LINC Asia-Pacific 2016 live case guide

Find all live cases and live case centers listed below.

Singapore General Hospital, Singapore, Singapore

3 livecase(s)
  • Thursday, March 10th: - , Room 1 - Main Arena 1

    Case 25 – SGH 01: Chimney EVAS

    Center:
    Singapore General Hospital, Singapore, Singapore
    Case 25 – SGH 01: male, 65 years (CKM)
    Operators:
    • Tze Tec Chong ,
    • Kiang Hiong Tay
    CLINICAL DATA
    Asymptomatic 6.9cm AAA
    Ex-smoker, hypertensive, hyperlipidaemia, chronic obstructive airway disease,
    ischemic heart disease, mulitnodular goitre, chronic kidney disease (baseline sCr 300+),
    anaemia of chronic illness (Hb 7 to 8 g/dl), Ca prostate (conservative treatment)
    Ischemic bowel s/p subtotal colectomy and ileostomy in 2009

    PROCEDURAL STEPS
    1. Bilateral femoral arterial punctures, US guided,
    pre close with Proglide x 2 each side.
    Bilateral brachial arterial punctures, US guided, 6F sheaths

    2. Both renal arteries cannulated from brachial approach with TERUMO glidewire
    and MPA catheter. Exchanged for Rosen wire and 7F x 90cm Destination sheaths
    (TERUMO) to introduce 5x38 mm BeGraft (INNOMED) for renal chimneys

    3. Nellix device introduced from below over Lunderquist wires.
    Test fill endobags with saline followed by angio run
    to confirm good aneurysm seal/exclusion.

    4.Fill endobags with polymer and allow to cure.
    Check for endoleaks. Secondary fill if needed.
    View image
  • Thursday, March 10th: - , Room 1 - Main Arena 1

    Case 27 – SGH 02: Left brachiocephalic vein occlusion

    Center:
    Singapore General Hospital, Singapore, Singapore
    Case 27 – SGH 02: male, 70 years (DFN)
    Operators:
    • Ankur Patel,
    • Sum Leong
    CLINICAL DATA
    Recurrent left arm swelling
    Diabetic, hypertensive, hyperlipidaemia, ischaemic heart disease.
    End stage kidney disease on hemodialysis via left arm brachiocephalic AVF x 6 years.

    CURRENT STATE
    Had left arm swelling 3 months ago due to left brachiocephalic vein occlusion treated successfully with balloon angioplasty. Now symptoms recurred.

    PROCEDURAL STEPS
    1. Antegrade puncture of left BCAVF, 7F sheath

    2. Lesion crossing
    - 0.035 TERUMO glidewire and 4F Ber catheter
    - Right femoral approach if lesion crossing failed via arm approach.

    3. Angioplasty
    - 14.0/40 mm Conquest balloon (C.R.BARD)

    4. Stenting if poor result
    - Sinus XL stent (OPTIMED)
    View image
  • Thursday, March 10th: - , Room 1 - Main Arena 1

    Case 29 – SGH 03: Long segment SFA and ATA CTO

    Center:
    Singapore General Hospital, Singapore, Singapore
    Case 29 – SGH 03: female, 75 years (CEM)
    Operators:
    • Kiang Hiong Tay,
    • Karthikeyan Damodharan
    CLINICAL DATA
    Non healing right big toe ulcer x 3 months
    Diabetic, hypertensive, hyperlipidaemia, ischaemic heart disease with CABG 10 yrs ago
    (EF 50%), end stage kidney disease on hemodialysis
    Toe pressures: right 40mmHg, left 129mmHg
    Duplex scan of right leg showed long segment CTO of upper/mid SFA and anterior tibial

    PROCEDURAL STEPS
    1. Ultrasound guided downhill puncture
    - 6F Britetip sheath

    2. Subintimal crossing of SFA CTO
    - 0.035 TERUMO glidewire and 4F Ber catheter
    - Retrograde popliteal access if antegrade crossing failed.

    3. Angioplasty
    - 6.0/200mm Mustang balloon (BOSTON SCIENTIFIC)
    - Ranger drug eluting balloon (BOSTON SCIENTIFIC)

    4. Subintimal crossing of ATA/DP CTO
    - V18 Control wire and 4F Ber catheter.
    - Pedal plantar loop technique if antegrade crossing failed.

    5. Angioplasty
    - 3.0/150 mm Sterling balloon (BOSTON SCIENTIFIC)
    - Ranger drug eluting balloon (BOSTON SCIENTIFIC)
    View image
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