LINC Asia-Pacific 2016 live case guide

Find all live cases and live case centers listed below.

Conference day 1

  • - , Room 1 - Main Arena 1

    Case 01 – NY 01: Chronic total occlusion RSFA (TASC D)

    Center:
    Mount Sinai Hospital, New York, USA
    Case 01 – NY 01: male, 71 years, (C-T)
    Operators:
    • Prakash Krishnan,
    • Karthik Gujja,
    • Vishal Kapur
    R leg claudication, Rutherford class II, category III, Fontaine IIB
    US duplex showed occlusion of RSFA

    RISK FACTORS
    Hypertension, diabetes mellitus II, dyslipidemia, ex smoker, PAD

    PROCEDURAL STEPS
    1. Left common femoral access and up and over
    - 7F Pinnacle destination sheath 45 cm, up and over (TERUMO)
    - If necessary, R pedal posterior tibial retrograde access (4F COOK sheath)

    2. Intra-luminal approach
    - 0.014" 4F Viance catheter, 150 cm (MEDTRONIC)
    - 0.038" Vertip catheter, 125 cm (CARDINAL HEALTH)
    - 0.014" Confianza wire, 300 cm (ABBOTT VASCULAR)
    - 0.035" Glide wire, 300 cm (TERUMO)

    3. Filter placement
    - exchanged with 0.014" Bare wire, 315 cm (ABBOTT VASCULAR)
    - Emboshield filter 4/7 mm embolic protection system (ABBOTT VASCULAR)

    4. PTA and stenting as indicated
    - Lutonix drug coated balloons 6.0/150 mm (C.R.BARD)
    - Supera stenting 5.5/100 mm (ABBOTT VASCULAR)
    View image
  • - , Room 1 - Main Arena 1

    Case 02 – CGH 01: Right SFA occlusion, popliteal stenosis

    Center:
    Changi General Hospital, Singapore, Singapore
    Case 02 – CGH 01: male, 56 years (E-F)
    Operators:
    • Steven Kum,
    • Yih Kai Tan,
    • Sven Bräunlich
    CLINICAL DATA
    PAOD Rutherford 3
    Dm hypertension, hyperlipidemia, ex smoker
    EF 60% Cr 120

    PROCEDURAL STEPS
    1. Cross-over access via right groin
    - 6F Balkin sheath (COOK)

    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 PTA 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 vessel preparation
    - 5.0/100 mm Vascutrak scoring PTA catheter (C.R.BARD)

    5. PTA with DEB
    - 5/6mm Lutonix drug-coated balloon (C.R.BARD)

    6. Spot stent on indication and postdilatation
    - 5/80 mm SUPERA stent (ABBOTT)
    View image
  • - , Room 1 - Main Arena 1

    Case 03 – NY 02: Severely calcified chronic total occlusion of LSFA

    Center:
    Mount Sinai Hospital, New York, USA
    Case 03 – NY 02: male, 70 years (A-K)
    Operators:
    • Prakash Krishnan,
    • Karthik Gujja,
    • Vishal Kapur
    CLINICAL DATA
    Left leg pain, Rutherford class II, category III, Fontaine IIB
    ABI R LE - 0.9 and L LE - 0.6
    US duplex showed occlusion of calcified LSFA

    RISK FACTORS
    Hypertension, diabetes mellitus type II, dyslipidemia, ex-smoker,
    CAD s/p multiple PCI's, PAD

    PROCEDURAL STEPS
    1. Right common femoral access and cross-over approach
    - 7F Pinnacle destination sheath 45 cm up and over sheath (TERUMO)

    2. Guide wire passage
    - 0.014" Spartacore wire, 300 cm (ABBOTT VASCULAR)
    - 0.038" Vertebral 135" Tempa Aqua catheter, 125 cm (CARDINAL HEALTH)
    - 0.014" Confianza wire, 300 cm (ABBOTT VASCULAR)
    - 0.035" Glide wire, 300 cm (TERUMO)

    3. Filter placement
    - exchanged with 0.014/Bare wire, 315 cm (ABBOTT VASCULAR)
    - Emboshield filter 4/7 mm embolic protection system (ABBOTT VASCULAR)

