Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

Directional Atherectomy - DA - Puttaswamy 3y data

Regsitry ste up at North Shore Aus

VP found better PP results with CLI patients than IC pateitns

PP better in larger vessels, but no diff between tibial and SFA Pop

NO distal emboi complications needed surgical inervention

No major amputation

Qn from Zeller: why differen in your study in terms of outcome at different vessels compared to other study - A: may be due difference in lesion lengths treated.

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

Ultrascore balloon data - Beasley

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

Recorded case on Serranator serration - Lichtenberg

vessel wall compliance is the main issue. Some vesle areas with very stiff hard calcium. Even broke a Terumo wire. Therefore used Go Back. Got needle into calcium. Then an 0018.

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

Serration for lumen gain - Wisgott

Serration allows greater directed force at lower pressures

Slow inflation

Can treat all lesion morphologies

Christian Wisgott

Even showed a case of focal non-response to atherectomy that worked with Serranator

Schneider comments - learning from dCB era that vessel prep v important.

Bob Beasley from Miami agrees with what PS says. Interesting that may take atherectomy out of the picture.

Deloose - can it be definitive Rx in BTK?

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

PMT and Scaffolds BTK - discussion Scheinert

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

Drug eluting scaffolds at BTK - Lieven Maene

The challenges with BTK have not changed much in 2 decades.

Focus more on vessel prep and vessel check. WE were undertreating! Underestimated the diameter BTK.

Also were underestimating the exten of dissections.

Changed approach - incorporated vessel check. Extravascular US. Built into the machine.

Need scaffold. Scaffolds do affect negative remodelling so need drugs, may need long term drugs.

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

ALI Rx with JET-i percutaneous thrombectomy

JET-i system. Israel made.

6F device for arterial 8F venous

high pressure saline pump

50m IC ED pxn

150 cm long stents SFA Pop all occluded

started with 35 wires then 0018 for the JET-i

pushablility and trackability over the 6F are very good. Even on organised blood clots. It can track through stents even without the guide wire scafoold.

Good result no signs of distal embolisation.

Questions

Comparable for arterial the Rotarex and the JET-i.

Suggests prospective trials (ML). DS says - how imporant is th pulse spray? ML - think it is… rubber-like material in the viabahn.

how much blood loss? average 150-200 mls.

ANy experience with PE so far? No.

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

SUPERSUB - 2 yr Supera data from Abano Terms

Palena

Tasc C and D Supera study - not reandomised, observational

Correction PP was 12 mo not 24 as says on slide

enrolled 92 pts

All lesions treated were CTO

Lesion length 26 cm on average

Most reinterventions happeneed within the 1st year

The fatal MI was 5months after procedure

All pts at baseline were Rutherford 4,5,6

They did SF12 data too

Questions from Dierk S

Palena says Eluvia data is competitive. Difficult to compare populations. Supersub data has NO endoluminal crossing patients. Diffiutl to filter out the effect of drug elution. Difficult to compare that with the mimetic technology effect / impact.

9% comlication rate with PRESTO technique… how should we deal with the puncture holes?

We are aggressive with labelling complication. Even a pre dilation perforation is marked by us as a copmlication, such as during vessel prep.

Qn: yo used quite a few 4mm Supera?

We tried to avoid even the 4.5mm diameter … however the P3 cases perform well with the smallest one. Some other of our centres were using 4mm.

How many stent occlusions in FU (DS)? Comparing freedom from TLR and PP there is not much difference. Have the percentages not the exact number…Not many.

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

Multicentre Polish AIOD data

From Poznan

DM and CKD in about 20-25% cases

Used brachial access in only 20% patients

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

Five year FU data on CERAB

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

BELSTREAM - first data set on BD Lifestream

Data on use of BD’s Balloon Expandable Covered stents - Lifestream - for AIOD

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

Versatility of Advanta V12 : M Steinbauer

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

AIOD presentations on VBX and Viabahn

VBX slides by Jean Bismuth, Viabahn pxn by Piazza

PIAZZA - self expanding pitch

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

RE-ENTRY. Pioneer. Mo Hamady.

Mo Hamady from Imperial. 31 cases with a mean lesion length of 14 cm and FU of 12 months.

Sean Matheiken 6/6/22 Sean Matheiken 6/6/22

CERAB. Andrej. Live. 6.6.22

Commenced session with intro by Dierk Scheinert

AIOD. 6 Jun 2022 Monday is BH in Germany.

10-14 measurement on the disal aorta

not really calcified

choosing CERAB

coming from arm

Rretro up from left with Command 18 was very easy

6 balllon coming in

5F from the arm. Took a straight stiff Terumo and hammered with n o success

cut off the Judkins tip for better grip - no luck

changed to 6F at the arm and used a Multi 6F and a Judkins

Tried a CTO wire no luck

Supracore wires

somtehing about trying to get into a balloon …

different angulations to see distance between wires

Ballooned balloon below then sent the wire from above down - it passed down then into the EIA easily

useing a Jukdins wide catehter and passed the brachial wire into it - usually easy in a narrow EIA

Now chaning from 18 to 35 system for better stability

Now - decide “what to take in”

REturn3ed to Andrej after 4 talks, case completed. Has placed a large single aortic stent and then CERAB reconstructions from both groins. Interestingly did not have retained wire cacess from teh left recanalised CTO while he deployed the top aortic!

Used V12s all the way through I think?