New devices Pedro Pinto Cardoso, HSM CHLN, CALM
New devices for CTOs
• Guidewires
• Microcatheters
• Radiofrequency
• Pharmacotherapy
New devices Pedro Pinto Cardoso, Serviço de Cardiologia HSM CHLN
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
New Guidewires
New devices Pedro Pinto Cardoso, Serviço de Cardiologia HSM CHLN
• SENTAI family• Samurai• Fighter• Hornet
• Asahi SION blue ES
• Suoh 03
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
SENTAI™ Guidewires
Frontline
MARVEL™ SAMURAI™
SpecialtyCrossingSAMURAI™
RC FIGHTER™ HORNET™
HORNET™10
HORNET™14
SENTAI™Family
IC-367903-AAJAN2016
©BostonScientificCorporation.AllRightsReserved.
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
Samurai™Technology
Corewire
InnerCoil Coil
Samurai™Inner CoilTechnology(ICT)
Goodtipstrength, tipflexibility,andreducedwhipping.
• Easeofshaping• Goodshaperetention• SuperioroperabilityduringaSide
BranchApproach
Corewire
Innercoil Coil
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
NameDiameter*(inch/mm)
Length(cm)
Coil(cm)
Radiopaque(cm) TipLoad(gf) Core
MaterialTip
Shape Coating
SAMURAIRC
0.014/0.36
190300 24 4 1.2 Stainless
Steel Straight Hydrophilic(FullLength)
KeyPoints
Easy-to-shape,atraumatic tip
InnerCoilTechnology(ICT)
1:1torqueability
Full coil-lengthhydrophiliccoating
Moderaterailsupport
4.5gHydrophilicCoating
0.014inch*
PTFE Coating
Radiopaque(4 cm)
CoilLength(24cm)/HydrophilicCoating(24cm)
SamuraiRC™TechnologyNewgenerationcrossingwirewithmoderatesupport
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
NameDiameter*(inch/mm)
TipDiameter**(inch/mm)
Length(cm)
Coillength(cm)
Radiopaque(cm)
TipLoad(gf)
CoreMaterial
TipShape Coating
FIGHTER 0.014/0.36
0.009/0.23
190300 18 3.5 1.5 Stainless
Steel Straight PolymerJacket,Hydrophilic
KeyPoints
Tapered tip
Clearpolymerjacket
Hydrophilic coating
Ideal prolapsewire
Moderaterailsupport
4.5gHydrophilicCoating
0.014inch*
PTFE Coating
Radiopaque(3.5 cm)
0.00
9inch**
Polymer(Coil)Length(18cm)
Fighter™Technology“Small”knucklewire– Fielder likewire
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
4.5gHydrophilicCoating
0.014inch*
PTFE Coating
Radiopaque(3.5 cm)
CoilLength(15cm)/HydrophilicCoating
0.00
8inch**
NameDiameter*(inch/mm)
TipDiameter**(inch/mm)
TotalLength(cm)
CoilLength(cm)
Radiop-aque(cm)
TipLoad(gf)
PenetrationForce
(gf/mm2)^^
CoreMaterial
TipShape Coating
Hornet 0.014/0.37
0.008/0.20
190300 15 3.5 1 31 Stainless
Steel Straight Hydrophilic
Hornet10 0.014/0.37
0.008/0.20
190300 15 3.5 10 308 Stainless
Steel Straight Hydrophilic
Hornet14 0.014/0.37
0.008/0.20
190300 15 3.5 14 432 Stainless
Steel Straight Hydrophilic
KeyPoints^
Tapered tip:lowesttipprofileonmarket(.008”)**
Hornet14:highest tiploadonmarket
Hornet 10&14:highestpenetrationforceonmarket
Hydrophilic coating
Hornet™FamilyNewgeneration penetration wires
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
AsahiSIONblueES™Newgeneration extra support wire
Atraumatic tipImproved torqueEasy navigationExcellent support
Improvesdevice deliveryAlternative toBHW/Grand Slam
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
New Microcatheters
New devices Pedro Pinto Cardoso, Serviço de Cardiologia HSM CHLN
• Asahi Caravel – new generation microcatheter
• Turnpike LP – new generation microcatheter
• FineDuo – dual lumen microcatheter
• Threader – microdilatation catheter
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
AsahiCaravel™Newgeneration microcatheter
Tapered tipHighly flexible and atraumatic tipLow profile (two in6Frguide)
Improved wire supportImproved visibility
Managed by pushing and not rotating
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
TurnpikeLP™Newgeneration microcatheter
Lower distalshaft profileIncreased flexibility inthe distalshaft and tip
Improved deliverability
