0.035“ stiff angled glidewire, 180 cm (TERUMO)
    – potentially CART-technique
    5. Stenting
    – LifeStream covered stent 8.0 mm in kissing technique for the aorto-iliac bifurcation (BARD/BD)
    – Covera Plus selfexpanding covered stent 8.0/100 mm right iliac (BARD/BD)
    View image
  • Wednesday, March 13th: - , Room 1 - Main Arena

    Case 15 – Subacute occlusion left popliteal artery

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 15 – LEI 07: male, 68 years (K-T)
    Operators:
    • Matthias Ulrich,
    • Manuela Matschuck
    CLINICAL DATA
    Subacute occlusion left popliteal artery, severe claudication
    Permanent atrial fibrillation, previously unknown
    NSTEMI 2/2019, PTCA RCA

    RISK FACTORS
    Former smoker, diabetes mellitus Type 2, art. hypertension

    PROCEDURAL STEPS
    1. Antegrade access left groin
    – 6F 50 cm sheath, Raab modification with detachable valve (COOK)
    2. Guidewire passage
    – Command 18 guidewire (ABBOTT)
    3. Thrombectomy
    – Rotarex (STRAUB MEDICAL)

    In case of incomplete thrombectomy:
    4. Low-dose thrombolysis for < 12 hours
    View image
  • Wednesday, March 13th: - , Room 1 - Main Arena

    Case 18 – Long CTO right SFA in a CLI patient

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 18 – LEI 08: male, 72 years (G-B)
    Operators:
    • Andrej Schmidt,
    • Axel Fischer
    CLINICAL DATA
    Critical limb ischemia right, minor ulceration bilateral forefoot
    ABI right 0.54, left 0.65; Rutherford class 5
    PTA left iliac and left profunda femoris 2/2019
    CAD; CABG 2016
    Diabetes mellitus Type 2

    RISK FACTORS
    Art. hypertension, former smoker

    PROCEDURAL STEPS
    1. Left femoral retrograde and cross-over access
    – 6F 40 cm Balkin Up&Over sheath (COOK)
    2. Antegrade guidewire passage
    – V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
    – Sterling balloon 4.0/100 mm as support catheter (BOSTON SCIENTIFIC)

    In case of antegrade failure:
    3. Retrograde approach via proximal anterior tibial artery
    – 7 cm 21 Gauge needle (COOK)
    – V-18 Control guidewire (BOSTON SCIENTIFIC)
    – 0.018“ support catheter, 90 cm (e.g. Rubicon, BOSTON SCIENTIFIC)
    4. PTA and stenting
    – Sterling 5.0 or 6.0 mm balloon (BOSTON SCIENTIFIC)
    – Eluvia drug-eluting stents (BOSTON SCIENTIFIC)
    View image

Live case transmission centers

 

During LINC Asia-Pacific 2019 several live cases will be performed from 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
• Seoul National University Hospital, Seoul, Republic of Korea with Hwan Jun Jae, Saebeom Hur, and Sanghyun Ahn 
• The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong with Bryan Yan and Steven Kum
• University Hospital Leipzig, Department of Angiology, Leipzig, Germany with Andrej Schmidt

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