LINC Asia-Pacific 2018 live case guide

Find all live cases and live centers listed below

 

 

Conference day 2

  • - , Room 1 - Main Arena

    Case 11 –TASC D iliac occlusion, left

    Center:
    Seoul National University Hospital
    Case 11 – SNU 02: male, 63 years (K-B)
    Operators:
    • Hwan Jun Jae,
    • Saebeom Hur
    CLINICAL DATA
    Severe claudication left calf, walking capacity 100 meters

    IMPORTANT ITEMS
    Quit smoking 1 year ago after 90-pack-years
    ABI : unavailable
    Bladder cancer (UCC) with M/bone (T7)
    s/p Radical Cystectomy ('12.11.6) & T7 transverse tumorectomy ('13.3.27)
    EGC, s/p LADG ('16.5.18)
    Old Tbc; GB stone, s/p L-Cholecystectomy (30YA)
    Rt. leg neural damage (after TA, >20Y)

    PROCEDURAL STEPS
    1. Right groin retrograde and cross-over approach
    - 0.035" Radiofocus soft angled guidewire 150 cm (TERUMO)
    - 7F 40 cm Balkin Up&Over sheath (COOK)
    2. Left groin retrograde approach
    - 0.035" Radiofocus guidewire 190 cm (TERUMO)
    - 6F 10 cm Super sheath (BOSTON SCIENTIFIC)
    --> 8F sheath after passage
    3. Guidewire passage and PTA
    - 0.035" Radiofocus soft angled guidewire 150 cm (TERUMO) and 5F Davis catheter 70 cm (TERUMO) for intraluminal or subintimal GW passage
    - 4.0/40 mm Armada 35 balloon (ABBOTT)
    - 6.0 or 7.0/100 mm Armada balloon (ABBOTT)
    - Bail-out usage of Goose neck snare (EV3) or Outback (CORDIS)
    4. Stenting
    - 8 mm/60 mm Lifestream balloon-expandable covered stent (BARD)
    - Consider bilateral common iliac kissing stent
    - 7 mm/120 mm self-expandable stent for left external iliac segment
    View image
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    Case 12 – Right in-stent occlusion

    Center:
    The Chinese University of Hong Kong, Prince of Wales Hospital
    Case 12 – POW 04: male, 57 years (WKS)
    Operators:
    • Bryan Yan,
    • Skyi Yin Chun Pang,
    • Sven Bräunlich,
    • Steven Kum
    CLINICAL DATA
    PAOD Rutherford 3
    DM, HT, smoker, CAD s/p multiple PCI 2006, 2013, 2014
    Bilateral PVD s/p multiple interventions, left popliteal stent 2014,
    DCB for in-stent occlusion 2016
    CTA excluded entrapment syndrome, recent stent re-occlusion

    PROCEDURAL STEPS
    1. Contralateral cross-over access via right groin
    - 6F 40 cm long Balkin sheath (COOK)
    2. Antegrade passage of the lesion with hydrophilic wire
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 0.035" Radiofocus Terumo angled soft guidewire, 250 cm (TERUMO)
    3. Retrograde tibial access in event of antegrade failure
    4. Mechanical thrombectomy and debulking
    - Predilatation with 2/3 x 120 balloon
    - 6F Rotarex (STRAUB MEDICAL)
    5. Treatment with In.Pact 5 mm DCB
    View image
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    Case 13 – Left SFA long occlusion

    Center:
    Beijing PLA Hospital
    Case 13 – BPH 03: male, 72 years (ZYM)
    Operators:
    • Wei Guo,
    • Xin Jia
    CLINICAL DATA
    Left calf claudication, walking capacity 100 meters, Rutherford 3

    RISK FACTORS
    Smoking, hypertension

    PROCEDURAL STEPS
    1. Right femoral access and cross-over approach
    - 6F 40 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 left infrapopliteal artery in case of failure
    4. PTA and DCB
    - Pacific OTW balloon 5 x 200 mm (MEDTRONIC)
    - ORCHID DCB 6 x 200 mm (ACOTEC)
    View image
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    Case 14 – TASC D SFA occlusion right

