Library

Welcome to the Library of Vascupedia. Use our filters on the left side of the page to quickly find the content of your interest. You may select an area of interest and the respective indication or the media type.

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.
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
Case report

Extreme retrograde metatarsal puncture in a complex CLI case

After an unsuccessful antegrade recanalization attempt of the ATA/DP  due to vessel perforation, an extreme retrograde puncture of the first metatarsal artery was performed. Following a  1.5 mm balloon dilatation, the rendezvous of the wires was obtained using the CART technique. 2 mm DCB balloon angioplasty of the DP, 2.5mm for the distal ATA and 3mm for the proximal ATA were subsequently performed.  The completion angio showed full blushing of the target lesion, and  excellent flow on the forefoot including the plantar arch.

December 3, 2019 1 Comment
Poll 04/10/2019 – 31/10/2019

Choice of antiplatelet therapy around complex revascularisation

A 79-year-old diabetic male patient with no history of coronary disease is referred to you to undergo angioplasty for tissue loss on the tips of the hallux and second toe. He is taking Aspirin 75mg. From preoperative imaging he needs a 20cm SFA occlusion stopping before the adductor hiatus recanalizing as well as multilevel tibial disease which appears to be a combination of short occlusions and stenoses. The dorsal pedal is seen in the foot and is in continuity with the arch. The PT artery appears occluded through it’s whole length.

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
Review of the literature

Drug-Coated balloons in BTK: Where do we stand and what are the open questions?

This presentations gives a critical overview of the Drug-coated balloons in the BTK-area. Where do we stand and what are the open questions. Review of all available studies and the literature.

January 28, 2019 No Comments
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
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

Recorded video case

Venous arterialisation for no option CLI: Limflow procedure

This case demonstrates the unique Limflow procedure for the so-called ‘no option’ CLI patients. This term is used for advanced disease with occlusion of the pedal arteries used for distal bypass or angioplasty targets. This ‘desert foot’ also represents an end-stage pathology that commonly leads to failure of all conventional revascularization attempts. In this video, you will learn the steps of the procedure, all devices needed and important technical tips and tricks for a successful outcome.

June 28, 2018 3 Comments