EMBOLIZATION DEVICE UPDATE

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1 EMBOLIC SPHERES Product Composition Type Sizes (µm) Color Coded AngioDynamics LC Bead Polyvinyl alcohol hydrogel microsphere Calibrated sphere , , Labels are color coded and the beads are tinted blue for better visualization peripheral AVMs BioSphere Medical Embosphere Trisacryl crosslinked with gelatin Spherical , , microsphere , , , Labels are color coded Embolization of AVMs, HVTs, and symptomatic uterine fibroids EmboGold AVMs Quadrasphere Super absorbent polymer Expanding Dry sizes: , spherical , microsphere peripheral AVMs Boston Scientific Contour SE Spherical PVA Sphere , , , , Packaging by size Embolization of peripheral HVTs, including leiomyoma uteri and peripheral AVMs CeloNova BioSciences, Inc. Embozene Color-Advanced Hydrogel core with Polyzene-F coating Sphere 40, 100, 250, 400, 500, 700, 900. are dyed size-specific AVMs colors for definitive visualization and increased procedural safety, with corresponding color-coded syringes, labels, and boxes. Terumo Interventional Systems Bead Block Acrylamido polyvinyl alcohol macromer Sphere , , , , Spheres, syringe, and box by size AVMs APRIL 2009 I ENDOVASCULAR TODAY I 67

2 VASCULAR PLUGS AGA Medical Product Material Amplatzer Vascular Plug Amplatzer Vascular Plug II Sizes (mm) Delivery Cable Length (cm) Recommended Guide Catheter ID Sizes (inch) Nitinol Arterial and venous embolizations in the peripheral vascula ture EMBOLIZATION COILS Boston Scientific * Product VortX-18 Diamond Shape Fibered Platinum VortX-18 Fibered Platinum Material Platinum Diameter (mm) Length (cm) Small 2.3, 4.1, secondary/large secondary: 2/3, 2/4, 2/5, 2/6 5.8, 8 2.2, 4.2, 6, 8.5 Recommended Delivery Catheter ID Sizes (inch) inch fibered platinum coils are intended for arterial and venous embolizations in the Straight.018-inch Fibered Platinum Figure inch Fibered Platinum Multi-Loop inch Fibered Platinum Complex Helical inch Fibered Platinum Multi-Loop inch Fibered Platinum Embolization VortX-35 Vascular Occlusion Interlock Fibered IDC Occlusion System Platinumtungsten alloy Straight 0.2, , 6, 7, 8, 10, 11 2, 3, 4, 5, 6, 7 3, 4, 5, 6, 7, 9 2, 3, 4, 5, For arterial and venous embolizations in the Apex diameter/base diameter: 2/4, 3/5, 3/6, 3/7 2D Helical: 3, 4, 5, 6, 8, 10, 12, 14 VortX Diamond: small secondary/ large secondary 2/3, 2/4, 2/5, 2/6 3, 3.5, 5.3, 6.7 6, 8, 10, 12, 15, 20, , 4.1, 5.8, To obstruct or reduce rate of blood flow in the device is not intended for neurovascular use *Please reference appropriate product Instructions for Use from Boston Scientific for a list of indications, warnings, precautions, and potential adverse effects. 68 I ENDOVASCULAR TODAY I APRIL 2009

3 EMBOLIZATION COILS (CONTINUED) Cook Medical Product Nester Embolization Material Diameter (mm) Length (cm) Recommended Delivery Catheter ID Sizes (inch) Platinum 4, 6, 8, 10, Arterial and venous embolization MicroNester Embolization 3, 4, 6, 8, Tornado Embolization 5-3, 6-3, 7-3, 8-4, 8-5, Embolization of selective vessel supply to AVMs, trauma, bleeding, and other vascular lesions Tornado Embolization Microcoils 3-2, 4-2, 5-2, 6-2, 7-3, 8-4, Embolization of selective vessel supply to AVMs, trauma, bleeding, and other vascular lesions Hilal Embolization Straight to Embolization of selective vessel supply to AVMs and other vascular lesions of the brain, spinal cord, and spine MReye Embolization Inconel 3, 5, 8, 10, 12, 14, 15, 20, 25 2, 3, 4, 5, 8, 10, 12, or Arterial and venous embolization Stainless Steel Embolization MReye Flipper Embolization Stainless steel 6, 8, 10, 15, 20 8, 10, Inconel 3, 5, 6.5, 8 3, 4, 5, 6, 8, 10, Arterial and venous vessel embolization in the peripheral vasculature Terumo Interventional Hydro Pushable Systems inch System Hydro Pushable inch System Hydro inch System Framing inch System Platinum and hydrogel 2, 3, 4, 5, 6, 8, 10 2, 4, 6, 10, 14 4, 5, 6, 8, 10, 15 4, 6, 10, , , 10, 15, 20 6, 8, 10 10, 15, , , 20, , 30 Platinum 8, 10, 14, 20 20, 26, 34, Arterial and venous vessel embolization in the peripheral vasculature APRIL 2009 I ENDOVASCULAR TODAY I 69

