LINC Asia-Pacific 2015 live case guide

Find all live cases and live case centers listed below.

Changi General Hospital, Singapore

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

    Case 01 – Right popliteal occlusion

    Center:
    Changi General Hospital, Singapore
    Case 01 – CGH 01: male, 64 years (J-N-C)
    Operators:
    • Steven Kum,
    • Tan Yih Kai,
    • Sven Bräunlich,
    • Tjun Tang
    CLINICAL DATA
    PAOD Rutherford 3
    DM Hypertension Graves Disease
    AF EF 60% Cr normal

    PROCEDURAL STEPS
    1. Antegrade access via right groin
    - 6F sheath (TERUMO)

    2. Passage of the lesion with hydrophilic wire
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 4F Ber II catheter (CORDIS)

    3. Retrograde ATA access in event of antegrade failure
    - 4F Micropuncture® Pedal Access Set (COOK)
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 2.6F CXI support catheter, 90 cm (COOK)

    4. Predilatation and lesion preparation
    - 3.5 x 120 Chocolate balloon (QT VASCULAR)

    5. PTA with DEB
    - In.Pact Pacific 4 or 5 x 120 mm DEB-balloon (MEDTRONIC)

    6. Stenting on indication
    View image
  • Monday, March 9th: - , Main Arena

    Case 03 – Right SFA occlusion

    Center:
    Changi General Hospital, Singapore
    Case 03 – CGH 02: female, 65 years (R?)
    Operators:
    • Steven Kum,
    • Tan Yih Kai,
    • Sven Bräunlich
    CLINICAL DATA
    PAOD Rutherford 3
    DM hypertension hyperlipidemia EF 60% Cr 140

    PROCEDURAL STEPS
    1. Contralateral cross-over access via left groin
    - 0.035" Radiofocus Terumo angled soft guidewire, 260 cm (TERUMO)
    - 4F Ber II catheter (CORDIS)
    - 0.035" Supra Core guidewire, 300 cm (ABBOTT)
    - 6F 40 cm long Balkin sheath (COOK)

    2. Passage of the lesion with hydrophilic wire and predilatation
    - 0.018" V-18 Control Wire, 300 cm (BOSTON SCIENTIFIC)
    - 0.035" Radiofocus Terumo angled soft guidewire, 250 cm (TERUMO)
    - 4F Ber II catheter (CORDIS)
    - 0.018" Trailblazer support catheter (COVIDIEN)

    3. Vessel preparation
    - 4 or 5 x 120 mm 3.5 x 120 Chocolate balloon (QT VASCULAR)

    4. Treatment with DEB
    - In.Pact Pacific 5/6 x 120 mm DEB-balloon (MEDTRONIC)

    5. Stenting on indication
    - Spot-stenting with a COMPLETE SE stent (MEDTRONIC)
    View image
  • Monday, March 9th: - , Overflow

    Case 11 – May Thurner syndrome

    Center:
    Changi General Hospital, Singapore
    Case 11 – CGH 04: female (R)
    Operators:
    • Tan Yih Kai,
    • Steven Kum,
    • Sven Bräunlich,
    • Tjun Tang
    CLINICAL DATA
    Left leg swelling previous DVT right Ca Breast
    CT venogram done
    Diagnostic angio and IVUS done

    PROCEDURAL STEPS
    1. General anaesthesia

    2. Left mid SFV access under ultrasound
    - 5F sheath (TERUMO)
    - 12F Peel-away Safe-sheath (ANGIODYNAMICS)

    3. Passage of the lesion with hydrophilic wire and stiff wire
    - 0.035" Radiofocus angled soft guidewire, 260 cm (TERUMO)
    - 4F Ber II catheter (CORDIS)
    - 0.035" Supra Core guidewire, 300 cm (ABBOTT)

    4. Venogram and IVUS
    - 8.5F Visions® PV.035 (VOLCANO)

    5. Predilatation
    - 12 x 40 Mustang balloon (BOSTON SCIENTIFIC)
    - 16/18 x 40 Atlas balloon (BARD)

    6. Iliac vein stenting
    - Wallstent 18 x 90 (BOSTON SCIENTIFIC)

    7. Postdilatation
    - 16/18 x 40 Atlas balloon (BARD)

    8. Postimplantation IVUS and sealing of puncture site
    View image
  • Monday, March 9th: - , Main Arena

    Case 07 – Left SFA occlusion

    Center:
    Changi General Hospital, Singapore
    Case 07 – CGH 03: male, 83 years (C-S-L)
    Operators:
    • Sven Bräunlich,
    • Steven Kum,
    • Tan Yih Kai
    CLINICAL DATA
    PAOD Rutherford 3
    COPD hypertension hyperlipidemia IHD EF 60% CKD Cr 200

