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LINC Asia-Pacific 2017 live case guide

Find all live cases and live case centers listed below.

Conference day 2

  • - , 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
  • - , Room 1 - Main Arena

    Case 12 – Right SFA long occlusion

    Center:
    Gwangju
    Case 12 – CNUH 01: male, 85 years
    Operators:
    • Jae Kyu Kim,
    • Nam Yeol Yim
    CLINICAL DATA
    Mild claudication right leg, walking distance 200 meters
    ABI 0.65/0.86 (PT)
    Left iliac artery occlusion: Stent, left SFA and popliteal artery multiple stenosis: Stent, LUTONIX DCB. 02/2017
    Lower abdominal aorta stenosis: stent. 02/2011

    RISK FACTORS
    Hypertension medications

    PROCEDURAL STEPS
    1. Access left groin and cross-over approach/antegrade approach
    - 7F Ansel sheath 45 cm (COOK)

    2. Passage of the lesion with hydrophilic guide wire
    - 5F Headhunter diagnostic catheter (BOSTON SCIENTIFIC)

    3. Predilation and vessel preparation
    - 5.0/100 mm Vascutrack scoring PTA catheter (BARD)

    4. PTA with DEB
    - LUTONIX drug coated balloon catheter (BARD) 6.0/150 mm

    5. Spot stenting if necessary
    - LIFE stent (BARD) 6.0 mm
    View image
  • - , 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
  • - , Room 1 - Main Arena

    Case 14 – Left SFA multifocal stenosis

    Center:
    Gwangju
    Case 14 – CNUH 02: male, 77 years
    Operators:
    • Jae Kyu Kim,
    • Nam Yeol Yim
    CLINICAL DATA
    Mild claudication right leg, walking distance 200 meters
    ABI 0.6/0.5

    RISK FACTORS
    Hypertension

    PROCEDURAL STEPS
    1. Access left groin antegrade
    - 5/6F Ansel sheath 45 cm (COOK)

    2. Passage of the lesion with hydrophilic guide wire
    - 2.35" 90 cm CXI support catheter (COOK)
    - 0.014" 300 cm V 18 control guidewire (BOSTON SCIENTIFIC)

    3. PTA with DEB
    - LUTONIX drug coated balloon catheter (BARD) 6.0/150 mm

    4. Spot stenting if necessary
    - LIFE stent (BARD) 6.0 mm
    View image
  • - , 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
  • - , Room 2 - Technical Forum

    Case 22 – Iliac vein compression

    Center:
    Singapore, Changi General Hospital
    Case 22 – CGH 04: male (S-K)
    Operators:
    • Steven Kum,
    • Tan Yih Kai,
    • Darryl Lim,
    • Derek Lim
    CLINICAL DATA
    Left and right leg swelling
    Previous spine instrumentation

    PROCEDURAL STEPS
    1. Bilateral SFV access under ultrasound
    - 5F Terumo sheath (TERUMO)
    - 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 (BARD)

    5. Iliac vein stenting
    - Sinus Obliquus 16 x 150 (OPTIMED)

    6. Postdilatation and IVUS control
    - 16/18 x 40 Atlas balloon (BARD)
    View image
  • - , Room 1 - Main Arena

    Case 16 – AV fistula stenosis

    Center:
    Gwangju
    Case 16 – CNUH 03: male, 72 years
    Operators:
    • Jae Kyu Kim,
    • Nam Yeol Yim
    CLINICAL DATA
    ESRD s/p HD for 7 years
    Right radiocephalic AVF (7 years ago) had obstructed and HD through perm cath started
    Right brachiobasilic AVF creation (2016-11-7)

    RISK FACTORS
    Hypertension (30y ago)
    Diabetes (30y ago)
    US surveillance: Tight stenosis with decreased volume flow along venous limb of AVF (109 ml/min).
    Routine hemodialysis (3 times a week) through perm cath

    PROCEDURAL STEPS
    1. Retrograde puncture of AV fistula
    - 21 Gauge micro puncture kit (COOK)
    - 6F sheath (BOSTON SCIENTIFIC)

    2. PTA along venous limb of AVF with DEB
    - Lesion crossing with 0.035" hydrophilic guide wire (TERUMO) and 4F catheter (MERIT MEDICAL)
    - Vessel preparation with 5 mm – 40 mm high pressure balloon
    - 5 mm – 40 mm Lutonix DEB (BARD)
    View image
  • - , Room 1 - Main Arena

    Case 17 – Chronic, calcified common iliac occlusion left

    Center:
    Leipzig, Dept. of Angiology
    Case 17 – LEI 06: male, 56 years (J-L)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication left leg, walking capacity 150 meters
    Failed recanalizaiton attempt left common iliac artery 2/2017
    Stenting right CIA 2/2017

    RISK FACTORS
    Art. Hypertension, nicotine abuse

    PROCEDURAL STEPS
    1. Left brachial approach
    - 6F 90 cm Check-Flo Performer (COOK)

    2. Left femoral approach
    - 7F 20 cm Radiofocus Introducer sheath (TERUMO)

    3. Guidewire passage
    - Stiff straight glidewire 260 cm (TERUMO) from both sides
    - CART-technique with 5.0/40 mm Admiral balloon (MEDTRONIC)

