Taipei Tzu Chi General Hospital, Taipei City, Taiwan
2 livecase(s)
Wednesday, March 9th:
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Room 1 - Main Arena 1
Case 13 – TTC 01: Restenosis and reocclusion of left TP trunk to posterior tibial artery
Center:
Taipei Tzu Chi General Hospital, Taipei City, Taiwan
Case 13 – TTC 01: male, 83 years (C-C)
Operators:
Hsin-Hua Chou,
Hsuan Li Huang
CLINICAL DATA
Bilateral feet resting pain (left > right) with ulceration at left great toe for 1 month
PTA for left TP trunk and post. tibial A 02/2013
PTA and stenting for right SFA 01/2016, PTA for right peroneal artery 01/2016
ESRD under regular H/D, 3-V CAD s/p PCI, Type 2 DM, HTN
ABI: right:0.73; left:0.58
ANGIOGRAPHY
Stenosis at left popliteal artery, restenosis at left TP trunk to single remaining post. tibial A, reocclusion at left distal post. tibial A
PROCEDURAL STEPS 1. Left CFA antegrade access
- 6F 10 cm sheath (TERUMO)
- 6F 55 cm Multipurpose guiding catheter (BOSTON SCIENTIFIC)
2. Passage of the lesion(s)
- 0.014" PT2 guidewire, 300 cm (BOSTON SCIENTIFIC)
- 0.018" CXI support-catheter, 150 cm (COOK)
- In case of failure, exchange to V-18 control guidewire, 300 cm (BOSTON SCIENTIFIC)
3. Lesion preparation
- Amphirion Deep, 2.0–2.5/210 mm (MEDTRONIC)
4. Drug-coated balloon angioplasty
- Lutonix 014 Drug-coated balloon, 2.5/120 mm for distal post. tibial A (COOK)
- Lutonix 014 Drug-coated balloon, 3.0/120 mm for proximal post. tibial artery (COOK)
5. Stenting for TP trunk on indication
- Bioabsorbable vascular scaffold 3.5/28 mm (ABBOTT)
- With/without OCT study (ST. JUDE MEDICAL)
6. Drug-coated balloon angioplasty
- In.PACT Admiral drug-coated balloon 4.0/80 mm for pop. A (MEDTRONIC)
Wednesday, March 9th:
-
,
Room 2 - Technical Forum
Case 23 – TTC 02: Calcified stenosis of left common femoral artery
Center:
Taipei Tzu Chi General Hospital, Taipei City, Taiwan
Case 23 – TTC 02: male, 60 years, (Chen)
Operators:
Hsuan Li Huang,
Hsin-Hou Chou
CLINICAL DATA
Intermittent claudication of left leg for months
Diabetes mellitus, arterial hypertension, hyperlipidemia
Duplex US showed the dampened waveform distal to CFA
The ABI levels: left 0.77, right 0.89
CTA: heavily calcified stenosis involving Lt CFA, mild stenosis at left middle SFA
PROCEDURAL STEPS 1. Right femoral cross-over access
- 8F Balkin 40 cm cross-over sheath (COOK)
2. Guidewire passage and distal protection
- 0.014" PT2 guidewire 300 cm (BOSTON SCIENTIFIC)
- Spider FX embolic protection device (MEDTRONIC-COVIDIEN)
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