    Center:
    Seoul National University Hospital
    Case 14 – SNU 03: male, 72 years (Y-O)
    Operators:
    • Hwan Jun Jae,
    • Saebeom Hur
    CLINICAL DATA
    Severe claudication right calf, 100 m

    IMPORTANT ITEMS
    Hypertension
    s/p Thrombectomy, Lt. CFA to crural a.. Rt. CFA, DFA, SFA, Endarterectomy, both CFA
    Fem-Fem bypass (Lt to Rt) with 7 mm PTFE graft (2015.11.19)
    Right ABI : 0.33 (2016.2.4) --> 0.58 (2016.10.31) --> 0.60 (2017.8.18) --> 0.65 (2018.2.6)
    In hospital cardiac arrest, idopathic (2015.11.19)
    DVT in Rt. popliteal vein, on astrix, pletaal, berasil, podox, roisol

    PROCEDURAL STEPS
    1. Right groin antegrade approach
    - 0.035" Radiofocus soft angled guidewire 150 cm (TERUMO)
    - 6F 10 cm Supersheath sheath (BOSTON SCIENTIFIC)
    2. (PRN) Right ATA retrograde approach
    - 0.018" V-18 guidewire (BOSTON SCIENTIFIC)
    - CXI supporting catheter 90 cm (COOK)
    3. Guidewire passage and PTA
    - 0.018" V-18 guidewire (BOSTON SCIENTIFIC) and CXI catheter 90 cm (COOK) for intraluminal or subintimal GW passage
    - (PRN) Jetstream artherectomy (BOSTON SCIENTIFIC) with embolic protection device, if intraluminal passage achieved
    - (PRN) reverse-CART if subintimal passage was made
    - 5.0 mm Armada balloon (ABBOTT)
    4. Stenting
    - Multiple 6 mm Eluvia drug eluting stent (BOSTON SCIENTIFIC)
    View image
  • - , Room 1 - Main Arena

    Case 15 – Right popliteal occlusion, tibial stenosis

    Center:
    The Chinese University of Hong Kong, Prince of Wales Hospital
    Case 15 – POW 05: male, 47 years (CCM)
    Operators:
    • Bryan Yan,
    • Skyi Yin Chun Pang,
    • Sven Bräunlich,
    • Steven Kum
    CLINICAL DATA
    PAOD Rutherford 3
    Smoker, PVD s/p popliteal balloon angioplasty 2012, recurrent claudication
    Resting ABI: 0.58 / 1.14

    PROCEDURAL STEPS
    1. Contralateral cross-over access via Left groin
    - 6F 40 cm long Balkin sheath (COOK)
    2. Antegrade passage of the lesion with hydrophilic wire
    - 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
    - 0.014 COMMAND ES (ABBOTT VASCULAR)
    3. Retrograde tibial access in event of antegrade failure
    4. Consider debulking if true lumen, otherwise vessel prep and predilatation
    5. Treatment of SFA/Pop and tibials
    - Ranger DCB (BOSTON SCIENTIFIC)
    6. Spot stenting on indication
    View image
  • - , Room 2 - Technical Forum

    Case 21 – Instent-restenosis of central vein stent with focal stenosis at brachial vein in brachio-brachial arterio-venous fistula for hemodialysis

    Center:
    Seoul National University Hospital
    Case 21 – SNU 04: female, 73 years (J-W)
    Operators:
    • Saebeom Hur,
    • Sanghyun Ahn
    CLINICAL DATA
    Hemodialysis via Permcath
    Left arm swelling (+)

    PATIENT HISTORY
    2017.3.9 AVF formation (Br-Br), Lt.
    2017.4.24 Lt. autogenous brachial-brachial upper arm transposition (2nd)
    2017.8.16 – 8.19 wound care
    2017.9.20 First use(+)
    2017.10.11 Stent placement for Lt. innominate vein occlusion
    2017.12.14 PTA for brachial vein stenosis
    using 7*40 mm Mustang balloon & 6 mm*2 cm Cutting balloon