    4. Implantation of a covered stent
    - 8.0/38 mm LifeStream (BARD)
    View image
  • - , Room 1 - Main Arena

    Case 18 – Subacute in-stent reocclusion left SFA

    Center:
    Leipzig, Dept. of Angiology
    Case 18 – LEI 07: male, 61 years (H-S)
    Operators:
    • Matthias Ulrich,
    • Andrej Schmidt
    CLINICAL DATA
    Severe claudication left calf, walking capacity 100 meters, since 2 months
    Stenting left SFA 2/2014
    CAD, PTCA 2012
    ABI left 0.64; right 0.81
    Duplex-sonography: total occlusion of stents left SFA

    RISK FACTORS
    Art. Hypertension, diabetes mellitus type II
    Former smoker
    Moderat renal insufficiency, GFR 55ml/min

    PROCEDURAL STEPS
    1. Right groin retrograde and cross-over approach
    - IMA diagnostic 5F catheter (CORDIS/CARDINAL HEALTH)
    - 0.035" angled soft Radiofocus glidewire, 190 cm (TERUMO)
    - 0.035" SupraCore guidewire, 190 cm (ABBOTT)
    - 8F Balkin Up&Over Sheath, 40 cm (COOK)

    2. Passage of the occlusion and percutaneous thrombectomy
    - 0.035" stiff angled glidewire 260 cm (TERUMO)
    - 0.035" QuickCross support catheter 135 cm (SPECTRANETICS)
    - Exchange to Rotarex guidewire (STRAUB MEDICAL)
    - 8F Rotarex thrombectomy catheter (STRAUB MEDICAL)

    3. PTA with DCBs
    - In.Pact Pacific 5.0/120 mm drug-coated balloons (MEDTRONIC)
  • - , Room 1 - Main Arena

    Case 19 – Right SFA long occlusion

    Center:
    Gwangju
    Case 19 – CNUH 04: male, 75 years
    Operators:
    • Jae Kyu Kim,
    • Nam Yeol Yim
    CLINICAL DATA
    Severe claudication right leg, walking distance 50 meters

    RISK FACTORS
    Former smoker
    Laryngeal cancer under CTX procedural steps

    PROCEDURAL STEPS
    1. Access left groin and cross-over approach
    - 7F Ansel sheath 45 cm (COOK)

    2. Intraluminal Passage of the lesion with hydrophilic guide wire
    - 5F Headhunter diagnostic catheter (BOSTON SCIENTIFIC)
    - 0.035" Glidewire (TERUMO)
    - If necessary, 2.35" 90 cm CXI support catheter (COOK)
    - 0.014" 300 cm PT2 guidewire (BSC)

    3. Filter placement
    - 0.014" 300 cm Throughway/Commend ES guidewire (BOSTON SCIENTIFIC/ABBOTT)
    - 4/7 mm 200 cm Spider FX emboli protection device (eV3)

    4. Atherectomy and thrombectomy
    - 2.4/3.4 Jet stream Pathway rotational atherectomy

    5. PTA
    - LUTONIX drug coated balloon catheter (BARD) 6.0/150 mm

    6. Spot stenting if necessary
    - LIFE stent (BARD) 6.0 mm
    View image
  • - , Room 1 - Main Arena

    Case 20 – Popliteal and BTK-CTO with CLI

    Center:
    Leipzig, Dept. of Angiology
    Case 20 – LEI 08: male, 64 years (V-S)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    CLI with restpain right foot, Rutherford class 4,
    TEA right groin 1/2016, stenting right SFA 2010
    PTA of a restenosis right SFA 2/2017

    RISK FACTORS
    Diabetes mellitus type 22, former smoker, art. Hypertension

    PRESENT STATE
    ABI right 0.32

    PROCEDURAL STEPS
    1. Right antegrade approach
    - 6F 55 cm Check-Flow Performer sheath (COOK)

    2. Guidewire passage of the popliteal and peroneal artery right
    - 0.018" Connect guidewire, 300 cm (ABBOTT)
    - 0.018" Seeker support catheter, 90 cm (BARD)

    3. In case of antegrade failure retrograde access via the peroneal artery
    - 7 cm 21 Gauge needle (COOK)
    - 0.018" Seeker support catheter (BARD)

    4. Atherectomy and PTA
    - HawkOne directional atherectomy (MEDTRONIC)
    - Armada 14 balloon (ABBOTT)
    - Pacific balloon (MEDTRONIC)

    5. Arterial wall injection of dexamethason
    - BullFrog Micro-Infusion-Device (MERCATOR MEDSYSTEMS)
    View image
  • - , Room 1 - Main Arena

    Case 21 – Restpain left with popliteal reocclusion

    Center:
    Leipzig, Dept. of Angiology
    Case 21 – LEI 09: female, 78 years (M-V)
    Operators:
    • Matthias Ulrich,
    • Yvonne Bausback
    CLINICAL DATA
    Critical limb ischemia with restpain left foot, Rutherford class 4
    PTA left SFA and popliteal artery (DCBs) 5/2013
    PTA right SFA 2/2017
    CAD, PTCA 2015
    Renal insufficiency, GFR 55 ml/min

    RISK FACTORS
    Former nicotine abuse, art. Hypertension

    PRESENT STATE
    ABI left: 0.1

    PROCEDURAL STEPS
    1. Left antegrade approach
    - 6F 55 cm Check-Flo Performer (COOK)

    2. Guidewire passage
    - 0.018" Connect 250 T, 300 cm guidewire (ABBOTT)

    3. PTA
    - Armada 5.o/40 mm and 6.0/40 mm balloon (ABBOTT)

    4. Stenting
    - 5.0/60 mm Supera stent (ABBOTT)
    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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