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Experts opinion
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LINC 2020: Prestige Pilot study — IVUS guided atherectomy and DCB therapy Dr Michael Lichtenberg

Dr Michael Lichtenberg (Vascular Centre Clinic Arnsberg, Arnsberg, DE) discusses the latest findings from the Prestige Pilot study. Prestige Pilot investigates if a lesion preparation strategy with Phoenix® atherectomy before DCB (drug coated balloon) usage in patients with PAD (peripheral artery disease) Rutherford Stage 4-5 and mild/moderate/severe calcium can improve outcomes including patency and limb salvage and evaluate safety and performance of the combination therapy.
Vascupedia VIEWS 2.0

Vascupedia VIEWS Episode 6 Vein bypass grafting: tips and tricks to beat all endovascular techniques

Vascupedia Views Episode 6

Vein bypass grafting: tips and tricks to beat all endovascular techniques

Dr. Hany Zayed  (UK)

Moderator: Dr. Lorenzo Patrone (UK)

May 20, 2020 2 Comments
Experts opinion
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IVUS vs Angiography in patients with peripheral vascular disease

Dr Konstantinos Stavroulakis (St. Franziskus Hospital, Münster, DE) discusses Angiography alone in the lower limb - First results comparing IVUS and angiography in the leg. Questions : 1.What was the need for comparing IVUS and angiography in the leg? 2.What are your findings to date and what conclusions (if any) can be made? 3.What further data should be anticipated from the trial? 4.What further research, in your opinion, is needed? Source: https://www.radcliffevascular.com
Recorded video case

IVUS guided kissing endovascular lithoplasty and bare-metal-stent implantation for a coral reef aortic stenosis in visceral segment

Recorded case of a 72 yrs old woman with CLTI (Rutherford V,  TASC D lesion), not suitable for open repair, treated in a hybrid setting with IVUS guided kissing endovascular lithoplasty and bare-metal-stent implantation for a coral reef aortic stenosis in visceral segment, with a stent-graft for the right CIA and bare-metal-stent for the right CEA for the iliac high-grade stenosis and a femorofemoral bypass.

May 14, 2020 No Comments
Case report

Anterior tibial artery revascularization with piercing technique.

This case report was previously published in CLIC LATAM course in 2019.

We report case of a 60-year-old male patient with a history of hypertension and diabetes mellitus who currently has critical limb ischemia of the left foot with rest pain and trophic disorders at second and third toes and the forefoot. (WIfI 122 classification).

Angiography showed occlusion of both tibial arteries.

Due to the high risk of amputation, it was decided to continue with angioplasty of both tibial arteries.

Strategy:

Ultra-sound guided puncture of the left common femoral artery.

5 Fr sheath placement.

CXI support catheter.

V-14 and V-18 guidewires.

Conventional balloon angioplasty.

Endoluminal and antegrade revascularization with balloon angioplasty of the posterior tibial artery was performed without complications.

The anterior tibial artery could not be recanalized anterogradely with the V-14 guide, so a V-18 guide was used. Once the V-18 guidewire was located in the dorsalis pedis artery, an unsuccessful attempt was made to progress the CXI catheter to be able to exchange the 0.018” guide for a 300 cm 0.014” guide and perform balloon angioplasty due to the severe calcification of the vessel. A piercing technique was performed by fracturing arterial calcium with the percutaneous puncture of the vessel with an 18G puncture needle at the ankle level. Then, the progression of the  CXI catheter towards the dorsalis pedis artery is achieved and the exchange of guides is carried out to continue with balloon angioplasty. There were no complications secondary to the use of an aggressive technique such as “piercing” in this case, which carries a high risk of amputation without adequate revascularization.

May 3, 2020 2 Comments