    4. Athrectomy and thrombectomy, if embolization occurs
    - Jet stream Pathway rotational athrectomy 2.4/3.4 (BOSTON SCIENTIFIC)
    - PENUMBRA aspiration thrombectomy (PENUMBRA)

    5. PTA and stenting as indicated
    - Lutonix drug coated balloons 6.0/150 mm (C.R.BARD)
    - Supera stenting 5.5/100 mm (ABBOTT VASCULAR)
    View image
  • - , Room 1 - Main Arena 1

    Case 04 – NY 03: Chronic total occlusion with in-stent occlusion in mid segment RSFA

    Center:
    Mount Sinai Hospital, New York, USA
    Case 04 – NY 03: male, 76 years (J-S)
    Operators:
    • Prakash Krishnan,
    • Karthik Gujja,
    • Vishal Kapur
    CLINICAL DATA
    R leg claudication, Rutherford class II, category III, Fontaine IIB
    US duplex showed occlusion of RSFA with instent occlusion in mid RSFA

    RISK FACTORS
    Hypertension, diabetes mellitus II, dyslipidemia, ex smoker, PAD

    PROCEDURAL STEPS
    1. Left common femoral access and up and over
    - 7 Fr Pinnacle destination sheath 45 cm, up and over (TERUMO)
    - If necessary, R pedal posterior tibial retrograde access (4F COOK sheath) and direct stent access

    2. Intra-luminal approach
    - 0.014" 4F Viance catheter, 150 cm (MEDTRONIC)
    - 0.038" Vertip catheter, 125 cm (CARDINAL HEALTH)
    - 0.014" Confianza wire, 300 cm (ABBOTT VASCULAR)
    - 0.035" Glide wire, 300 cm (TERUMO)

    3. Thrombectomy
    - Angiojet Rheolytic aspiration thrombectomy (BOSTON SCIENTIFIC) or
    - PENUMBRA aspiration thrombectomy (PENUMBRA)

    4. Filter placement
    - Spider filter 7 mm (MEDTRONIC)

    5. Athrectomy and thrombectomy, if embolization occurs
    - Silver Hawk Directional athrectomy LSM (MEDTRONIC)
    - PENUMBRA aspiration thrombectomy (PENUMBRA)

    6. PTA and stenting as indicated
    - INPACT drug coated balloons 6.0/120 mm (MEDTRONIC)
    - Supera stenting 5.5/100 mm (ABBOTT VASCULAR)
    View image
  • - , Room 1 - Main Arena 1

    Case 05 – CGH 02: Right SFA occlusion, iliac stenosis

    Center:
    Changi General Hospital, Singapore, Singapore
    Case 05 – CGH 02: male, 58 years (O-E)
    Operators:
    • Steven Kum,
    • Yih Kai Tan,
    • Sven Bräunlich
    CLINICAL DATA
    PAOD Rutherford 5 right ankle wound,
    Left fem-pop bypass, left CIA BMS 2 weeks ago ESRF DM EF 60%

    PROCEDURAL STEPS
    1. Brachial access via left brachial artery
    - 6F x 90 cm Shuttle sheath (COOK)

    2. Stenting of right iliac lesion
    - 8/9 mm Assurant Cobalt balloon mounted stent for CIA (MEDTRONIC)
    - 8mm Complete SE self expanding stent for EIA (MEDTRONIC)
    - Post dilatation 7/8 mm REEF HP balloon (MEDTRONIC)

    3. Passage of lesion with GW
    - 0.035“ Standard J-Tip guidewire, 150 cm (CARDINAL HEALTH)

    4. Retrograde SFA access in event of antegrade failure, rendezvous and predil via brachial
    - Pacific 4 x 120 balloon x 180 shaft length (MEDTRONIC)

    5. Antegrade right CFA access and treatment of right SFA
    - In.Pact Pacific 5/6 x 120 mm DEB-balloon (MEDTRONIC)
    - Spot-stenting with a COMPLETE SE or Everflex stent (MEDTRONIC)