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
FineDuo™
MultifunctionCatheterhavingtwoGuidewirelumen(RX/OTW)
forSideBranchAccess;especiallyhelpfulforGWmanipulationinBifurcationStentingprocedure
Duallumen microcatheter
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
Achieves
supe
riorcrossability
SUPPORT
Doublemarkersfacilitate anaccurate placementtoaccess• Any side branch orcollaterals• Themost distalstent strut
0.5mm
1.0mm0.5mm
5mm
Double radiopaque markers are located specifically for better visualization
u OTW lumen exit port in between both markers
u 1 mm Distal marker on RX lumen part
u Distal marker on RX lumen part is located at 0.5 mm
Doubleradiopaquemarkers
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
Threader™Microdilatation catheter
Joins the concept of microcatheter and pre-dilatation balloon
1.2x12mmOTWsemi-compliant balloon
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
New Concepts - out of the box tools
New devices Pedro Pinto Cardoso, Serviço de Cardiologia HSM CHLN
• Radiofrequency – PlasmaWire System
• Pharmacotherapy – Collagenase
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
PlasmaWire System™Radiofrequency
PlasmaWire System• RF Generator (RFG)• Connector Cable• Two 0.014” RF wires (PlasmaWire)• FIM results presented at TCT 2016
Plasmaablation inbone (calcium)
Clearchannel created without charring
Plasmaablation in hotdog
Clearchannelcreatedwithoutcharring(electrodesoffsetby2 mm)
Approximately0.009 inch
Approximately2mm
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
PotentialIndicationsofPlasmaWire™Systemlocalized
plasma ablation
Ablationof proximalfibrous cap
Recanalization withCTO exit
Antegrade re-entryre-entry fromsubintimawith
ablation
ablationatCTOexit
breakoffibrouscapwith ablation
Retrograde re-entrywithorw/ocalcium
ablation
channelin calciumdensecalcium
FIM of PlasmaWire
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
PotentialIndicationsofPlasmaWire™Systemlocalized
plasma ablation
Ablationof proximalfibrous cap
Recanalization withCTO exit
Antegrade re-entryre-entry fromsubintimawith
ablation
ablationatCTOexit
breakoffibrouscapwith ablation
Retrograde re-entrywithorw/ocalcium
ablation
channelin calciumdensecalcium
FIM of PlasmaWire
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
PotentialIndicationsofPlasmaWire™Systemlocalized
plasma ablation
Ablationof proximalfibrous cap
Recanalization withCTO exit
Antegrade re-entryre-entry fromsubintimawith
ablation
ablationatCTOexit
breakoffibrouscapwith ablation
Retrograde re-entrywithorw/ocalcium
ablation
channelin calciumdensecalcium
FIM of PlasmaWire
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
PotentialIndicationsofPlasmaWire™Systemlocalized
plasma ablation
Ablationof proximalfibrous cap
Recanalization withCTO exit
Antegrade re-entryre-entry fromsubintimawith
ablation
ablationatCTOexit
breakoffibrouscapwith ablation
Retrograde re-entrywithorw/ocalcium
ablation
channelin calciumdensecalcium
FIM of PlasmaWire
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
PotentialIndicationsofPlasmaWire™Systemlocalized
plasma ablation
Ablationof proximalfibrous cap
Recanalization withCTO exit
Antegrade re-entryre-entry fromsubintimawith
ablation
ablationatCTOexit
breakoffibrouscapwith ablation
Retrograde re-entrywithorw/ocalcium
ablation
channelin calciumdensecalcium
FIM of PlasmaWire
New devices Pedro Pinto Cardoso, HSM CHLN, CALM
Intra-LesionalMZ-004Collagenasefor CTOsBacterial collagenase obtained by fermentation of Clostridium histolyticum
Circulation 2003;108:1259
collagenase-enabled wire-crossing animal CTO model First-in-Man experience
• 20 patients with prior CTO PCI failure• 300 – 1200 mcg delivered into proximal cap• 15 of 20 crossed successfully 1 day later
Circulation 2012;125:522