LINC Asia-Pacific 2018 live case guide

Find all live cases and live centers listed below

 

 

Conference day 1

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    Case 01 – Right popliteal stenosis, ATA occlusion

    Center:
    The Chinese University of Hong Kong, Prince of Wales Hospital
    Case 01 – POW 01: male, 69 years, (LCW)
    Operators:
    • Bryan Yan,
    • Skyi Yin Chun Pang,
    • Sven Bräunlich,
    • Steven Kum
    CLINICAL DATA
    PAOD Rutherford 3
    Dm hypertension, hyperlipidemia, left SFA stent, left May Thurner stenting
    Recent directional atherectomy to right SFA with DCB

    PROCEDURAL STEPS
    1. Antegrade right groin access
    2. Passage of the lesion with hydrophilic wire
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 0.035" Terumo angled soft/stiff guidewire, 260 cm (TERUMO)
    - 4F Ber II catheter (CORDIS)
    3. Retrograde ATA/DP access in event of antegrade failure
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 2.6F CXI support catheter, 90 cm (COOK)
    4. Predilatation and vessel preparation
    5. PTA popliteal and ATA with DEB
    - 3/4/5 mm Ranger DCB (BOSTON SCIENTIFIC)
    View image
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    Case 02 – Superficial femoral artery stenosis/occlusion suspected by arterial function test

    Center:
    Seoul National University Hospital
    Case 02 – SNU 01: male, 66 years (K-K)
    Operators:
    • Jae Kyu Kim,
    • Saebeom Hur
    CLINICAL DATA
    Claudication right calf
    s/p stent insertion at Rt. focal stenosis and Lt CTO, CIA (kissing stent) (2016.2.27)
    Right ABI : 0.55 (2016.1.29) à 0.86 (2016.11.18) à 0.76 (2017.5.12) à 0.61 (2017.10.20)
    Parkinsonism and neurogenic bladder

    RISK FACTORS
    Hypertension, hyperlipidemia

    PROCEDURAL STEPS
    1. Right groin antegrade approach
    - 7F sheath
    2. Guidewire passage and PTA
    - 0.035" Radiofocus soft angled guidewire 150 cm (TERUMO) and 5F Davis catheter 90 cm (TERUMO) for intraluminal or subintimal GW passage
    - Jetstream (BOSTON SCIENTIFIC) with Emboshield (ABBOTT) or HalkOne (MEDTRONIC) with SpiderFX (COVIDIEN)
    - 5.0 mm Ultraverse balloon (BARD)
    - 5.0 or 6.0 mm Lutonix drug coated balloon (BARD)
    3. (PRN) Bail-out stenting
    - Innova stent (BOSTON SCIENTIFIC) or Supera stent (ABBOTT)
    View image
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    Case 03 –Left SFA long occlusion

    Center:
    Beijing PLA Hospital
    Case 03 – BPH 01: male, 68 years (ZSX)
    Operators:
    • Wei Guo,
    • Xiaohui Ma
    CLINICAL DATA
    Left leg claudication, walking capacity 100 meters, Rutherford 3

    RISK FACTORS
    Smoking, diabetes

    PROCEDURAL STEPS
    1. Right femoral access and cross-over approach
    - 6F 40 cm sheath (COOK)
    2. Passage of the occlusion right SFA
    - 0.018" V18 guidewire, 300 cm (BOSTON SCIENTIFIC)
    - 0.018" Trailblazer support catheter, 135 cm (MEDTRONIC)
    3. Retrograde approach via the right infrapopliteal artery in case of failure
    4. PTA and DCB
    - Savvy Long OTW balloon 5 x 200 mm (CORDIS)
    - ORCHID DCB 6 x 200 mm (ACOTEC)
    View image
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    Case 04 –Right SFA CTO, bi-Iliastenosis, CFA stenosis

    Center:
    The Chinese University of Hong Kong, Prince of Wales Hospital
    Case 04 – POW 02: male, 65 years (YH-W)
    Operators:
    • Bryan Yan,
    • Skyi Yin Chun Pang,
    • Sven Bräunlich,
    • Steven Kum
    CLINICAL DATA
    PAOD Rutherford 3, bilateral claudication
    DM hypt, smoker, Cr 180, failed right leg angioplasty 2002

