CLINICAL DATA
PAOD Rutherford 3
DM Hypertension Graves Disease
AF EF 60% Cr normal
PROCEDURAL STEPS 1. Antegrade access via right groin
- 6F sheath (TERUMO)
2. Passage of the lesion with hydrophilic wire
- 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
- 4F Ber II catheter (CORDIS)
3. Retrograde ATA access in event of antegrade failure
- 4F Micropuncture® Pedal Access Set (COOK)
- 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
- 2.6F CXI support catheter, 90 cm (COOK)
4. Predilatation and lesion preparation
- 3.5 x 120 Chocolate balloon (QT VASCULAR)
5. PTA with DEB
- In.Pact Pacific 4 or 5 x 120 mm DEB-balloon (MEDTRONIC)
CLINICAL DATA
PAOD Rutherford 3
DM hypertension hyperlipidemia EF 60% Cr 140
PROCEDURAL STEPS 1. Contralateral cross-over access via left groin
- 0.035" Radiofocus Terumo angled soft guidewire, 260 cm (TERUMO)
- 4F Ber II catheter (CORDIS)
- 0.035" Supra Core guidewire, 300 cm (ABBOTT)
- 6F 40 cm long Balkin sheath (COOK)
2. Passage of the lesion with hydrophilic wire and predilatation
- 0.018" V-18 Control Wire, 300 cm (BOSTON SCIENTIFIC)
- 0.035" Radiofocus Terumo angled soft guidewire, 250 cm (TERUMO)
- 4F Ber II catheter (CORDIS)
- 0.018" Trailblazer support catheter (COVIDIEN)
3. Vessel preparation
- 4 or 5 x 120 mm 3.5 x 120 Chocolate balloon (QT VASCULAR)
4. Treatment with DEB
- In.Pact Pacific 5/6 x 120 mm DEB-balloon (MEDTRONIC)
5. Stenting on indication
- Spot-stenting with a COMPLETE SE stent (MEDTRONIC)
CLINICAL DATA
Left leg swelling previous DVT right Ca Breast
CT venogram done
Diagnostic angio and IVUS done
PROCEDURAL STEPS 1. General anaesthesia
2. Left mid SFV access under ultrasound
- 5F sheath (TERUMO)
- 12F Peel-away Safe-sheath (ANGIODYNAMICS)
3. Passage of the lesion with hydrophilic wire and stiff wire
- 0.035" Radiofocus angled soft guidewire, 260 cm (TERUMO)
- 4F Ber II catheter (CORDIS)
- 0.035" Supra Core guidewire, 300 cm (ABBOTT)
4. Venogram and IVUS
- 8.5F Visions® PV.035 (VOLCANO)
5. Predilatation
- 12 x 40 Mustang balloon (BOSTON SCIENTIFIC)
- 16/18 x 40 Atlas balloon (BARD)
CLINICAL DATA
PAOD Rutherford 3
COPD hypertension hyperlipidemia IHD EF 60% CKD Cr 200
PRESENT STATE
Left hip replacement Ca prostate CO2 angiography done
PROCEDURAL STEPS 1. Antegrade access via left groin
- 5F sheath (TERUMO)
- CO2 angiography with CO2 angioset (OPTIMED)
2. Passage of the lesion with hydrophilic wire
- 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
- 4F Ber II catheter (CORDIS)
3. Retrograde distal SFA access in event of antegrade failure
- Supine frog leg position
- 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
- 2.6F CXI support catheter, 90 cm (COOK)
4. Predilatation and lesion preparation
- Paseo 18 4/5 x 120 balloon (BIOTRONIK)
5. PTA with DEB
- Lux 5 x 120 mm DEB-balloon (BIOTRONIK)
6. Postdilatation and stenting on indication
- REEF 5 x 40 high pressure balloon (MEDTRONIC)
- 4F Pulsar 18 stent (BIOTRONIK)
CLINICAL DATA
CLI left 2nd toe gangrene
PAOD Rutherford 5
DM hypertension hyperlipidemia Cr 116
PROCEDURAL STEPS 1. Antegrade access via left groin
- 5F sheath (TERUMO)
2. Antegrade passage of the lesion with hydrophilic wire
- 0.014" COMMAND Extra support wire 300 cm (ABBOTT)
- 2 x 80 Armada 14 (ABBOTT)
3. Retrograde passage of lesion via ultrasound guided DP puncture
- 4F Micropuncture® transpedal set (COOK)
- EDGE ultrasound high frequency probe (SONOSITE)
- 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
- 2.6F Angled CXI support catheter, 90 cm (COOK)
4. Predilatation and lesion preparation
