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CLINICAL DATA Rest pain left foot, Rutherford class 4 Severe claudication left, walking capacity 100 meters Angiography during PTA right iliac arteries after coronary angiography 12/2015 ABI Left 0.42 RISK FACTORS CAD with PTCA 12/2015 Carotid TEA bilateral (19) Permanent atrial fibrillation Chronic renal insufficiency GFR 62 ml/min Former smoker, art. Right groin retrograde and cross-over approach - 0.035" Supra Core Guidewire 190 cm (ABBOTT) - 7F-40 cm Balkin Up&Over Sheath (COOK) 2. Retrograde approach via the proximal anterior tibial artery - 21 Gauge 7 cm Micropuncture needle (COOK) - 0.018" Connect Guidewire 300 cm (ABBOTT) - 0.018" Quick Cross Support-Catheter 90 cm (SPECTRANETICS) 4.

hypertension, diabetes mellitus type 2, former smoker PROCEDURAL STEPS 1.

Right groin retrograde and cross-over approach - IMA-diagnostic 5F-catheter (CORDIS/CARDINAL HEALTH) - 0.035" angled soft Radiofocus glidewire, 190 cm (TERUMO) - 0.035" Supra Core guidewire, 190 cm (ABBOTT) - 8F Balkin Up&Over Sheath, 40 cm (COOK) 2. Stenting on indication - Epic Selfexpanding Nitinol-Stent (BOSTON SCIENTIFIC) CLINICAL DATA Severe claudication left calf, walking-capacity 150-200 meters since 9/2015 ABI left 0,67 Stenting left SFA 08/2014 Stenting iliac arteries left 2003 and right 12/2015 CAD with PTCA 2003 RISK FACTORS Art.

H., Eric Lumiere, Mark Sixma presents M6, Assaf, Nathan Nicholson, Shinovi, The Thrillseekers, Re Order, Above & Beyond, Omnia, Marco V, Skylex, Radion6Daniel Kandi, Soren Andrews, Jack Vath, Breame, Noise Zoo, Jeef B, Mhammed El Alami, Seawayz, Sollito, Taival, Falcon, Alex Wright, Mohammed Khalila, Edelways, Miroslav Vrlik, Martin Jurenka, Witness45, Moonsouls, Raminio, Forion, Symon & Jay, Suncatcher, Exolight, Anders Duvald, Sam Laxton, Andre Visior, Dreamy, Naoufal Lamrani, Julia Lav, Emanuele Congeddu, First Sight, Mike Van Fabio, Matt Cerf, Jaren, Feel, Rene Ablaze, Fiona Reid, Aimoon, Ozzyxpm, Suzy Solar, Matt Chowski, Xenera, Ma2shek, Ferry Tayle, Kiran M, Suncatcher, Temple One, Zack Mia Above & Beyond, Justine Suissa, Andrew Bayer, Dirty South, ANIMA!

T Project, Ridgewalkers, Aimoon, NX-Trance, Fresh Code, Roman Messer, Second Reason, Attila Syah, Gamma (Ind), Darren Porter, Photographer Alan Morris, Ana Criado, Adam Ellis, Fenna Day, Susana, Kaimo K, Jo Cartwright, Re Order, Katty Heath, Richard Durand, Neev Kennedy, Nitrous Oxide, Maria Nayler, Sarah Russell, Somna, Cathy Burton, Liam Wilson, Diana Leah, The Opposiz, Mike Van Fabio, Gemma Pavlovic, Mhammed El Alami, 4 Strings, Denise Rivera, Store N Forward, Sylvia Brandse, Ellie Lawson, Myde, Elles De Graaf, Jericho Frequency, Stargazers, Beat Service, Fredd Moz, DJ Xquizit, Tim Hilberts, Andre Visior, Raz Nitzan, Kate Louise Smith, Chris Metcalfe, Bluskay, Key Player, Esmee Bor Stotijn, A. Postdilatation of the whole graft - Exchange to 12F-12 cm sheath bilateral (COOK) - Reliant balloons both sides (MEDTRONIC) CLINICAL DATA Incidental finding of an eccentric AAA, 5.3 cm diameter RISK FACTORS CAD with NSTEMI 10/2015, PTCA LAD Chronic renal insufficiency (GFR 72 ml/min) Art. Percutaneous access both groins in local anaesthesia - 5F-10 cm Radifocus-sheaths (TERUMO) - 0.035" Supra Core guidewire 190 m (ABBOTT) - Preloading of 2 Proglide-systems per groin (ABBOTT) - 0.035" Lunderquist 260 cm guidewires bilateral (COOK) 2.Graft implantation - Implantation of the Altura Stentgraft system and extension to the hypogastric artery bilateral (LOMBARD MEDICAL) 3.Passage of the occlusion - Stiff angled Radiofocus guidewire 0.035”, 260cm (TERUMO) - Armada 35 balloon 4.0/120mm (ABBOTT) In case of failure form antegrade: - Retrograde approach vie peroneal or posterior tibial artery 3. Stenting - Supera Interwoven Nitinol Stent (ABBOTT) CLINICAL DATA Incidental finding of an eccentric AAA, 5.3 cm diameter RISK FACTORS CAD with NSTEMI 10/2015, PTCA LAD Chronic renal insufficiency (GFR 72 ml/min) Art. Percutaneous access both groins in local anaesthesia - 5F-10 cm Radifocus-sheaths (TERUMO) - 0.035" Supra Core guidewire 190 m (ABBOTT) - Preloading of 2 Proglide-systems per groin (ABBOTT) - 0.035" Lunderquist 260 cm guidewires bilateral (COOK) 2.PTA - Armada 5/40 and 6/40 mm balloon (ABBOTT) - Conquest High Pressure Balloon (C. Graft implantation - Implantation of the Altura Stentgraft system and extension to the hypogastric artery bilateral (LOMBARD MEDICAL) 3.Passage of the in-stent occlusion left SFA - Judkins Right 5F-catheter (CORDIS/CARDINAL HEALTH) - 0.035" Radiofocus angled stiff glidewire, 260 cm (TERUMO) - Exchange to 0.018" Guidewire (STRAUB MEDICAL) 3. hypertension, diabetes mellitus type II, former smoker PROCEDURAL STEPS 1.

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