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Basic vascular surgery skills

Knee Disarticulation (Major Amputation)

Unfortunately, sometimes happens that we can not save a leg with our interventions. Here only the amputation remains. In this short film from the series “Basic vascular surgery skills” – you can follow the individual steps for disarticulation in the knee joint as a major amputation of the lower leg.

November 8, 2019 No Comments
Technical note

Retrograde recanalisation of the peroneal. Step by step with tips and tricks

The peroneal artery often represents the last arterial supply to the foot. The retrograde puncture of this vessel is often avoided because of its deep location and its small diameter. In this video all the tricks to succeed are presented with a step by step approach and a mix of procedural and fluoroscopical imaging to better understand the procedure

September 13, 2019 No Comments
Recorded video case

Retrograde femoropopliteal recanalization through the dorsal pedal artery

This case demonstrates the recanalization of the femoropopliteal artery in a patient with CLTI. The reason for the solely retrograde approach was a Y-graft for AAA having the anastomoses at both common femoral arteries, the above-knee amputation of the contralateral limb and the extent of the disease. Primary stent implantation was performed by using the Pulsar-18 (Biotronik) bare-metal stent, which has a 4Fr profile and a proven efficacy according to the 4EVER trial.

July 14, 2019 No Comments
Recorded video case

TUTORIAL VIDEO: Venous arterialization using conventional “off-the-shelf” devices

Although we favor a more distal location of the AVF to circumvent the need to use covered stent extensions to destroy the valves and avoid bleeding off venous flow via collaterals, sometimes (e.g. due to extreme vessel calcification) it is unavoidable to have to look for a more proximal inflow. The versatility of the VAST maneuver allows to perform a proximal DVA at the origin of the PT artery with conventional off-the-shelf devices.”

JEVT 2019 Apr;26(2):213-218
JEVT 2019 Jun;26(3):427-428

July 7, 2019 1 Comment
Technical note

Retrograde access for tibioperoneal interventions: tips and tricks

Dr. Fadi Saab (Interventional cardiologist) demonstrates important technical steps for the optimization of tibioperoneal interventions in patients with critical limb-threatening ischemia (CLTI). In this video, you will find information about the steps of retrograde puncture, important tips, the explanation of CTOP classification and many other technical issues. Moreover, the experts discuss the feasibility and safety of retrograde puncture and share their experience on the CLTI treatment

January 20, 2019 No Comments
Live case

Two different techniques for retrograde infrainguinal CTO recanalization

This live case demonstrates two different techniques of retrograde recanalization: through collaterals of the CTO and through a retrograde tibial puncture. Moreover, you will see tips and tricks about the snaring of the wire and the further steps of such a procedure. Finally, the intervention was performed with CO2 angiography due to the chronic kidney disease of this patient suffering from chronic limb-threatening ischemia (CLTI).

November 26, 2018 No Comments
Review of the literature

Treatment of CLTI in patients with chronic kidney disease

Dr. Reimers and Dr. Ferraresi (Interventional Cardiologists, Milan, Italy) present an overview of the challenges and treatment options in patients with critical limb-threatening ischemia and chronic kidney disease (CKD). They explain the BAD and SAD classification and its impact on the final outcome. Finally, a comprehensive review of the literature regarding different treatment options in CKD and hemodialysis patients with CLI is provided.

October 22, 2018 No Comments
Review of the literature

Micro-oxygen sensors for the forefoot in patients with critical limb ischemia

Dr. Bisdas (Vascular Surgeon, Athens, Greece) presents the Lumee micro-oxygen sensors (Profusa) for the monitoring of the forefoot perfusion in patients with critical limb-threatening ischemia. In this video, you will see the technology behind the device and how it works during the operation and the follow-up of the patient. Moreover, the current results and the key findings of the ongoing OMNIA study are summarized.

October 18, 2018 No Comments
Awareness

The CLI Global Society

Dr. Fadi Saab presents the background, the structure and the activities of the CLI Global Society. The lack of awareness within the healthcare community and the general public remains the biggest challenge in CLI treatment. In 2017, primary amputation was still the first-line treatment and the costs of the disease were among the greatest healthcare expenditures. In this regard, the CLI Global Society has the mission to change this and to reduce both amputation and mortality rate in this cohort.

October 11, 2018 No Comments
Poll 01/10/2018 – 31/10/2018

Critical limb-threatening ischemia – CLI Global Society

Patient’s characteristics

 

Gender: Male

Age: 79 years old

Comorbidity: Arterial hypertension, hypercholesterinemia, chronic kidney disease (GFR: 53 ml/min/1,73m²), NYHA II, Coronary artery disease, previous CABG

Symptoms:  Toe ulceration of the left limb

Previous operations: None

ABI: incompressible, Toe pressure: 32 mmHg

Vascular Imaging – Duplex ultrasound: Isolated tibial vessel disease