    6. Consider DEB of PFA
    View image
  • - , Room 2 - Technical Forum

    Case 12 – CGH 05: Right CLI and ATA occlusion

    Center:
    Changi General Hospital, Singapore, Singapore
    Case 12 – CGH 05: male, 66 years (T-C-B)
    Operators:
    • Steven Kum,
    • Yih Kai Tan,
    • Sven Bräunlich
    CLINICAL DATA
    CLI right 2nd toe gangrene PAOD Rutherford 5
    DM hypertension hyperlipidemia IHD EF 45% Cr 102.
    Recent cross-over POBA for SFA CTO, pop and peroneal stenosis

    PROCEDURAL STEPS
    1. Antegrade access via right groin
    - 5F TERUMO sheath

    2. Antegrade passage of the lesion with hydrophilic wire
    - 0.014" COMMAND extra support wire 300 cm (ABBOTT)
    - 2 x 40 Advance 14LP balloon (COOK)

    3. Retrograde passage of lesion via ultrasound guided DP puncture
    - 4F Micropuncture® Transpedal Set (COOK)
    - EDGE ultrasound high frequency probe (SONOSITE)
    - 0.014” COMMAND extra support wire 300 cm (ABBOTT)
    - 2 x 40 Advance Micro 14 via retrograde

    4. PTA of ATA
    - 3.0 x 120 mm Jade high pressure balloon (ORBUS NEICH)

    5. Consider DEB/stent if any SFA/pop restenosis seen
    View image
  • - , Room 1 - Main Arena 1

    Case 06 – LEI 01: Restenosis after CEA right ICA 2005

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 06 – LEI 01: male, 69 years (K-O)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Progressive, asymptomatic restenosis right internal carotid artery after CEA 2005
    CEA left ICA 2007
    CAD, MI and PTCA 2012
    art. hypertension
    DUPLEX
    Progression to 3.5 m/sec. right ICA

    PROCEDURAL STEPS
    1. Access right groin
    - 9F – 20 cm sheath (TERUMO)

    2. Cannulation of the right external carotid artery
    - Judkins Right 5F diagnostic catheter (CARDINAL HEALTH)
    - 0.035" soft angled glidewire, 180 cm (TERUMO)
    - 0.035" SupraCore 300 cm stiff guidewire (ABBOTT)

    3. Cerebral protection
    - MOMA endovascular clamping device 9F (MEDTRONIC)

    4. Cannulation, predilatation, stenting and postdilatation of the right ICA
    - 0.014" Galleo Pro 175 cm guidewire (BIOTRONIK)
    - MiniTreck RX-balloon 3.5/20 mm (ABBOTT)
    - CGuard carotid embolic protection system (Inspire MD/PENUMBRA)
    - 5.0/20 mm RX-balloon (BOSTON SCIENTIFIC)
    View image
  • - , Room 1 - Main Arena 1

    Case 07 – LEI 02: Reocclusion right SFA

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 07 – LEI 02: female, 62 years (M-Z)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Reocclusion right SFA
    Claudication right calf, walking capacity 150 meters, ABI right 0.67
    PTA right SFA 2012 with plane balloon angioplasty elsewhere
    PTA left SFA/stenting 2013
    Re-PTA left SFA 12/2015

    RISK FACTORS
    15 cm long reocclusion right mid SFA
    art. hypertension, former smoker, diabetes mellitus type 2

    PROCEDURAL STEPS
    1. Access left groin and cross-over approach
    - 5F diagnostic IMA-catheter (CARDINAl HEALTH)
    - 0.035" soft angled glidewire 180 cm (TERUMO)
    - 0.035" stiff SupraCore guidewire 190 cm (ABBOTT)

    2. Passage of the right SFA-CTO
    - 0.018" Cruiser S 300 cm guidewire (BIOTRONIK)
    - Passeo 4/120 mm balloon (BIOTRONIK)

    3. PTA with drug-coated balloons and stenting on indication
    - Passeo LUX DCB 5.0/120 mm (BIOTRONIK)
    - Pulsar 18 stent (BIOTRONIK)
    View image
  • - , Room 1 - Main Arena 1

