challenging bilateral iliac occlusions · il c/d leslons. the prtmarr endpoint was a composite of...

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Challenging Bilateral Iliac Occlusions Mr. Hany Zayed MD, MSc, FRCS Consultant Vascular Surgeon Guy’s and St. Thomas’ NHS Foundation Trust

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Page 1: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30

Challenging Bilateral Iliac Occlusions

Mr. Hany Zayed MD, MSc, FRCS

Consultant Vascular Surgeon

Guy’s and St. Thomas’ NHS Foundation Trust

Page 2: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30

Disclosure

Speaker name:

.................................................................................

I have the following potential conflicts of interest to report:

Consulting

Employment in industry

Stockholder of a healthcare company

Owner of a healthcare company

✓ Other(s)

I do not have any potential conflict of interest

Page 3: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 4: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 5: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 6: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 7: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 8: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 9: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 10: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 11: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 12: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30

• 74 Yrs

• Cardiovascular Risk Factors:

IHD, Coronary stenting

Pacemaker

HTN

Hyperchol.

• Life-limiting Intermittent Claudication:

Sole carer of Wheelchair-bound wife.

• Best medical treatment

• Completed SET

Page 13: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 14: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30

Revascularisation Plan

• Right Femoral endarterectomy + Access

• Left Brachial Percutaneous Access:

Imaging

Antegrade recanalisation if Retrograde approach fails

• Left Femoral Percutaneous Access

Page 15: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 16: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 17: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 18: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 19: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 20: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 21: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 22: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30

Which Covered-Stent to use ?

Page 23: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 24: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 25: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30
Page 26: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30

Conclusion

• VBX is a useful addition to the endovascular armamentarium.

• Potential solution to challenging Aorto-Iliac occlusive disease.

Page 27: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30

Thank You

Page 28: Challenging Bilateral Iliac Occlusions · Il C/D leslons. The prtmarr endpoint was a composite of device- or procedure-related death w'thln 30 days. myocardial hfarctlon wlthln 30

Challenging Bilateral Iliac Occlusions

Mr. Hany Zayed MD, MSc, FRCS

Consultant Vascular Surgeon

Guy’s and St. Thomas’ NHS Foundation Trust