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LINC Asia-Pacific 2017 live case guide

Find all live cases and live case centers listed below.

Conference day 1

  • - , Room 1 - Main Arena

    Case 01 – Left SFA occlusion

    Center:
    Singapore, Changi General Hospital
    Case 01 – CGH 01: male, 70 years, (TGL)
    Operators:
    • Sven Bräunlich,
    • Steven Kum,
    • Tan Yih Kai,
    • Darryl Lim,
    • Derek Lim
    CLINICAL DATA
    PAOD Rutherford 3
    COPD hypertension hyperlipidemia EF 40% Cr normal

    PROCEDURAL STEPS
    1. Crossover access via right groin 6F sheath
    - Passage of the lesion with hydrophilic wire 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 4F Ber II catheter (CORDIS)

    2. Retrograde SFA approach in event of antegrade failure

    3. Predilatation and lesion preparation, consider debulking

    4. PTA with DCB or stent (DES)
    - Ranger 5/6 x 100 (BOSTON SCIENTIFIC)
    - Eluvia 6 x 150 (BOSTON SCIENTIFIC)

    5. Post dilatation and stenting
    - Mustang 5/6 x 40 balloon (BOSTON SCIENTIFIC)
    View image
  • - , Room 1 - Main Arena

    Case 02 – SFA-CTO left

    Center:
    Beijing
    Case 02 – BPH 01: male, 78 years (YH-W)
    Operators:
    • Xin Jia,
    • Zhang Minhong
    CLINICAL DATA
    Severe claudication left calf, walking capacity 100 meters

    IMPORTANT ITEMS
    DM type 2, hypertension, former smoker
    ABI: left 0.61
    Rutherford 3
    CTA: moderately calcified SFA-CTO left

    PROCEDURAL STEPS
    1. Right femoral access and cross-over approach
    - 6F 55 cm sheath (COOK)

    2. Passage of the occlusion left SFA
    - 0.018" V18 guidewire, 300 cm (BOSTON SCIENTIFIC)
    - 0.018" Trailblazer support catheter, 135 cm (MEDTRONIC)

    3. Retrograde approach via the distal SFA right in case of failure to pass from antegrade
    - 21 Gauge 9 cm Micropuncture needle (COOK)
    - 0.018" V18 guidewire, 300 cm (BOSTON SCIENTIFIC)
    - 0.018" Trailblazer support catheter, 90 cm (MEDTRONIC)

    4. PTA and stenting on indication
    - Passeo18 ballon 3 x 100 mm, 4 x 100 mm (BIOTRONIK)
    - Orchid DCB 5.0/120 mm (ACOTEC SCIENTIFIC)
    - Smart Control stent (CORDIS)

    5. Puncture site closure
    - Exoseal 6F (CORDIS)
    View image
  • - , Room 1 - Main Arena

    Case 03 – Right SFA in-stent occlusion

    Center:
    Singapore, Changi General Hospital
    Case 03 – CGH 02: male, 70 years (V-F)
    Operators:
    • Steven Kum,
    • Tan Yih Kai,
    • Sven Bräunlich,
    • Darryl Lim,
    • Derek Lim
    CLINICAL DATA
    PAOD Rutherford 3

    RISK FACTORS
    DM, hypertension, smoker, allergic to Plavix

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

    2. Passage of the lesion with hydrophilic wire
    - 0.035" Terumo angled soft/stiff guidewire, 260 cm (TERUMO)
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 4F Ber II catheter (CORDIS)

    3. Retrograde stent puncture in event of antegrade failure
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 0.035" Terumo angled soft/stiff guidewire, 260 cm (TERUMO)

    4. Predilatation and vessel preparation, consider debulking
    - 5.0 mm Pacific (MEDTRONIC)

    5. PTA with DEB
    - 5/6mm InPact Pacific (MEDTRONIC)

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

    Case 10 – CAS of a progressive internal artery stenosis

    Center:
    Leipzig, Dept. of Angiology
    Case 10 – LEI 05: male, 67 years (S-R)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Progressive stenosis left internal carotid artery stenosis
    Minor stroke left hemispheric 1/2012
    CAD, CABG 2012

    RISK FACTORS
    Art. Hypertension, diabetes mellitus type II, former smoker

    PRESENT STATE
    Duplex: PSV left 5.2 m/sec.
    MR-angiography: high grade stenosis left ICA;
    intracranial MR without pathological findings

    PROCEDURAL STEPS
    1. Right groin access
    - 9F 25 cm sheath (TERUMO)

    2. Cannulation of the left external carotid artery
    - 5F Judkins right diagnostic catheter (CARDINAL HEALTH)
    - 0.035" soft angled glidewire, 190 cm (TERUMO)
    - Exchange to 0.035" SupraCore guidewire, 190 cm (ABBOTT)