    PRESENT STATE
    Left hip replacement Ca prostate CO2 angiography done

    PROCEDURAL STEPS
    1. Antegrade access via left groin
    - 5F sheath (TERUMO)
    - CO2 angiography with CO2 angioset (OPTIMED)

    2. Passage of the lesion with hydrophilic wire
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 4F Ber II catheter (CORDIS)

    3. Retrograde distal SFA access in event of antegrade failure
    - Supine frog leg position
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 2.6F CXI support catheter, 90 cm (COOK)

    4. Predilatation and lesion preparation
    - Paseo 18 4/5 x 120 balloon (BIOTRONIK)

    5. PTA with DEB
    - Lux 5 x 120 mm DEB-balloon (BIOTRONIK)

    6. Postdilatation and stenting on indication
    - REEF 5 x 40 high pressure balloon (MEDTRONIC)
    - 4F Pulsar 18 stent (BIOTRONIK)
    View image
  • Tuesday, March 10th: - , Main Arena

    Case 12 – Left ATA occlusion

    Center:
    Changi General Hospital, Singapore
    Case 12 – CGH 05: male, 58 years (K-S-O)
    Operators:
    • Steven Kum,
    • Tan Yih Kai,
    • Sven Bräunlich
    CLINICAL DATA
    CLI left 2nd toe gangrene
    PAOD Rutherford 5
    DM hypertension hyperlipidemia Cr 116

    PROCEDURAL STEPS
    1. Antegrade access via left groin
    - 5F sheath (TERUMO)

    2. Antegrade passage of the lesion with hydrophilic wire
    - 0.014" COMMAND Extra support wire 300 cm (ABBOTT)
    - 2 x 80 Armada 14 (ABBOTT)

    3. Retrograde passage of lesion via ultrasound guided DP puncture
    - 4F Micropuncture® transpedal set (COOK)
    - EDGE ultrasound high frequency probe (SONOSITE)
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 2.6F Angled CXI support catheter, 90 cm (COOK)

    4. Predilatation and lesion preparation
    - 2.5 x 100 mm Vascutrak scoring PTA catheter (BARD)

    5. PTA with DEB
    - 2.5 or 3 x 120 mm Lutonix drug-coated balloon (BARD)
    View image
  • Tuesday, March 10th: - , Main Arena

    Case 15 – Left SFA occlusion

    Center:
    Changi General Hospital, Singapore
    Case 15 – CGH 06: male, 75 years (M-L)
    Operators:
    • Sven Bräunlich,
    • Steven Kum,
    • Tan Yih Kai
    CLINICAL DATA
    Left leg claudication PAOD Rutherford 3
    DM hypertension left CFA
    Endarterectomy right SFA stent
    EF 60%
    CKD Cr 190

    PROCEDURAL STEPS
    1. Contralateral cross-over access via right groin
    - 0.035" Radiofocus angled soft guidewire, 260 cm (TERUMO)
    - 4F Ber II catheter (CORDIS)
    - 0.035" Supra Core guidewire, 300 cm (ABBOTT)
    - 6F 40 cm long Balkin sheath (COOK)
    - CO2 angiography with CO2 Angioset (OPTIMED)

    2. Passage of the lesion with CTO device and predilatation
    - Truepath CTO device (BOSTON SCIENTIFIC)
    - 0.018" Rubicon catheter (BOSTON SCIENTIFIC)
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - Sterling balloon 4 x 120 (BOSTON SCIENTIFIC)

    3. Treatment with DEB and postdilatation
    - Ranger drug eluting balloon 5/6 x 120 (BOSTON SCIENTIFIC)
    - Mustang balloon 6 x 40 (BOSTON SCIENTIFIC)

    4. Stenting on indication
    - Spot-stenting with Innova stent (BOSTON SCIENTIFIC)
    View image
  • Tuesday, March 10th: - , Main Arena