    PROCEDURAL STEPS
    1. Crossover access via left groin
    - 6F Balkin sheath (COOK)
    2. Passage of the lesion with hydrophilic wire
    - 0.035" Terumo angled soft/stiff guidewire, 260 cm (TERUMO)
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 4F Ber II catheter (CORDIS)
    3. Retrograde stent puncture in event of antegrade failure
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 0.035" Terumo angled soft/stiff guidewire, 260 cm (TERUMO)
    4. Predilatation and vessel preparation, consider debulking
    - 5.0 mm Pacific (MEDTRONIC)
    - HawkOne (MEDTRONIC)
    5. PTA with DEB and spot stent
    - 5/6mm InPact Pacific (MEDTRONIC)
    - Everflex 5/6 mm (MEDTRONIC)
    6. Consider treatment of right CFA with HawkOne (MEDTRONIC)
    7. Stenting of left and right iliac stenosis
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    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
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    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
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    Case 06 – Right SFA long occlusion

    Center:
    Beijing PLA Hospital
    Case 06 – BPH 02: female, 80 years (XSY)
    Operators:
    • Wei Guo,
    • Xin Jia
    CLINICAL DATA
    Right calf claudication for one year, walking capacity 100 meters, Rutherford 3

    RISK FACTORS
    Diabetes, hypertension

    PROCEDURAL STEPS
    1. Left femoral access and cross-over approach
    - 6F 40 cm sheath (COOK)
    2. Passage of the occlusion right SFA
    - 0.018" V18 guidewire, 300 cm (BOSTON SCIENTIFIC)
    - 0.018" Trailblazer support catheter, 135 cm (MEDTRONIC)
    3. Retrograde approach via the right infrapopliteal artery in case of failure
    4. PTA and primary stent
    - Passeo18 balloon 4 x 170 mm (BIOTRONIK)
    - Pulsar18 stent 5 x 200 mm (BIOTRONIK)
    View image
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    Case 07 – Right SFA occlusion, left iliac occlusion

    Center:
    The Chinese University of Hong Kong, Prince of Wales Hospital
    Case 07 – POW 03: male, 54 years (KWM)
    Operators:
    • Bryan Yan,
    • Skyi Yin Chun Pang,
    • Sven Bräunlich,
    • Steven Kum
    CLINICAL DATA
    PAOD Rutherford 3 R>L
    AF on Warfarin, hypertension, hyperlipidemia

    PROCEDURAL STEPS
    1. Left brachial and left femoral approach
    - 6 x 90 Flexor sheath (COOK)
    2. Bi-directional wiring of left iliac CTO
    - 0.0355 Terumo Glidewire or wire 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    3. Balloon angioplasty and stenting of left iliac system
    4. Crossover access via left groin 6F sheath
    5. Passage of the right SFA CTO
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 4F Ber II catheter or 4/5F Judkins (CORDIS) or CXI (COOK)
    6. Retrograde SFA approach in event of antegrade failure
    7. Predilatation and lesion preparation
    8. PTA and stenting of SFA
    - 6 mm Zilver PTX (COOK)
    9. Stenting of right iliac system
    View image
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    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
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    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

Conference day 2

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    Case 11 –TASC D iliac occlusion, left

    Center:
    Seoul National University Hospital
    Case 11 – SNU 02: male, 63 years (K-B)
    Operators:
    • Hwan Jun Jae,
    • Saebeom Hur
    CLINICAL DATA
    Severe claudication left calf, walking capacity 100 meters

    IMPORTANT ITEMS
    Quit smoking 1 year ago after 90-pack-years
    ABI : unavailable
    Bladder cancer (UCC) with M/bone (T7)
    s/p Radical Cystectomy ('12.11.6) & T7 transverse tumorectomy ('13.3.27)
    EGC, s/p LADG ('16.5.18)
    Old Tbc; GB stone, s/p L-Cholecystectomy (30YA)
    Rt. leg neural damage (after TA, >20Y)