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

    4. Predilatation, stenting, and postdilatation
    - 3.5/20 mm MiniTrek RX balloon (ABBOTT)
    - Roadsaver carotid artery stent system (TERUMO)
    - 5.0/20 mm Sterling RX balloon (BOSTON SCIENTIFIC)

    5. Aspiration of potential plaque-debris before declamping of the MOMA-system

    6. Final angiography
  • - , Room 1 - Main Arena

    Case 04 – Long, calcified SFA-CTO right

    Center:
    Beijing
    Case 04 – BPH 02: female, 80 years (X-SY)
    Operators:
    • Wei Guo,
    • Xiong Jiang
    CLINICAL DATA
    Rest pain right calf

    IMPORTANT ITEMS
    CHD, DM type 2, hypertension, hyperlipidimia
    ABI 0.4 right
    Rutherford 4
    CTA: Long SFA and BTK occlusion right, moderately calcified

    PROCEDURAL STEPS
    1. Left femoral access and cross-over approach
    - 0.035" angled soft Radiofocus guidewire, 260 cm (TERUMO)
    - 0.035" SupraCore guidewire, 300 cm (ABBOTT)
    - 4F 70 cm Sheath (COOK)

    2. Passage of the occlusion right SFA
    - 0.018" V18 guidewire, 300 cm (BOSTON SCIENTIFIC)
    - 0.018" Trailblazer support catheter, 135 cm (MEDTRONIC)

    3. Retrograde approach via the popliteal artery right, in case of failure to pass from antegrade
    - 21 Gauge 9 cm Micropuncture needle (COOK)
    - 0.018" V18 guidewire, 300 cm (BOSTON SCIENTIFIC)
    - 0.018" Trailblazer support catheter, 90 cm (MEDTRONIC)

    4. PTA and stenting on indication
    - Passeo18 ballon 4 x 170 mm (BIOTRONIK)
    - Pulsar18 stent 5 x 200 mm (BIOTRONIK)
    View image
  • - , Room 1 - Main Arena

    Case 05 – Chronic total occlusion left SFA

    Center:
    Leipzig, Dept. of Angiology
    Case 05 – LEI 01: male, 66 years (J-R)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication left calf, Rutherford class 3
    CAD, MI 2002, PCA 2002 and 2016

    RISK FACTORS
    Nicotin abuse, art. Hypertension

    PRESENT STATE
    ABI left 0.67
    Angiography during coronary angiography: long SFA-CTO left

    PROCEDURAL STEPS
    1. Access right groin and cross-over approach
    - 5F diagnostic IMA-catheter (CORDIS/CARDINAl HEALTH)
    - 0.035" soft angled glidewire 180 cm (TERUMO)
    - 0.035" stiff SupraCore guidewire 190 cm (ABBOTT)
    - 5F Fortress Cross-over sheath 45 cm (BIOTRONIK)

    2. Guidewire passage
    - 0.035" stiff angled glidewire (TERUMO)
    - 0.018" Cruiser guidewire (BIOTRONIK)

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

    Case 06 – Chronic occlusion left SFA, reocclusion

    Center:
    Leipzig, Dept. of Angiology
    Case 06 – LEI 02: male, 55 years (M-L)
    Operators:
    • Andrej Schmidt,
    • Yvonne Bausback
    CLINICAL DATA
    Severe claudication left calf, Rutherford class 3
    PTA left CFA and SFA 2/2015
    CAD, PTCA 2012

    RISK FACTORS
    Nicotine abuse, art. Hypertension

    PRESENT STATE
    ABI left 0.67

    PROCEDURAL STEPS
    1. Access right groin and cross-over approach
    - 5F diagnostic IMA-catheter (CORDIS/CARDINAL HEALTH)
    - 0.035" soft angled glidewire 180 cm (TERUMO)
    - 0.035" stiff SupraCore guidewire 190 cm (ABBOTT)
    - 6F 40 cm Up&Over Sheath, 40 cm (COOK)

    2. Passage of the left SFA-CTO
    - 0.018" Connect Guidewire, 300 cm (ABBOTT)
    - CXC 0.018" 135 cm support catheter (COOK)

    3. Predilatation and stenting
    - Advance balloon 5.0/100 mm (COOK)
    - 14 cm 6 mm Zilver-PTX stent (COOK)
    View image
  • - , Room 1 - Main Arena