    Case 16 – Left SFA in-stent occlusion

    Center:
    Changi General Hospital, Singapore
    Case 16 – CGH 07: male, 55 years (B-P-T)
    Operators:
    • Sven Bräunlich,
    • Tan Yih Kai,
    • Steven Kum,
    • Tjun Tang
    CLINICAL DATA
    Left leg claudication PAOD Rutherford 3
    DM hypertension hyperlipidemia PCI 2011 EF 55% Cr normal
    Left SFA stent in subintimal spot stent Taiwan late 2014

    PROCEDURAL STEPS
    1. Contralateral cross-over access via right groin
    - 0.035" Radiofocus angled soft guidewire, 260 cm (TERUMO)
    - 4F Ber II catheter (CORDIS)
    - 0.035" Supra Core guidewire, 300 cm (ABBOTT)
    - 6/8F 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 angled soft guidewire, 250 cm (TERUMO)
    - 4F Ber II catheter (CORDIS)

    3. Retrograde puncture of occluded stent in event of antegrade failure
    - 0.035" Radiofocus angled soft guidewire, 250 cm (TERUMO)
    - 4F CXI support catheter, 90 cm

    4. Mechanical thrombectomy and debulking
    - Predilatation with Powercross 3 x 120 balloon (COVIDIEN)
    - 6/8F Rotarex (STRAUB MEDICAL)

    5. Postdebulking IVUS
    - 0.014" Eagle Eye® Platinum IVUS catheter with virtual histology

    6. Treatment with DEB and stenting on indication
    - In.Pact Pacific 5/6 x 120 mm DEB-balloon (MEDTRONIC)
    - SUPERA stent (ABBOTT)
    View image
  • Tuesday, March 10th: - , Main Arena

    Case 18 – Right SFA/popliteal occlusion

    Center:
    Changi General Hospital, Singapore
    Case 18 – CGH 08: male, 70 years (A-H-T)
    Operators:
    • Steven Kum,
    • Tan Yih Kai,
    • Sven Bräunlich
    CLINICAL DATA
    Right leg claudication PAOD Rutherford 3
    DM hypertension hyperlipidemia EF 69% Cr normal
    Right CFA endarterectomy and patch Oct 2014 failed antegrade attempt

    PROCEDURAL STEPS
    1. Antegrade access via right groin
    - 6F sheath (TERUMO)

    2. Passage of the lesion with hydrophilic wire
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 4F Ber II catheter (CORDIS)

    3. Retrograde PT access in event of antegrade failure
    - 4F Micropuncture® pedal access set (COOK)
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 2.6F CXI support catheter, 90 cm (COOK)

    4. Predilatation and lesion preparation
    - 5/6 x 120 mm Fox SV (ABBOTT)
    - 5/6 x 40 mm Armada 35 (ABBOTT)

    5. Stent implantation and postdilatation
    - SUPERA 5 mm x 150 stent (ABBOTT)

    6. Consider treatment of runoff
    - 0.014" COMMAND extra support wire, 300 cm (ABBOTT)
    - 2.5 x 15 NC TREK balloon for PT lesion (ABBOTT)

    7. Implantation of bioabsorbable scaffold
    - 2.5 x 28 ABSORB bioabsorbable vascular scaffold/BVS (ABBOTT) for TPT and PT lesion
    View image
  • Tuesday, March 10th: - , Main Arena

    Case 19 – Left popliteal stenosis

    Center:
    Changi General Hospital, Singapore
    Case 19 – CGH 09: female, 65 years (R)
    Operators:
    • Sven Bräunlich,
    • Steven Kum,
    • Tan Yih Kai
    CLINICAL DATA
    PAOD Rutherford 3
    DM hypertension hyperlipidemia EF 60% Cr 140

    PROCEDURAL STEPS
    1. Contralateral cross-over access via right groin
    - 0.035" Radiofocus angled soft guidewire, 260 cm (TERUMO)
    - 4F Ber II catheter (CORDIS)
    - 0.035" Supra Core guidewire, 300 cm (ABBOTT)
    - 7F 40 cm long Balkin sheath (COOK)

    2. Passage of the lesion with hydrophilic wire and filter placement
    - 0.014" PT2 MS 300 cm guidewire (BOSTON SCIENTIFIC)
    - 4F Ber II catheter (CORDIS)
    - 0.018" Trailblazer support catheter (COVIDIEN)
    - Spider FX 3 mm into ATA (COVIDIEN)

    3. Directional arterectomy
    - Turbohawk (COVIDIEN)

    4. Treatment with DEB
    - In.Pact Pacific 5/6 x 120 mm DEB-balloon (MEDTRONIC)

    5. Filter retrieval
    View image
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