- 2.5 x 100 mm Vascutrak scoring PTA catheter (BARD)
5. PTA with DEB
- 2.5 or 3 x 120 mm Lutonix drug-coated balloon (BARD)
CLINICAL DATA
Left leg claudication PAOD Rutherford 3
DM hypertension left CFA
Endarterectomy right SFA stent
EF 60%
CKD Cr 190
PROCEDURAL STEPS 1. Contralateral cross-over access via right groin
- 0.035" Radiofocus angled soft guidewire, 260 cm (TERUMO)
- 4F Ber II catheter (CORDIS)
- 0.035" Supra Core guidewire, 300 cm (ABBOTT)
- 6F 40 cm long Balkin sheath (COOK)
- CO2 angiography with CO2 Angioset (OPTIMED)
2. Passage of the lesion with CTO device and predilatation
- Truepath CTO device (BOSTON SCIENTIFIC)
- 0.018" Rubicon catheter (BOSTON SCIENTIFIC)
- 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
- Sterling balloon 4 x 120 (BOSTON SCIENTIFIC)
3. Treatment with DEB and postdilatation
- Ranger drug eluting balloon 5/6 x 120 (BOSTON SCIENTIFIC)
- Mustang balloon 6 x 40 (BOSTON SCIENTIFIC)
4. Stenting on indication
- Spot-stenting with Innova stent (BOSTON SCIENTIFIC)
CLINICAL DATA
Left leg claudication PAOD Rutherford 3
DM hypertension hyperlipidemia PCI 2011 EF 55% Cr normal
Left SFA stent in subintimal spot stent Taiwan late 2014
PROCEDURAL STEPS 1. Contralateral cross-over access via right groin
- 0.035" Radiofocus angled soft guidewire, 260 cm (TERUMO)
- 4F Ber II catheter (CORDIS)
- 0.035" Supra Core guidewire, 300 cm (ABBOTT)
- 6/8F 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 angled soft guidewire, 250 cm (TERUMO)
- 4F Ber II catheter (CORDIS)
3. Retrograde puncture of occluded stent in event of antegrade failure
- 0.035" Radiofocus angled soft guidewire, 250 cm (TERUMO)
- 4F CXI support catheter, 90 cm
4. Mechanical thrombectomy and debulking
- Predilatation with Powercross 3 x 120 balloon (COVIDIEN)
- 6/8F Rotarex (STRAUB MEDICAL)
CLINICAL DATA
Right leg claudication PAOD Rutherford 3
DM hypertension hyperlipidemia EF 69% Cr normal
Right CFA endarterectomy and patch Oct 2014 failed antegrade attempt
PROCEDURAL STEPS 1. Antegrade access via right groin
- 6F sheath (TERUMO)
2. Passage of the lesion with hydrophilic wire
- 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
- 4F Ber II catheter (CORDIS)
3. Retrograde PT access in event of antegrade failure
- 4F Micropuncture® pedal access set (COOK)
- 0.018" V-18 control wire, 300 cm (BOSTON SCIENTIFIC)
- 2.6F CXI support catheter, 90 cm (COOK)
4. Predilatation and lesion preparation
- 5/6 x 120 mm Fox SV (ABBOTT)
- 5/6 x 40 mm Armada 35 (ABBOTT)
5. Stent implantation and postdilatation
- SUPERA 5 mm x 150 stent (ABBOTT)
6. Consider treatment of runoff
- 0.014" COMMAND extra support wire, 300 cm (ABBOTT)
- 2.5 x 15 NC TREK balloon for PT lesion (ABBOTT)
7. Implantation of bioabsorbable scaffold
- 2.5 x 28 ABSORB bioabsorbable vascular scaffold/BVS (ABBOTT) for TPT and PT lesion
CLINICAL DATA
PAOD Rutherford 3
DM hypertension hyperlipidemia EF 60% Cr 140
PROCEDURAL STEPS 1. Contralateral cross-over access via right groin
- 0.035" Radiofocus angled soft guidewire, 260 cm (TERUMO)
- 4F Ber II catheter (CORDIS)
- 0.035" Supra Core guidewire, 300 cm (ABBOTT)
- 7F 40 cm long Balkin sheath (COOK)
2. Passage of the lesion with hydrophilic wire and filter placement
- 0.014" PT2 MS 300 cm guidewire (BOSTON SCIENTIFIC)
- 4F Ber II catheter (CORDIS)
- 0.018" Trailblazer support catheter (COVIDIEN)
- Spider FX 3 mm into ATA (COVIDIEN)
3. Directional arterectomy
- Turbohawk (COVIDIEN)
4. Treatment with DEB
- In.Pact Pacific 5/6 x 120 mm DEB-balloon (MEDTRONIC)
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