    PROCEDURAL STEPS
    1. Right groin retrograde and cross-over approach
    - 0.035" Radiofocus soft angled guidewire 150 cm (TERUMO)
    - 7F 40 cm Balkin Up&Over sheath (COOK)
    2. Left groin retrograde approach
    - 0.035" Radiofocus guidewire 190 cm (TERUMO)
    - 6F 10 cm Super sheath (BOSTON SCIENTIFIC)
    --> 8F sheath after passage
    3. Guidewire passage and PTA
    - 0.035" Radiofocus soft angled guidewire 150 cm (TERUMO) and 5F Davis catheter 70 cm (TERUMO) for intraluminal or subintimal GW passage
    - 4.0/40 mm Armada 35 balloon (ABBOTT)
    - 6.0 or 7.0/100 mm Armada balloon (ABBOTT)
    - Bail-out usage of Goose neck snare (EV3) or Outback (CORDIS)
    4. Stenting
    - 8 mm/60 mm Lifestream balloon-expandable covered stent (BARD)
    - Consider bilateral common iliac kissing stent
    - 7 mm/120 mm self-expandable stent for left external iliac segment
    View image
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    Case 12 – Right in-stent occlusion

    Center:
    The Chinese University of Hong Kong, Prince of Wales Hospital
    Case 12 – POW 04: male, 57 years (WKS)
    Operators:
    • Bryan Yan,
    • Skyi Yin Chun Pang,
    • Sven Bräunlich,
    • Steven Kum
    CLINICAL DATA
    PAOD Rutherford 3
    DM, HT, smoker, CAD s/p multiple PCI 2006, 2013, 2014
    Bilateral PVD s/p multiple interventions, left popliteal stent 2014,
    DCB for in-stent occlusion 2016
    CTA excluded entrapment syndrome, recent stent re-occlusion

    PROCEDURAL STEPS
    1. Contralateral cross-over access via right groin
    - 6F 40 cm long Balkin sheath (COOK)
    2. Antegrade passage of the lesion with hydrophilic wire
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 0.035" Radiofocus Terumo angled soft guidewire, 250 cm (TERUMO)
    3. Retrograde tibial access in event of antegrade failure
    4. Mechanical thrombectomy and debulking
    - Predilatation with 2/3 x 120 balloon
    - 6F Rotarex (STRAUB MEDICAL)
    5. Treatment with In.Pact 5 mm DCB
    View image
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    Case 13 – Left SFA long occlusion

    Center:
    Beijing PLA Hospital
    Case 13 – BPH 03: male, 72 years (ZYM)
    Operators:
    • Wei Guo,
    • Xin Jia
    CLINICAL DATA
    Left calf claudication, walking capacity 100 meters, Rutherford 3

    RISK FACTORS
    Smoking, hypertension

    PROCEDURAL STEPS
    1. Right femoral access and cross-over approach
    - 6F 40 cm sheath (COOK)
    2. Passage of the occlusion left SFA
    - 0.018" V18 guidewire, 300 cm (BOSTON SCIENTIFIC)
    - 0.018" Trailblazer support catheter, 135 cm (MEDTRONIC)
    3. Retrograde approach via the left infrapopliteal artery in case of failure
    4. PTA and DCB
    - Pacific OTW balloon 5 x 200 mm (MEDTRONIC)
    - ORCHID DCB 6 x 200 mm (ACOTEC)
    View image
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    Case 14 – TASC D SFA occlusion right

    Center:
    Seoul National University Hospital
    Case 14 – SNU 03: male, 72 years (Y-O)
    Operators:
    • Hwan Jun Jae,
    • Saebeom Hur
    CLINICAL DATA
    Severe claudication right calf, 100 m

    IMPORTANT ITEMS
    Hypertension
    s/p Thrombectomy, Lt. CFA to crural a.. Rt. CFA, DFA, SFA, Endarterectomy, both CFA
    Fem-Fem bypass (Lt to Rt) with 7 mm PTFE graft (2015.11.19)
    Right ABI : 0.33 (2016.2.4) --> 0.58 (2016.10.31) --> 0.60 (2017.8.18) --> 0.65 (2018.2.6)
    In hospital cardiac arrest, idopathic (2015.11.19)
    DVT in Rt. popliteal vein, on astrix, pletaal, berasil, podox, roisol

