LINC Asia-Pacific 2015 Live Case Guide

Find all Live Cases and Live Case Centers listed below.

University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany

10 livecase(s)
  • Monday, March 9th: - , Main Arena

    Case 05 – High grade progressive stenosis right ICA

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 05 – LEI 01: female, 60 years (C-K)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Progressive, asymptomatic stenosis right ICA
    PAOD, claudication both calfs

    RISK FACTORS
    Art. hypertension
    Diabetes mellitus
    Former smoker

    DUPLEX
    3.8m/sec.
    Cranial CT without pathological findings

    ANGIOGRAPHY
    Calcified, 80% stenosis right ICA

    PROCEDURAL STEPS
    1. 9F-sheath right groin
    - 9F 25 cm (TERUMO)

    2. Cannulation of the external carotid artery right
    - 5F diagnostic Right Judkins catheter (CORDIS)
    - 0.035" angled soft glidewire (TERUMO)

    3. Exchange to a stiff guidewire and positioning of the protection device
    - 0.035" SupraCore 300 cm (ABBOTT)
    - 9F MOMA-system (MEDTRONIC)
    - Endovascular clamping of the external and common carotid artery

    4. Cannulation of the stenosis and predilatation
    - 0.014" Galeo Pro ES, 175 cm (BIOTRONIK)
    - 3.5/20 mm MiniTrek RX-balloon (ABBOTT)

    5. Implantation of a stent and postdilatation
    - Cristallo Ideale 7-10/30 mm (MEDTRONIC)
    - 5.0/20 mm Submarine Rapido balloon (MEDTRONIC)

    6. Aspiration of potential debris and declamping
    View image
  • Monday, March 9th: - , Main Arena

    Case 06 – Occlusion mid SFA right

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 06 – LEI 02: male, 69 years (D-M)
    Operators:
    • Andrej Schmidt,
    • Sabine Steiner
    CLINICAL DATA
    Chronic ulcerations both calfs / feet
    PTA left SFA Feb. 2015
    CAD with PTCA 2010

    RISK FACTORS
    Diabets mellitus, type 2
    Art. hypertension

    ANGIOGRAPHY
    During PTA left leg: SFA-occlusion right

    ABI RIGHT
    Pressure not tolerated due to ulceration

    PROCEDURAL STEPS
    1. Access left groin and cross-over approach
    - 5F IMA diagnostic catheter (CORDIS)
    - 0.035" angled soft glidewire (TERUMO)

    2. Passage of the occlusion right SFA and predilatation
    - 0.018" Cruiser S 300 cm guidewire (BIOTRONIK)
    - 5.0/120 mm Passeo 18 balloon (BIOTRONIK)

    3. PTA with drug-releasing balloon
    - Passeo-18 LUX 5/120 mm (BIOTRONIK)

    4. Stenting on indication
    - Pulsar 18 selfexpanding stent (BIOTRONIK)
    View image
  • Monday, March 9th: - , Main Arena

    Case 08 – Long, chronic SFA-occlusion right

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 08 – LEI 03: male, 62 years (W-T)
    Operators:
    • Matthias Ulrich,
    • Andrej Schmidt
    CLINICAL DATA
    Severe bilateral claudication intermittens
    Walking capacity 150 meters
    Failed recanalization attempt right SFA Feb. 2015
    CAD, PTCA 2012

    RISK FACTORS
    Diabetes mellitus type 2
    Art. hypertension
    Former smoker

    ANGIOGRAPHY
    bilateral long SFA-occlusions

    ABI
    Right 0.54; left 0.60

    PROCEDURAL STEPS
    1. Access left groin and cross-over access
    - 5F IMA-catheter (CORDIS)
    - 0.035" SupraCore guidewire 200 cm (ABBOTT)
    - 6F 40 cm Balkin Up&Over sheath (COOK)

    2. Passage of the occlusion
    Second antegrade attempt:
    - 0.035" CXI Support-Catheter 135 cm (COOK)
    - 0.035" stiff angled glidewire, 300 cm (TERUMO)

    In case of failure to pass from antegrade:
    3. Retrograde puncture of the distal SFA
    - 21 Gauge 9 cm puncture-needle (COOK)
    - 0.018" V-18 Control guidewire 300 cm (BOSTON SCIENTIFIC)
    - 0.018" CXI support catheter 90 cm (COOK)
    - Snaring of the retrograde guidewire from above

