Michael Lichtenberg

Dr
Interventional Angiologist
  • Function: Director
  • Speciality: Angiology
  • Country: DE
  • Working place: Klinikum Arnsberg, Arnsberg, DE

Activities

Review of the literature

Iliofemoral outflow obstruction: Awareness, Diagnostic approach, Treatment strategies

This presentation gives an overview on the current evidence for diagnosic approach and treatment of acute and chronic iliofemoral venous outflow obstruction.

June 30, 2018 No Comments
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Comment on Jun 29, 2018

Xiaolei Sun commented on presentation Venous arterialisation for no option CLI: Limflow procedure.

»What a case presented. Thank Dr. Michael Lichtenberg. As for the pain and edema after the venous arterialisation, in my opinion, it is due to the pathological cause of ischemia reperfusion injury with a mount of temporary release of inflammatory factors. The better with the revascularization, the worse with the edema. Thus, some anti-inflammatory drug might be a good option, such as glucocorticoid once or twice.«
Comment on Jun 29, 2018

Michael Lichtenberg commented on presentation Venous arterialisation for no option CLI: Limflow procedure.

»Two important questions. Because of the massive venous filling after the procedure a significant edema in these patients is usually seen which causes pain. Leg elevation and bed rest for 2-3 days together with pain medication is recommended during this initial phase. Anticoagulation (Vit. K antagonist) plus at least one antplatelet medication (preferable Clopidogrel) is standard after the procedure.«
Comment on Jun 28, 2018

Theodosios Bisdas commented on presentation Venous arterialisation for no option CLI: Limflow procedure.

»Michael thank you for this excellent video. I have two questions about the postoperative course: 1. These patients develop severe pain after the revascularization, probably due to the hyperemia. Have you seen also the same problem in your patients? Do you have any specific recommendation? 2. What is the postoperative anticoagulation in those patients?«
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
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Comment on Jun 15, 2018

Michael Lichtenberg replied to your comment on presentation Revascularization of chronic iliiac vein obstruction.

»Great question Theo. I recommend to use IVUS always also after venous stent implantation to proof Aspect Ratio = 1. If AR is > 1 another post dilatation must be done to achieve good flow and long term patency (for more details see uploaded paper on lumen quality). Michael«
Comment on Jun 15, 2018

Theodosios Bisdas commented on presentation Revascularization of chronic iliiac vein obstruction.

»Dear Michael! Thank you for the nice case! What are you doing, if the IVUS shows a recoil of the stent? Repeat-PTA, Stent-in-Stent or your give time to the stent to work on the lesion? Finally, can you provide us your algorithm about anticoagulation?«
Comment on Jun 15, 2018

MARTIN MARESCH commented on presentation Revascularization of chronic iliiac vein obstruction.

»Nice case Michael. Can you make some comments regarding your access strategy? I would access PV or combine JV access for precise distal positioning of the stent. One more question is overlapping contralateral side since it's givving me bad dreams; you do have significant number of the cases- what is the incidence of the contralateral thrombosis as the consequence of compromised flow in your cohort? Have you considered other tactic (Oblique stent, Gianturco Z stent)?«
Recorded video case

Revascularization of chronic iliiac vein obstruction

Revascularization strategy of a chronic iliofemoral DVT in a 45 year old female patient with venous claudication and persistent swelling of left leg.

June 13, 2018 3 Comments
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Technical note

Lumen Shape: A New Measurement to Consider in Treatment of Iliofemoral Venous Outflow Obstruction

Exploring the role of pre-and post-procedure lumen shape in predicting patient outcomes

June 10, 2018 No Comments
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Poll 01/12/2018 – 31/12/2018

Chronic deep vein thrombosis and postthrombotic syndrome

Case presentation:

41 years old female patient presenting with swelling of both limbs, diffuse aching, heaviness and tiring of both extremities since 5 years from a previous deep vein thrombosis on both limbs. At the time of presentation, the patient showed severe dermatoliposclerosis on the right extremity and ulceration at the level of the left internal malleolus. The patient had no other risk factors except Factor V Leiden mutation.