    PROCEDURAL STEPS
    1. Right groin antegrade approach
    - 0.035" Radiofocus soft angled guidewire 150 cm (TERUMO)
    - 6F 10 cm Supersheath sheath (BOSTON SCIENTIFIC)
    2. (PRN) Right ATA retrograde approach
    - 0.018" V-18 guidewire (BOSTON SCIENTIFIC)
    - CXI supporting catheter 90 cm (COOK)
    3. Guidewire passage and PTA
    - 0.018" V-18 guidewire (BOSTON SCIENTIFIC) and CXI catheter 90 cm (COOK) for intraluminal or subintimal GW passage
    - (PRN) Jetstream artherectomy (BOSTON SCIENTIFIC) with embolic protection device, if intraluminal passage achieved
    - (PRN) reverse-CART if subintimal passage was made
    - 5.0 mm Armada balloon (ABBOTT)
    4. Stenting
    - Multiple 6 mm Eluvia drug eluting stent (BOSTON SCIENTIFIC)
    View image
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    Case 15 – Right popliteal occlusion, tibial stenosis

    Center:
    The Chinese University of Hong Kong, Prince of Wales Hospital
    Case 15 – POW 05: male, 47 years (CCM)
    Operators:
    • Bryan Yan,
    • Skyi Yin Chun Pang,
    • Sven Bräunlich,
    • Steven Kum
    CLINICAL DATA
    PAOD Rutherford 3
    Smoker, PVD s/p popliteal balloon angioplasty 2012, recurrent claudication
    Resting ABI: 0.58 / 1.14

    PROCEDURAL STEPS
    1. Contralateral cross-over access via Left groin
    - 6F 40 cm long Balkin sheath (COOK)
    2. Antegrade passage of the lesion with hydrophilic wire
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 0.014 COMMAND ES (ABBOTT VASCULAR)
    3. Retrograde tibial access in event of antegrade failure
    4. Consider debulking if true lumen, otherwise vessel prep and predilatation
    5. Treatment of SFA/Pop and tibials
    - Ranger DCB (BOSTON SCIENTIFIC)
    6. Spot stenting on indication
    View image
  • - , Room 2 - Technical Forum

    Case 21 – Instent-restenosis of central vein stent with focal stenosis at brachial vein in brachio-brachial arterio-venous fistula for hemodialysis

    Center:
    Seoul National University Hospital
    Case 21 – SNU 04: female, 73 years (J-W)
    Operators:
    • Saebeom Hur,
    • Sanghyun Ahn
    CLINICAL DATA
    Hemodialysis via Permcath
    Left arm swelling (+)

    PATIENT HISTORY
    2017.3.9 AVF formation (Br-Br), Lt.
    2017.4.24 Lt. autogenous brachial-brachial upper arm transposition (2nd)
    2017.8.16 – 8.19 wound care
    2017.9.20 First use(+)
    2017.10.11 Stent placement for Lt. innominate vein occlusion
    2017.12.14 PTA for brachial vein stenosis
    using 7*40 mm Mustang balloon & 6 mm*2 cm Cutting balloon

    PROCEDURAL STEPS
    1. US guided brachial vein access
    - 0.035" Radiofocus soft angled guidewire 150 cm (TERUMO)
    - 7F 10 cm Supersheath sheath (BOSTON SCIENTIFIC)
    2. Guidewire passage and PTA
    - 0.035" Radiofocus soft angled guidewire 150 cm (TERUMO) and Kumpe catheter 65 cm (COOK) for intraluminal GW passage
    - 6 mm, 7 mm/40 mm Conquest high-pressure balloon (BARD)
    - 6 mm, 7 mm/40 mm Lutonix drug coated balloon (BARD)
    3. (PRN) Stenting
    - 10 mm Niti-S stent (TAEWOONG)
    View image
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    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
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    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
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    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
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    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
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    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

Conference day 3

  • - , 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
  • - , 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
  • - , 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