    Case 08 – CGH 03: Left SFA occlusion

    Center:
    Changi General Hospital, Singapore, Singapore
    Case 08 – CGH 03: female, 63 years (K-C-E)
    Operators:
    • Sven Bräunlich,
    • Steven Kum,
    • Yih Kai Tan
    CLINICAL DATA
    PAOD Rutherford 3
    COPD hypertension hyperlipidemia IHD EF 55% Cr normal

    PROCEDURAL STEPS
    1. Antegrade access via left groin 6F sheath

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

    3. Predilatation and lesion preparation

    4. PTA with DEB
    - Lux 5/6 x 120 mm DEB-balloon (BIOTRONIK)

    5. Postdilatation and stent
    - Conquest 5/6 x 40 balloon (C.R.BARD)
    - 4F Pulsar 18 stent (BIOTRONIK)
    View image
  • - , Room 1 - Main Arena 1

    Case 09 – LEI 03: Occlusion left SFA

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 09 – LEI 03: male, 76 years (H-M)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication left calf, walking capacity 150 meters,
    ABI left 0.65
    Abdominal aortic aneurysm 3.2 cm
    Chronic renal insufficiency, GFR 35 ml/min
    COPD

    RISK FACTORS
    CO2-angiography: long SFA-occlusion left
    art. hypertension, former nicotin-abuse

    PROCEDURAL STEPS
    1. Access right groin and cross-over approach
    - 5F diagnostic IMA-catheter (CARDINAL HEALTH)
    - 0.035" soft angled glidewire 180 cm (TERUMO)
    - 0.035" stiff SupraCore guidewire 190 cm (ABBOTT)

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

    3. PTA and stenting
    - Advance 35 balloon (COOK)
    - Zilver-PTX drug-coated stent (COOK)
    View image
  • - , Room 1 - Main Arena 1

    Case 10 – LEI 04: Popliteal occlusion right, CLI

    Center:
    University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany
    Case 10 – LEI 04: male, 77 years (M-P)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Restpain right foot, ABI right 0.44
    Failed recanalization attempt 12/2015 and 1/2016 elsewhere
    CAD, PTCA 2013 and 2014
    Minor stroke 2012

    RISK FACTORS
    Angiography during previous recanalization-attempt:
    Popliteal occlusion right, failure to pass into the posterior tibial artery
    art. hypertension, former nicotin-abuse, diabetes mellitus type 2

    PROCEDURAL STEPS
    1. Access right groin anetgrade
    - 6F 55 cm sheath (COOK)

    2. Retrograde access via posterior tibial artery
    - Transpedal access kit (COOK)
    (21 Gauge 4 cm needle, 2.9F sheath)

    3. Retrograde CTO-passage and PTA
    - 0.014" CTO-Approach guidewire 18 gramm, 300 cm (COOK)
    - CXI 0.018" angled support-catheter, 90 cm (COOK)
    - Advance Micro Balloon 3.0/80 mm, 90 cm (COOK)

    4. PTA and stenting from antegrade
    - Advance 18 5.0 mm balloon (COOK)
    - Zilver-PTX stent for the proximal popliteal artery (COOK)
    View image
  • - , Room 1 - Main Arena 1

    Case 11 – CGH 04: May Thurner syndrome and GSV reflux

    Center:
    Changi General Hospital, Singapore, Singapore
    Case 11 – CGH 04: male, 58 years (P-C-M)
    Operators:
    • Steven Kum,
    • Yih Kai Tan,
    • Sven Bräunlich
    CLINICAL DATA
    Left leg swelling. Venous claudication and swelling x 100 metres
    Hypt, hyperlipidemia, AF on Dabigatran (Pradaxa), previous DVT years ago.
    CT venogram done. Duplex shows left SFJ/GSV reflux

    PROCEDURAL STEPS
    1. Left mid GSV access under ultrasound
    - 5F TERUMO sheath
    - 12F Peel-away safe-sheath (ANGIODYNAMICS)

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

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

    4. Predilatation
    - 16/18 x 40 Atlas balloon (C.R.BARD)

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

    6. Postdilatation and IVUS control
    - 16/18 x 40 Atlas balloon (C.R.BARD)

    7. RFA of GSV
    - Venefit with ClosureFast catheter to GSV
    View image
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