    Case 07 – CTO left distal SFA, CLI

    Center:
    Leipzig, Dept. of Angiology
    Case 07 – LEI 03: male, 65 years (S-P)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Critical limb ischemia left, ulceration Dig II and III left, Restpain, Rutherford class 5
    Bypass-occlusion both sides (P1 left)
    PTA right SFA 02/2017, CAD, PTCA 2010

    RISK FACTORS
    Art. Hypertension, diabetes mellitus, former nicotine abuse

    PRESENT STATE
    ABI right 0.72; left 0.3
    Angiography left: distal calcified SFA-CTO, BTK 3-vessel occlusion

    PROCEDURAL STEPS
    1. Left antegrade approach
    - 6F 20 cm Radiofocus Introducer Sheath (TERUMO)

    2. Guidewire passage of the SFA-CTO
    - 0.018" Connect 250 T guidewire, 300 cm (ABBOTT)
    - CXC 0.018" support catheter, 90 cm (COOK)

    3. Vessel preparation for the stent implantation
    - Advance Enforcer 35 Focal Force PTA balloon 6.0/40 mm, 50 cm (COOK)

    4. Stenting
    - Zilver-PTX 7/80 mm (COOK)
    View image
  • - , Room 1 - Main Arena

    Case 08 – Left SFA occlusion, TPT occlusion

    Center:
    Singapore, Changi General Hospital
    Case 08 – CGH 03: male, 56 years (P)
    Operators:
    • Steven Kum,
    • Tan Yih Kai,
    • Sven Bräunlich,
    • Darryl Lim,
    • Derek Lim
    CLINICAL DATA
    PAOD Rutherford 3
    Dm Hypertension, hyperlipidemia, ex-smoker, normal renal function

    PROCEDURAL STEPS
    1. Crossover access via left groin
    - 6F Balkin sheath (COOK)
    2. Passage of the lesion with hydrophilic wire
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 0.035" Terumo angled soft/stiff guidewire, 260 cm (TERUMO)
    - 4F Ber II catheter (CORDIS)

    3. Retrograde SFA access in event of antegrade failure
    - 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 (BARD)

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

    6. Spot stenting on indication and post dilatation
    - 5 mm SUPERA stent (ABBOTT)

    7. Treatment of TPT
    - 3.5 x 15 NC TREK balloon for TPT lesion (ABBOTT)
    - 3.5 x 28 ABSORB bioabsorbable vascular scaffold/BVS (ABBOTT) for TPT lesion
    - Post dilatation 3.5 x 15 NC TREK balloon (ABBOTT)
    View image
  • - , Room 1 - Main Arena

    Case 09 – CLI with long BTK-occlusions

    Center:
    Leipzig, Dept. of Angiology
    Case 09 – LEI 04: male, 73 years (K-M)
    Operators:
    • Andrej Schmidt,
    • Yvonne Bausback
    CLINICAL DATA
    CLI with ulceration left dig 2, restpain
    PTA/stent left popliteal artery 1/2016
    Amputaiton dig 1 left 1/2016
    Reocclusion left popliteal artery, Rotarex-thrombectomy 12/2016

    RISK FACTORS
    Former smoker, art. Hypertension

    PRESENT STATE
    Angiography 12/2016, ABI left 0.2

    PROCEDURAL STEPS
    1. Antegrade approach left
    - 5F 55 cm Check-Flo sheath (COOK)

    2. Guidewire passage left ATA
    - 0.014" PT2 guidewire, 300 cm (BOSTON SCIENTIFIC)
    - Ultraverse 0.014" balloon as support (BARD)

    In case of failure to pass from antegrade:
    3. Retrograde approach via the dorsalis pedis artery
    - Transpedal access set: 21 Gauge needle, 2.9F sheath (COOK)

    4. PTA
    - 2.5/250 mm VascuTrak scoring balloon (BARD)

    5. Drug-coated balloon treatment
    - Lutonix 2.5/150 mm and 3.0/150 mm drug-coated balloons (BARD)
    View image
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Live case transmission centers

 

During LINC Asia-Pacific 2017 several live cases will be performed from several international centers. All live case transmissions are coordinated, filmed, and produced by the mediAVentures crew, using the latest in high definition television and wireless technology.

• Beijing PLA Hospital, Beijing, China with Wei Guo
• Changi General Hospital, Singapore with Steven Kum
• Singapore General Hospital, Singapore with Tay Kiang Hiong, Chong Tze Tec
• Chonnam National University Hospital, Gwangju, South Korea with Jae-Kyu Kim 
• Mount Sinai Hospital, New York, USA with Prakash Krishnan
• University Hospital Leipzig, Division of Interventional Angiology, Leipzig, Germany with Andrej Schmidt, Matthias Ulrich, Johannes Schuster, Yvonne Bausback

 

 

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