LINC Asia-Pacific 2019 live case guide

Find all live cases and live centers listed below

Conference day 1

  • - , Room 1 - Main Arena

    Case 01 – SFA occlusion

    Center:
    Beijing PLA Hospital
    Case 01 – BPH 01: male, 62 years
    Operators:
    • Wei Guo
    CLINICAL DATA
    Severe claudication right calf for 3 years, walking capacity 100 meters
    Rutherford: 3
    TASC: B
    ABI: L 0.86, R 0.52

    RISK FACTORS
    Hypertension, smoking, DM

    PROCEDURAL STEPS
    1. Left femoral access and cross-over approach
    – 6F 55 cm sheath (COOK)
    2. Passage of the occlusion
    – 0.018" V-18 guidewire 300 cm (BOSTON SCIENTIFIC)
    – 0.018" Trailblazer support catheter, 135 cm (MEDTRONIC)
    3. POBA and DCB
    – 5/60 mm Armada 18 balloon (ABBOTT)
    – 5/60 mm DCB (AcoArt I)
    – 6/60 mm Zilver-stent (COOK) implantation in case of severe dissection
    4. Puncture site closure
    – Exoseal 6F (CORDIS/CARDINAL HEALTH)
    View image
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    Case 02 – In-stent restenosis right SFA

    Center:
    Seoul National University Hospital
    Case 02 – SNU 01: male, 74 years (M-H)
    Operators:
    • Hwan Jun Jae,
    • Saebeom Hur,
    • Sanghyun Ahn
    CLINICAL DATA
    Claudication right calf
    ABI: 0.76/0.96

    RISK FACTORS
    CAD, former smoker

    PROCEDURAL STEPS
    1. Antegrade approach right groin
    – 7F sheath (Terumo)
    2. Guidewire passage and PTA
    – 0.018" HT Command 18 LT wire 210 cm (ABBOTT) and Rubicon 18 support catheter 90 cm (BOSTON SCIENTIFIC) for intraluminal or subintimal guidewire passage
    3. Atherectomy of ISR
    – Jetstream (BOSTON SCIENTIFIC) with Emboshield (ABBOTT) or
    – HawkOne (MEDTRONIC) with SpiderFX (MEDTRONIC)
    4. PTA with scoring balloon
    – Vascutrak PTA dilatation catheters (BARD/BD)
    5. PTA
    – Lutonix drug coated balloon (BARD/BD)
    6. Bail-out stenting
    – Innova stent (BOSTON SCIENTIFIC)
    View image
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    Case 03 – Prox SFA diffuse disease and distal SFA occlusion

    Center:
    The Chinese University of Hong Kong, Prince of Wales Hospital
    Case 03 – POW 01: female, 65 years (PLT)
    Operators:
    • Bryan Yan,
    • Skyi Yin Chun Pang,
    • GuangMing Tan,
    • Sven Bräunlich
    CLINICAL DATA
    DM/HT/Lipid/IHD
    Right RF 4 claudication
    ABI right 0.5, left 0.83

    ANGIOGRAPHY
    Diagnostic angiogram shows right proximal SFA multi-focal stenosis and distal SFA occlusion

    PROCEDURAL STEPS
    1. Cross-over approach
    – 6F Destination cross-over sheath (TERUMO)
    2. Antegrade crossing
    – V18 wire (BOSTON SCIENTIFIC)
    – CTO wire (ASAHI)
    3. Retrograde distal access and wiring if antegrade failure
    4. Proximal SFA directional atherectomy
    – HawkOne (MEDTRONIC)
    – In.Pact DCB (MEDTRONIC)
    5. Bail-out stenting on indication
    – Complete nitinol-stent (MEDTRONIC)
    View image
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    Case 04 – Chronic CTO right SFA

    Center:
    Seoul National University Hospital
    Case 04 – SNU 02: male, 71 years (K-L)
    Operators:
    • Hwan Jun Jae,
    • Saebeom Hur,
    • Sanghyun Ahn
    CLINICAL DATA
    Claudication right calf, walking capacity 200 meters
    ABI: 0.72 / 0.87

    RISK FACTORS
    Art. hypertension

    PROCEDURAL STEPS
    1. Antegrade approach right groin
    – 6F sheath (TERUMO)
    2. Guidewire passage
    – 0.018“ Hi-Torque Command 18 LT wire 210 cm (ABBOTT)
    – Rubicon 18 support catheter 90 cm (BOSTON SCIENTIFIC)
    3. Predilatation
    – Sterling balloon (BOSTON SCIENTIFIC)
    4. PTA
    – Passeo-18 Lux drug coated balloon (BIOTRONIK)
    5. Bail-out stenting
    – Pulsar-18 self expanding stent (BIOTRONIK)
    View image
  • - , Room 1 - Main Arena

    Case 05 – SFA-CTO in a patient with severe claudication

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 05 – LEI 01: female, 65 years (I-S)
    Operators:
    • Andrej Schmidt,
    • Axel Fischer
    CLINICAL DATA
    Severe claudication left, walking capacity 150 meters
    ABI left 0.67, Rutherford class 3
    PTA / Stenting of the distal SFA 2016 elsewhere
    Aorto-iliac bifurcational stenting 2015, elsewhere
    CAD, PTCA 2012
    Art. hypertension, diabetes mellitus Type 2

    PROCEDURAL STEPS
    1. Antegrade access left
    – 5F 10 cm Radiofocus Introducer sheath (TERUMO)
    2. Guidewire passage
    – 0.018“ Command 18 Guidewire, 300 cm (ABBOTT)
    – Passeo 18 5.0/120 mm balloon (BIOTRONIK)

