Our Cases of the Month

Marco M. Excellent clinical case and surgical procedure !

v22e V. visiteur2@altilab.com

omer S. perfect.

Harun A. What do you think about putting some coils inside the sac before closing the neck. Because endoleak may persist while the patient using oral anticoagulant.

haldun T. why not putting in a 5 cm TEVAR extention since htere is enough proksimal graft length and adequate distance to the orifice of brachiocephalic artery??

Nayef Z. Super

Abdulkafi T. Thank you, well done . Please keep up with this educational stamina

khalid S. Suppose the occluded stent is extending to P2, p3 segment, what to do in this situation, up to where we could land the viaban stent graft

Joshua W. Very interesting case.

Yasser H. Great job team

Benjamin F. Thank you for your feed-back!

ahmed B. Nice duoet

Eli P. Very interesting!

Eli P. Thank you!

Tameka C. Very informative. New to CTO procedures..

Denis Nikolov D. Good job ;)

Mohamed M. Good

Alexandre P. Very nice case

Ben jemaa H. :)

Mohamed amine R.

dramthirugnanam@aol.com D. position is not perfect

dramthirugnanam@aol.com D. 2 mm can be inside

v22e V. Excelent case !

venkatesa reddy D. very good result

Mangesh T. My few questions about about Long Calcified SFA Recanalisation-

1.What was the prime aim of this Interventions to treat Proximal SFA Occlusion with Directional Atherectomy or Short segment occluded SFA?

2.Is Pre-dilatation with Coronary balloons (1.5-3.5mm) always necessary before Debulking of Femoro-Popliteal lesion with Atherectomy device?

3.Exact role of Chocolate Cutting balloon could not be understud? Why so many wires & balloons are used instead of doing Straightforward Hawkone Atherectomy and then Drug coated balloon plasty with In.pact Admiral?

4.Is their any loss of Paclitexel drug while doing Balloon Plasty multiple times?

5. After 'Inline flow' Recanalisation Why not below the knee Popliteo-tibial revascularisation Not attempted in same seating?

6.Does ABI Improved after long SFA Recanalisation & return of triphasic waveform in tibial arteries?

I feel Distal Embolisation protection device has No role in this Atherectomy + DEB Case!

So many hardware material uses is Luxury for IR Consultant!!

Do you agree with my comments?

Mangesh T. Great case done. Amazing results!!

Alexandre P. Interesting, than you

dHAMANEKAR M. Good case . With low dose

FAROUK E. VERY NICE STEP AND WISE DEPLOYMENT ... WELL DONE SIR ....

aksüyek A. nice case..

Alexandre P. Interesting

Adnan J. Very nice case thanks

Endres J. To push the amplatz guidwire into the carotid bifurcation is a hazardous maneuver!

aksüyek A. is triple therapy routine in your practice?

Milan M. Its a 50% Stenosis!

Mangesh T. Highly impressed with Proper guidance, Good Selection of Hardware materials, devices used & IR Techniques applied for the Re-Vascularisation of Chronically Occluded (Thrombotic) Left ilio-femoral Venous tract. Cause offcourse May-Thurner’s Compression. Few Questions to Main operator Dr. Houman Jalaie Sir are as follows-

1) Why Atlas gold high pressure balloon used in Post Stenting Dilatation when more pressure is needed in Pre-dilatation and breaking of Chronic fibrotic synaechie in Venous lumen?

2) Mustang has 24 atm bursting pressure while Atlas Gold & Conquest PTA Ballons has 30-40 atm bursting pressure.

3) How Vessel preparation prior to Dedicated Venous Stenting matters more?

4) Can we use Popliteal Vein Access site instead of Mid thigh SFV Site? so that 10 Fr Introducer sheath can be easily fixed and Large bore Stent deployment possible with long working shaft.

5) How aggressively , How long Post Venous Stenting Anticoagulation Therapy followed? What about Surviellence & follow up check ups Schedule in this case?