    PROCEDURAL STEPS
    1. US guided brachial vein access
    - 0.035" Radiofocus soft angled guidewire 150 cm (TERUMO)
    - 7F 10 cm Supersheath sheath (BOSTON SCIENTIFIC)
    2. Guidewire passage and PTA
    - 0.035" Radiofocus soft angled guidewire 150 cm (TERUMO) and Kumpe catheter 65 cm (COOK) for intraluminal GW passage
    - 6 mm, 7 mm/40 mm Conquest high-pressure balloon (BARD)
    - 6 mm, 7 mm/40 mm Lutonix drug coated balloon (BARD)
    3. (PRN) Stenting
    - 10 mm Niti-S stent (TAEWOONG)
    View image
  • - , Room 1 - Main Arena

    Case 16 – Reocclusion of the right popliteal and BTK-arteries

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 16 – LEI 05: female, 78 years (G-H)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    Severe claudication right leg and restpain at night, Rutherford class 4
    ABI right 0.6
    Renal impairment, atrial fibrillation

    IMPORTANT ITEMS
    PTA of right SFA 01/18
    PTA of right popliteal artery, ATA and peroneal artery 07/2017
    Angiography during PTA right 01/18:
    High-grade stenosis right SFA and reocclusion of the right popliteal arteries
    and of proximal BTK-arteries

    PROCEDURAL STEPS
    1. Left groin retrograde and cross-over approach
    - 6F 55 cm Check-Flo Performer, Raabe Modification (COOK)
    2. Guidewire passage of the occlusion
    - 0.035" stiff, angled glidewire, 260 cm (TERUMO)
    - 0.035" Seeker support catheter, 135 cm (BARD)
    - 0.018" Command 18 guidewire, 300 cm (ABBOTT)
    3. In case of failure antegrade approach via anterior tibial artery
    - 0.018" Command 18 guidewire, 300 cm (ABBOTT)
    - 0.018" Seeker support catheter (BARD)
    4. PTA with scoring balloons and DCBs
    - Vascutrak 3.0/150 mm and 4.0/120 mm (BARD)
    - Lutonix-BTK DCB (BARD)
    View image
  • - , Room 1 - Main Arena

    Case 17 – Reocclusion of right SFA, in-stent-reocclusion

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 17 – LEI 06: male, 64 years (J-H)
    Operators:
    • Matthias Ulrich,
    • Axel Fischer
    CLINICAL DATA
    PAOD Rutherford 3, painfree walking distance 50 m, ABI right 0.67
    PTA/Stent right SFA 2010

    RISK FACTORS
    Smoker, arterial hypertension, diabetes mellitus type 2

    PROCEDURAL STEPS
    1. Left groin retrograde and cross-over approach
    - IMA-diagnostic 5F catheter (CORDIS/CARDINAL HEALTH)
    - 0.035" angled soft Radiofocus guidewire, 190 cm (TERUMO)
    - 0.035" SupraCore guidewire, 190 cm (ABBOTT)
    - 8F Balkin Up&Over sheath, 40 cm (COOK)
    2. Guidewire passage and thrombectomy
    - Rotarex 8F (STRAUB MEDICAL)
    3. PTA with DCBs
    - 5.0 and 6.0 mm In.Pact Admiral drug-eluting balloons (MEDTRONIC)
    View image
  • - , Room 1 - Main Arena

    Case 18 – Extremely calcified distal SFA-occlusion left

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 18 – LEI 07: male, 66 years (B-A)
    Operators:
    • Andrej Schmidt,
    • Yvonne Bausback
    CLINICAL DATA
    Critical limb ischemia left, ulceration lateral forefoot, restpain during night
    Rutherford class 5
    Severe claudication left calf, walking capacity 50 meters
    ABI left 0.37
    PTA both iliac arteries 2/2018
    CAD, MI and PTCA 2010