    4. PTA and stenting
    - 5/100 Advance 18 balloon (COOK)
    - Zilver-PTX drug-eluting stent (COOK)
    View image
  • Monday, March 9th: - , Main Arena

    Case 09 – Occlusion of all BTK-arteries left

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 09 – LEI 04: female, 78 years (T-T)
    Operators:
    • Andrej Schmidt,
    • Johannes Schuster
    CLINICAL DATA
    Restpain left foot, Rutherford class 4
    PTA / stent left SFA 2011,
    PTA of a restenosis left SFA Feb 2015,
    Failure to recanalize the ATA from antegrade Feb 2015
    CAD with CABG and PTCA 1999

    RISK FACTORS
    Diabetes mellitus type 2
    Art. hypertension

    ABI
    Left 0.4

    PROCEDURAL STEPS
    1. Antegrade access left groin
    - 5F 55 cm Ansel sheath (COOK)

    2. Retrograde approach via the distal ATA
    - Micro-puncture set (COOK)
    . - 3F micropuncture sheath
    . - 4 cm 21 Gauge needle
    - 0.018" Connect guidewire 300 cm (ABBOTT)

    3. Retrograde guidewire passage and PTA
    - 0.014" Hydro-ST guidewire 300 cm (COOK)
    - 2.5/120 mm Advance Micro balloon, 90 cm (COOK)
    View image
  • Monday, March 9th: - , Main Arena

    Case 10 – Total occlusion all BTK-arteries right, CLI

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 10 – LEI 05: male, 71 years (D-F)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Restpain right foot,
    Bypass fem-pop nd PTA iliac arteries right 1/2014
    Failed recanalization attempt BTK right Feb 2015
    Chronic venous insufficiency

    RISK FACTORS
    Diabetes mellitus type 2
    Art. hypertension

    ANGIOGRAPHY
    During recanalization attempt right Feb. 2015:
    Bypass patent, all 3 BTK-arteries occluded

    PROCEDURAL STEPS
    1. Antegrade access right
    - 5F 55 cm Ansel-sheath (COOK)

    2. Retrograde access via the distal peroneal artery
    - 7 cm 21 Gauge needle (COOK)
    - 0.018" Connect guidewire 300 cm (ABBOTT)
    - 0.018" Seeker-support catheter 90 cm (BARD)

    3. Snaring of the retrograde guidewire from antegrade and antegrade PTA
    - 2.0 120 mm Pacific balloon (MEDRONIC)
    - 3.0/150 Lutonix DCB (BARD)
    View image
  • Tuesday, March 10th: - , Main Arena

    Case 17 – Chronic SFA-occlusion left

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 17 – LEI 06: male, 56 years (T-N)
    Operators:
    • Matthias Ulrich,
    • Andrej Schmidt
    CLINICAL DATA
    Severe claudication left calf
    Walking capacity 150 meters
    COPD

    CT
    Long SFA-occlusion left

    ABI
    0.62 left

    PROCEDURAL STEPS
    1. Access right groin and cross-over approach
    - 5F IMA-catheter (CORDIS)
    - 0.035" SupraCore guidewire 200 cm (ABBOTT)
    - 6F-40 cm Balkin Up&Over sheath (COOK)

    2. Passage of the occlusion and PTA
    - 0.035" angled stiff glidewire, 260 cm (TERUMO)
    - 0.035" Seeker support catheter, 135 cm (BARD)
    - 5.0/250 mm Vascutrak balloon (BARD)

    3. PTA with Drug-Coated balloons and stenting on indication
    - 5/150 Lutonix DCB (BARD)
    - LifeStent (BARD)
    View image
  • Tuesday, March 10th: - , Main Arena

    Case 20A – CLI minor gangrene forefoot left

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 20A – LEI 07A: male, 62 years (P-R)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    CLI wih ulcerations both feet,
    PTA right SFA and BTK-arteries Feb 2015
    CAD with PTCA 2013
    Renal insufficiency, GFR 64 ml/min

    ANGIOGRAPHY
    During PTA right leg:
    severely calcified distal SFA- and Apop-occlusion left
    ABI: > 1.3

    PROCEDURAL STEPS
    1. Antegrade approach left groin
    - 7F-55 cm Ansel sheath (COOK)