4 CEREBRAL COILS Product Materials Type Method of Detachment Key Benefits FDA Market Cleared Boston Scientific GDC Bare platinum GDC 3D, GDC 360, GDC Standard, GDC Soft, GDC Soft SR, GDC UltraSoft Matrix PGLA, bare platinum Matrix Firm, Matrix 3D, Matrix 360, Matrix Soft, Matrix SR, Matrix UltraSoft Electrolytic Durable aneurysm occlusion and benefits of healing mechanisms with Matrix biopolymer coating Codman Trufill DCS Neurovascular Orbit Bare platinum Complex Fill, Complex Standard, Mini Complex Fill, Helical Fill, and Tight Distal Loop technology Hydraulic Excellent conformability and concentric filling for outstanding packing density ev3 Inc. Axium Bare platinum Framing, filling, finishing Linear release Stretch-resistance, optimal balance of softness, stability and volume for increased packing volume MicroVention Terumo Hydro MicroPlex Bare-platinum and platinum hydrogel coated coils MicroPlex coil system (compass/complex for framing helical coils for filling HyperSoft for finishing), Hydro and HydroSoft embolic systems, which combine platinum coils and hydrogel technology (HydroSoft for filling/finishing) V-Grip controller self contained integrated power supply rapid coil : 0.75 seconds Hydrogel provides increased filling and greater mechanical stability; platinum coils provide versatile framework, stability and conformability Micrus Endovascular Micrus Stretch-resistant Endovascular bare-platinum and Microcoil cerecyte-pga coils System Micrusphere, Presidio, and Cashmere 3D ; Helipaq, Ultipaq, and Interpaq 2D Mechanical using resistive heating Frontline framing and filling coils; excellent conformability with increased packing volume; cerecyte line of enhanced embolic coils 70 I ENDOVASCULAR TODAY I APRIL 2009

5 NEUROVASCULAR LIQUID EMBOLICS Product Materials Indication Key Benefits FDA Market Cleared Codman Neurovascular Trufill n-bca Liquid Embolic System n-bca Embolization of cerebral AVMs when presurgical devascularization is desired Trufill n-bca is a clear, free-flowing PMA device liquid, which polymerizes quickly upon contact with body fluid or tissue; it offers convenient preparation and delivery, customized radiopacity for visualization, and effective penetration of AVMs ev3 Inc. Onyx Liquid Embolic System: Onyx 18 and Onyx 34 EVOH, DMSO, Tantalum US: presurgical embolization of brain AVMs; EU: embolization of vascular lesions Onyx Liquid Embolic System is an EVOH copolymer that provides full penetration and complete packing for neurovascular disorders, obliterating vascular lesions PMA device Onyx HD-500 US: treating intracranial, Onyx HD-500 is a high-viscosity saccular, sidewall aneurysms formulation liquid embolic for the that present with a wide treatment of intracranial widenecked aneurysms that provides neck ( 4 mm) or with a dome-to-neck ratio < 2 complete volumetric filling to that are not amenable to reduce recanalization and retreatment treatment with surgical clipping; EU: embolization of intracranial aneurysms HDE device Abbreviations for all charts: 2D, two-dimensional; 3D, three-dimensional; AVM, arteriovenous malformation; DMSO, dimethyl sulfoxide; EVOH, ethylene vinyl alcohol; HDE, humanitarian device exemption; HVT, hypervascular tumor; ID, inner diameter; n-bca, n- butyl cyanoacrylate; PGA, polyglycolic acid; PGLA, poly (lactic-co-gylcolic acid); PMA, premarket approval. APRIL 2009 I ENDOVASCULAR TODAY I 71