New York

• Wednesday, March 15th: 8:00 - 8:24, Room 1 - Main Arena

  Case 11 – Complex calcified left common iliac artery stenosis

  Center:

  New York

  Case 11 – MSH 01: female, 83 years (A-M)

  Operators:

  • Prakash Krishnan,
  • Vishal Kapur,
  • Karthik Gujja,
  • Farhan Majeed,
  • Rheoneil Lascano

  CLINICAL DATA
  Patient presents with 1 block life-style limiting severe left lower extremity claudication.
  Rutherford grade 1, category 3. Fontaine stage IIB. Claudication symptoms have been getting progressively worse over the last few weeks. No rest pain or ischemic ulcers noted.
  Left ABI 0.52. Right ABI 0.96.
  
  RISK FACTORS
  Hypertension, hyperlipidemia, peripheral arterial disease s/p
  right femoral-popliteal bypass (patent) and left femoral-popliteal bypass (patent),
  diabetes mellitus, and tobacco use
  
  PROCEDURAL STEPS
  1. Left groin access with retrograde approach
  - 0.035" SupraCore guidewire, 300 cm (ABBOTT VASCULAR)
  - 7F – 25 cm Pinnacle sheath (TERUMO)
  
  2. Passage through the left common iliac artery stenosis
  - 0.035" SupraCore guidewire, 300 cm (ABBOTT VASCULAR)
  
  3. Imaging for anatomical clarification
  - Volcano 0.035" Peripheral IVUS (PHILLIPS)
  
  4. PTA of the left common iliac artery with balloon
  - Armada 6 x 20 mm balloon (ABBOTT VASCULAR)
  
  5. Covered stent of the left common iliac artery
  - Atrium iCast covered stent 10 x 38 mm (GETINGE)

  View image
• Wednesday, March 15th: 9:55 - 10:25, Room 1 - Main Arena

  Case 13 – Heavily calcified right superficial femoral artery disease

  Center:

  New York

  Case 13 – MSH 02: female, 78 years (S-P)

  Operators:

  • Prakash Krishnan,
  • Vishal Kapur,
  • Karthik Gujja,
  • Farhan Majeed,
  • Rheoneil Lascano

  CLINICAL DATA
  Patient presents with 1 block life-style limiting severe right lower extremity claudication.
  Rutherford grade 1, category 3. Fontaine stage IIB. Claudication symptoms have been progressive. Symptoms have been persistent despite exercise program and medical therapy. No rest pain or ischemic ulcers noted.
  Right ABI 0.46. Left ABI 0.65
  
  RISK FACTORS
  Hypertension, hyperlipidemia, peripheral arterial disease s/p right common iliac
  artery stent, left common iliac artery stent, and left superficial femoral artery stent,
  diabetes mellitus, and tobacco use.
  
  PROCEDURAL STEPS
  1. Left groin access with retrograde cross over approach
  - UF 4F diagnostic catheter (ANGIODYNAMICS)
  - 0.035" SupraCore guidewire, 300 cm (ABBOTT VASCULAR)
  - 7F – 45 cm Pinnacle sheath (TERUMO)
  
  2. Passage through the right SFA calcified stenosis
  - 0.018" Trailblazer Vert support catheter, 135 cm (MEDTRONIC)
  - 0.014" Fielder guidewire, 300 cm (ASAHI)
  
  3. Filter placement
  - Fielder exchanged to a Barewire through the support catheter (ABBOTT VASCULAR)
  - Emboshield Nav 6 filter placement (ABBOTT VASCULAR)
  
  4. Jetstream atherectomy of the right SFA calcified disease
  - Jetstream 2.4/3.4 mm atherectomy (BOSTON SCIENTIFIC)
  - or: TurboHawk directional atherectomy (MEDTRONIC)
  
  5. PTA with a non-compliant balloon
  - Dorado 6 x 200 mm balloon (BARD)
  
  6. Drug-coated balloon therapy
  - In-Pact Admiral 6 x 150 mm balloon (MEDTRONIC)
  
  7. Stenting
  - 5.5 x 150 mm Supera interwoven self-expanding Nitinol stent (ABBOTT)

  View image
• Wednesday, March 15th: 11:37 - 12:08, Room 1 - Main Arena

  Case 15 – Long left superficial femoral artery in-stent occlusion

  Center:

  New York

  Case 15 – MSH 03: male, 78 years (R-A)

  Operators:

  • Prakash Krishnan,
  • Vishal Kapur,
  • Karthik Gujja,
  • Farhan Majeed,
  • Rheoneil Lascano

  CLINICAL DATA
  Patient presents with 1/2 block life-style limiting severe left lower extremity claudication.
  Rutherford grade 1, category 3. Fontaine stage IIB.
  Claudication symptoms have been progressive. No rest pain or ischemic ulcers noted.
  Left ABI 0.40
  
  RISK FACTORS
  Hypertension, hyperlipidemia, peripheral arterial disease s/p previous right and
  left superficial femoral artery stents, diabetes mellitus, and tobacco use
  
  PROCEDURAL STEPS
  1. Right groin access with retrograde cross over approach
  - UF 4F diagnostic catheter (ANGIODYNAMICS)
  - 0.035" SupraCore guidewire, 300 cm (ABBOTT VASCULAR)
  - 7F – 45 cm Pinnacle sheath (TERUMO)
  
  2. Passage through the left SFA instent restenosis
  - 0.035" Trailblazer Vert support catheter, 135 cm (MEDTRONIC)
  - 0.035" Stiff Angled Glidewire, 260 cm (TERUMO)
  
  3. Filter placement
  - Glidewire exchanged to a Barewire through the support catheter (ABBOTT VASCULAR)
  - Emboshield Nav 6 filter placement (ABBOTT VASCULAR)
  
  4. Mechanical thrombectomy of the left SFA disease
  - Angiojet mechanical thrombectomy (BOSTON SCIENTIFIC)
  
  5. PTA with a balloon
  - Armada 6 x 200 mm balloon (ABBOTT VASCULAR)
  
  6. Drug coated balloon therapy of the in-stent segment
  - In-Pact Admiral 6 x 150 mm balloon (MEDTRONIC)
  
  7. Stent placement in the proximal left SFA segment
  - Zilver PTX drug-eluting stent 6 x 120 mm (COOK MEDICAL)

  View image