    2. Guidewire passage
    - 0.035" stiff angled glidewire 260 cm (TERUMO)
    - 0.035" Seeker support catheter 90 cm (BARD)

    3. In case of antegrade failure retrograde approach via the severely diseased proximal ATA
    - 7 cm 21 Gauge needle (COOK)
    - 0.018" Connect 300 cm guidewire (ABBOTT)
    - CXC 0.018" 90 cm support catheter (COOK)

    4. PTA of the lesion
    - 5/40 and 6/40 Armada 35 (ABBOTT)

    In case of residual stenosis high-pressure balloon:
    - 6/20 mm Conquest (BARD)

    5. Stenting
    - Supera Interwoven nitinol stent (ABBOTT)
    View image
  • Tuesday, March 10th: - , Main Arena

    Case 20B – Multi-level lesion left (EIA, CFA and SFA-stenosis)

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 20B – LEI 07B: male, 49 years (S-P)
    Operators:
    • Andrej Schmidt,
    • Sabine Steiner
    CLINICAL DATA
    Severe claudication left, walking capacity 50 meters
    ABI left 0.4
    CAD with PTCA 2014

    RISK FACTORS
    Smoker
    Art. hypertension

    ANGIOGRAPHY
    Small external iliac artey left, high-grade stenosis left CFA, 
SFA diffusely diseased

    PROCEDURAL STEPS
    1. Access right groin and cross-over approach to left
    - 5F IMA diagnistic catheter (CORDIS)
    - 8F 40 cm Balkin Up&Over sheath (COOK)

    2. Directional atherectomy of the CFA left
    - Spider-Filter 6 mm distal SFA (COVIDIEN/MEDTRONIC)
    - TurboHawk LX-C (COVIDIEN/MEDTRONIC)

    3. PTA of the CFA and SFA
    - In.Pact Pacific 6 mm and 5 mm (MEDTRONIC)
    View image
  • Wednesday, March 11th: - , Main Arena

    Case 25 – Severely calcified SFA-occlusion left

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 25 – LEI 08: male, 72 years (G-W)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    CLI with toe-ulceration left since 1 month
    Severe claudication left calf
    CAD, PTCA 1998
    Chronic renal insufficiency, GFR 56 ml/ min

    ANGIOGRAPHY
    During PTA of an iliac stenosis left:
    Long, highly calcified SFA-occlusion left

    PROCEDURAL STEPS
    1. Right groin access and cross-over approach
    - 7F 40 cm Cross-over Balkin Up&Over sheath (COOK)

    2. Passage of the occlusion left SFA
    - 0.035" stiff angled glidewire, 260 cm
    - CXC 0.035" support catheter 135 cm (COOK)

    3. PTA
    - Armada 5/120 mm balloon (ABBOTT)

    In case of residual stenosis focal high-pressure PTA:
    - Conquest 6/20 mm non-compliant balloon (BARD)

    4. Stenting
    - Supera interwoven nitinol stents (ABBOTT)
    View image
  • Wednesday, March 11th: - , Main Arena

    Case 27 – CLI right with occlusion of the TPT and ATA

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 27 – LEI 09: male, 73 years (H-G-T)
    Operators:
    • Matthias Ulrich,
    • Andrej Schmidt
    CLINICAL DATA
    CLI with minor gangrene Dig 2 and rest-pain
    Failed antegrade recanalization attempt right Feb 2015
    CAD with PTC 2007
    Atrial fibrillation

    ANGIOGRAPHY
    Occlusion right TPT and ATA

    ABI
    Right 0.32

    PROCEDURAL STEPS
    1. Right antegrade access
    - 6F 55 cm Ansel-sheath (COOK)

    2. Retrograde passage of the ATA
    ADp-puncture with:
    - 3F micropuncture set (COOK)
    - 4 cm 21 Gauge needle (COOK)
    - 3F sheath (COOK)
    - 0.018" Connect 300 cm guidewire (ABBOTT)

    3. Passage of the lesion
    - 0.014" Hydro-ST Guidewire 300 cm (COOK)
    - Advance Micro balloon 2.5/120 mm from retrograde (COOK)
    - Potentially PTA of the TPT and ATA bifurcation in kissing-technique from above and below
    - Xience Prime Everolimus-eluting stent (ABBOTT)
    View image