    RISK FACTORS
    Art. hypertension, smoker

    PROCEDURAL STEPS
    1. Right groin and cross-over approach
    - 7F 55 cm sheath (COOK)
    2. Guidewire passage
    Antegrade:
    - 0.018" Command 18 or Connect 250 T guidewire, 300 cm (ABBOTT)
    - 4.0/40 mm Pacific balloon (MEDTRONIC)
    Retrograde in case of antegrade failure via proximal ATA left:
    - 0.018" Command 18, 300 cm (ABBOTT)
    - 0.018" Seeker 90 cm support catheter (BARD)
    3. PTA and stenting
    - 4.0, 5.0 and 6.0/40 mm Pacific balloon (MEDTRONIC)
    - Potentially Conquest high pressure balloon (BARD)
    - Supera Interwoven Nitinol Stent (ABBOTT)
    View image
  • - , Room 1 - Main Arena

    Case 19 – Long occlusion of the right SFA, CLI

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 19 – LEI 08: male, 72 years (J-H)
    Operators:
    • Matthias Ulrich,
    • Axel Fischer
    CLINICAL DATA
    CLI with ulceration dig 2 and 3 right, severe claudication right leg
    Rutherford class 5, ABI right 0.3
    Minor stroke 2013

    RISK FACTORS
    Smoker (30PY), arterial hypertension, hyperlipidemia

    PROCEDURAL STEPS
    1. Left groin retrograde and cross-over approach
    - IMA diagnostic 5F catheter (CORDIS/CARDINAL HEALTH)
    - 0.035" angled soft Radiofocus guidewire, 190 cm (TERUMO)
    - 0.035" SupraCore guidewire, 190 cm (ABBOTT)
    - 6F Balkin Up&Over sheath, 40 cm (COOK)
    2. Passage of the occlusion right SFA
    - 0.018" Advantage guidewire (TERUMO)
    - 0.018" CXI support catheter (COOK)
    3. Vessel preparation right SFA
    - Sterling 5.0/100 mm balloon (BOSTON SCIENTIFIC)
    4. Primary stenting
    - Eluvia DES (BOSTON SCIENTIFIC)
    View image
  • - , Room 1 - Main Arena

    Case 20 – ATA recanalization and dexamethason injection with a Bullfrog-device

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 20 – LEI 09: male, 80 years (N-M)
    Operators:
    • Andrej Schmidt,
    • Matthias Ulrich
    CLINICAL DATA
    PAOD Rutherford 5 left, forefeet ulcerations, ABI 0.35 left
    PTA left peroneal artery 01/2018, failled recanlisaton attempt left ATA 01/2018
    CAD, AMI 2008 and 2009, PTCA

    RISK FACTORS
    Diabetes mellitus type 2, arterial hypertension, hyperlipidemia, former smoker

    ANGIOGRAPHY
    During PTA left: distal occlusion of left ATA

    PROCEDURAL STEPS
    1. Left antegrade access
    - 6F 55 cm Flexor Check-Flo Introducer, Raabe Modification (COOK)
    2. Guidewire passage of the ATA-CTO
    - 0.014" Command ES guidewire, 300 cm (ABBOTT)
    - 3.5/120 mm Armada 14 balloon (ABBOTT)
    3. Arterial wall injection of dexamethason
    - BullFrog Micro-Infusion-Device (MERCATOR MEDSYSTEMS)
    View image

Live case transmission centers

 

During LINC Asia-Pacific 2018 several live cases will be performed from 4 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, Xin Jia, and Xiaohui Ma 
• Seoul National University Hospital, Seoul, Republic of Korea with Hwan Jun Jae, Jae Kyu Kim, Saebeom Hur, and Sang Hyun Ahn
• The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong with Bryan Yan, Steven Kum, Skyi Yin Chun Pang, and Sven Bräunlich
• University Hospital Leipzig, Department of Angiology, Leipzig, Germany with Andrej Schmidt, Matthias Ulrich, Yvonne Bausback, and Axel Fischer

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