1. 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

2. 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

3. 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

4. Pre-op MR Angiography

5. What to do with this type D lesion?

6. TASC II prefers open surgery…

7. People prefer minimally invasive…

8. Brachial access
4F long sheath, 90cm

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

10. Lesion passage : left leg

11. Lesion passage : left leg

12. Lesion passage : left leg

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

14. Lesion passage : right leg

15. Lesion passage : right leg

16. Bilateral femoral retrograde access

17. Bilateral femoral retrograde access

18. Bilateral femoral retrograde access

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

20. Bifurcation stenting

21. Bifurcation stenting

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

28. Post-op angiographic control

29. Post-op angiographic control

30. Post-op angiographic control

31. Post-op angiographic control

32. …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