A.Z. Sint-Blasius, Dendermonde

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Presentation transcript:

A.Z. Sint-Blasius, Dendermonde Real Life Experience of Endovascular first approach in TASC C and D patients after BRAVISSIMO Marc Bosiers Koen Deloose Joren Callaert Imelda Hospital, Bonheiden Patrick Peeters Jürgen Verbist OLV Hospital, Aalst Lieven Maene Roel Beelen R.Z. Heilig Hart, Tienen Koen Deloose, MD Koen Keirse

Patient demographics Gender : female Age : 55 years Medical history : Since 2002: COPD due to nicotine abuse Risk factors : Nicotine abuse (35 pack years) Arterial Hypertension

Pre-op symptomatology Symptoms : Bilateral intermittent claudication with walking distance <50m (Rutherford 3) Duplex US: Impeded flow over the entire femoral tract ABI left = 0.52 ABI right=0.76

Pre-op MR Angiography

What to do with this type D lesion?

TASC II prefers open surgery…

People prefer minimally invasive…

Brachial access 4F long sheath, 90cm

Lesion passage : left leg 0.035 curved stiff nitinol wire 4F Vertebral Glidecath, 120cm

Lesion passage : left leg

Lesion passage : left leg

Lesion passage : left leg

Lesion passage : right leg 0.035 curved stiff nitinol wire 4F Vertebral Glidecath, 120cm

Lesion passage : right leg

Lesion passage : right leg

Bilateral femoral retrograde access

Bilateral femoral retrograde access

Bilateral femoral retrograde access

Bifurcation stenting Kissing stents: 2x Omnilink Elite 7.0/59mm balloon expandable stents

Bifurcation stenting

Bifurcation stenting

Bilateral external iliac stenting 2x Absolute Pro 7.0/100mm self-expanding stents

Post-op angiographic control

Post-op angiographic control

Post-op angiographic control

Post-op angiographic control

…does it work on the long run? Physician initiated multi-center Belgian-Italian tRial investigating Abbott Vascular Iliac StentS In the treatMent of TASC A, B, C & D iliac lesiOns Omnilink Elite balloon-expandable stent Absolute Pro self-expanding nitinol stent