    In case of failure from antegrade:
    3. Retrograde approach via the distal SFA or stent-puncture
    – 9 cm 20 gauge needle (B. BRAUN)
    – V-18 Control guidewire, 300 cm (BOSTON SCIENTIFIC)
    4. Angioplasty, DCB-treatment and stenting
    – Passeo 18 Lux DCB 5.0/120 mm (BIOTRONIK)
    – Pulsar 18-T3 stent (BIOTRONIK)
    View image
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    Case 06 – Distal SFA-CTO left

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 06 – LEI 02: male, 62 years (F-F)
    Operators:
    • Matthias Ulrich,
    • Manuela Matschuck
    CLINICAL DATA
    Disabeling claudication left, walking capacity 100 meters
    ABI left 0.56, Rutherford class 3
    COPD, CAD

    RISK FACTORS
    Art. hypertension, diabetes mellitus Type 2, smoker

    PROCEDURAL STEPS
    1. Left antegrade access
    – 6F 55 cm sheath, Ansel-modification (COOK)
    2. Antegrade guidewire passage
    – Command 18 guidewire, 300 cm (ABBOTT)
    – CXI support catheter (COOK)

    In case of antegrade failure:
    3. Retrograde access to the proximal anterior tibial artery
    – 7 cm 21 Gauge needle (COOK)
    – Command 18 guidewire, 300 cm (ABBOTT)
    – CXI support catheter (COOK)
    4. Angioplasty and stenting
    – Advance 18 balloon 5.0/100
    View image
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    Case 07 – Long chronic total occlusion right SFA

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 07 – LEI 03: male, 63 years (F-H)
    Operators:
    • Andrej Schmidt,
    • Axel Fischer
    CLINICAL DATA
    Severe claudication right, walking capacity 150 meters
    ABI right 0.67, Rutherford class 3
    CAD, PTCA 2016
    Moderate renal insufficiency (GFR 58 ml/min)

    RISK FACTORS
    Art. hypertension

    PROCEDURAL STEPS
    1. Left retrograde and cross-over access
    – 6F 40 cm Balkin Up&Over sheath (COOK)
    2. Antegrade guidewire passage Zilver-PTX stents (COOK)
    – 6F Judkins-Right guiding catheter (MEDTRONIC)
    – CXC 0.035“ support catheter, 130 cm (COOK)
    3. Angioplasty and stenting Zilver-PTX stents (COOK)
    – Advance 35 balloon 5.0/100 mm (COOK)

    In case of residual stenosis:
    – Advance Enforcer balloon
    – Zilver-PTX stents (COOK)
    View image
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    Case 08 – CLI with total occlusion of the anterior tibial artery left

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 08 – LEI 04: male, 76 years (F-F)
    Operators:
    • Matthias Ulrich,
    • Manuela Matschuck
    CLINICAL DATA
    Critical limb ischemia left, ulcerations dig II and III
    ABI left 0.25, Rutherford class 5
    Renal insufficiency, GFR 40ml/min
    CAD, CABG 2012
    Heart failure, EF 35%

    RISK FACTORS
    Art. hypertension, former smoker

    PROCEDURAL STEPS
    1. Left antegrade approach
    – 5F 50 cm sheath, Ansel Modification (COOK)
    2. Guidewire passage
    – Command ES guidewire, 300 cm (ABBOTT)
    – 0.018“ Seeker support catheter, 130 cm (BARD/BD)

    In case of antegrade failure:
    3. Retrograde approach
    – Transpedal kit (COOK)
    – 21 Gauge 4 cm needle, 2.9F pedal sheath
    – CXI 0.018“ support catheter (COOK)
    4. PTA
    – VascuTrak scoring balloon 2.5–250 mm (BARD/BD)
    – Lutonix DCB 3.0/150 mm (BARD/BD)
    View image
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    Case 09 – Severely calcified occlusion right popliteal artery

    Center:
    University Hospital Leipzig, Department of Angiology
    Case 09 – LEI 05: male, 58 years (V-D)
    Operators:
    • Andrej Schmidt,
    • Axel Fischer
    CLINICAL DATA
    Critical limb ischemia right, minor ulcerations dig 1 right
    ABI right 0.44, Rutherford class 5
    CAD, CABG 2011
    COPD
    Renal insufficiency, GFR 65 ml/min

    PROCEDURAL STEPS
    1. Right antegrade approach
    – 7F 55 cm sheath, Ansel Modification (COOK)
    2. Guidewire passage antegrade
    – 0.018“ Connect 250 T guidewire, 300 cm (ABBOTT)
    – 0.018“ TrailBlazer support catheter, 90 cm (MEDTRONIC)
    3. Angioplasty
    Stepwise balloon-angioplasty:
    – 5.0/40 mm Armada 18 balloon (ABBOTT)
    – 6.0/40 mm Armada 18 balloon (ABBOTT)
    – 7.0/20 mm Conquest high pressure balloon (BARD/BD) (optional)
    4. Stenting
    – 5.5 or 6.5 mm Supera Interwoven Nitinol stent (ABBOTT)
    View image

Live case transmission centers

 

During LINC Asia-Pacific 2019 several live cases will be performed from 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
• Seoul National University Hospital, Seoul, Republic of Korea with Hwan Jun Jae, Saebeom Hur, and Sanghyun Ahn 
• The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong with Bryan Yan and Steven Kum
• University Hospital Leipzig, Department of Angiology, Leipzig, Germany with Andrej Schmidt

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