Gafer A. Hi can I join the discussion

fatih U. Great result.Sometimes ballooning the lateral branch ostium makes the proximal cap and main branch visible .2,0*12 or 15 mm for this case

Tekten T. Ok

Tekten T. Good job

Tekten T.

ahmed B. Nice case, But I have a question regarding the ballon inflation in the ostial lesion with the wired not secured distally. I think if a dissection could have happened it would have turned into disaster with the wire hanging infront of the lesion

Pierre D. very educational case

hazem E. excellent comprehensive presentation to the point clear steps

Venkatesa R. very good

Tekten T. thanks

Rajesh K. do you regularly land the proximal end of the stent into IVC or try to land it at the confluence? If the external compression is at the confluence then would you be convinced to extend into IVC?

Mangesh T. 1. What was the "Hematological cause" for recurrent bilateral lower limb ilio-femoral DVT? What kind of Hypercoaguble state of the blood causing thrombosis?

2. Where is the Venous access & entry side (Mid-SFV in thigh) or CFV in groin?

3. How to fix up 10Fr large bore sheath in Chronically occluded femoral vein?

4.Venous inflow from Profunda femoris (Deep femoral) is Sufficient even if Common femoral is badly damaged?

5. Incase of "Infra-inguinal ligament" Venous stent extension and keeping it above lesser trochanter bony landmark for SFV-DFV Confluence zone; how much long term patency of 2 stents expected with post Stenting good oral Anticoagulation and Anti-Platelets??

Sameh S. highly educative

mehmet M. good result. congragulationsLeave a new comment to the discussion

Anil D. Great results

Roberto R. Congratulations

Dr. S Vijay Kumar R. excellent demonstration of truely complex case

Sandeep S. why did we have to break the end of Eluvia stent towards the end of deployment.

Georgi G. Leave a new comment to the discussion

Max A. It appears to be more convenient in long ELUVIA stent.

Collu B. Congratulations for very informative case

ahmed S. excellent

Phatarpekar A. Naice

Serob M. Thomas Hovasse, super!

Mohammed H. excellent case

Sehgal S. Very well done.

Alexander P. Great job!!!

Surabhi M. Great result

Oğuz A. Where is the video¿

Naga ganesh K. Great job

Ahmed B. This comment has been moderated

Ahmed B. This comment has been moderated

Kamran Z. Very nice case!

Do you need to oversize the sinus xl?
Does it depend on the extent of calcium or the result after predilation wheather you oversize?

Kambiz S. Excellent

Alexander P. The best

Ulises L. Great result. Just 1 question, any reason not to perform it through radial approach using a slender sheath?

venkatesa reddy D. very well done

venkatesa reddy D. excellent results , perfect stent positioning at diagonal

Milan M. Nice example! According to your experience, how do the Micromash Stents behave in highly calcified lesions? Thank You

Mohammed R. Good

Maher J. Perfect job

Maher J. Nice job

Dawood W.
Leave a new comment to the discussion

apshilava G. Good job

Roberto B. Nice job. Rota modification of LAD plaque was essential to facilitate the procedure and to allow the passage of stents to distal LAD.

Pecheux M. Great

Mohamed M. Tough case

Georgi G. Leave a new comment to the discussion

ibrahim A. thanks for this nice symposium

marie C. thank you for this nice and difficult case

Popeski P. .

Ante K. Very nice job!
In 15.33 of movie I see stenosis of PFA what is disappears in another projection.

Majed A. Sehr schön

Chakyarpoyil A. well done

Babu E. Whether floppy or extra support rota wire used in this case for LAD?

Babu E. What was the size of burr used in LAD? How to choose among 2.25mm , 2.5mm or 2.75mm burrs for a given vessel with lesion?

bajarang B. want to see the full picture sir

venkatesa reddy D. very well explained use of rota

Aprigliano G. Of course you gained an immediate acceptable angiographic result. The patient is 50 yrs old, what should we attend from this procedure in terms of long term results? DES demonstrated to reduce long term restenosis in terms of intimal iperplasia but not in terms of stent fracture. May be interesting in this case another self expandable stent with unconventional design (Supera?). Thanks for sharin

Max A. We think that we can reduce the rate of restenosis .Best regards

Popeski P. .