US AORTIC PRODUCT CATALOG

Transcription

1 US AORTIC PRODUCT CATALOG Endurant Aptus II/IIs Valiant Captivia Heli-FX EndoAnchor System Aptus EndoAnchor TourGuide Sentrant Reliant

2 Endurant II/IIs Endurant AUI Talent Occluder Valiant Captivia Aptus EndoAnchor Aptus TourGuide Sentrant Reliant

3 TABLE OF CONTENTS 02 Endurant II / IIs AAA Stent System 28 Talent Occluder with Occluder Delivery System 30 Valiant Thoracic Stent 44 Aptus Heli-FX EndoAnchor System 46 TourGuide Steerable Sheath Captivia Delivery System 48 Sentrant Introducer Sheath with Hydrophilic Coating 50 Reliant Stent Balloon Catheter

4 Endurant II / IIs AAA Stent System FEATURES* Endurant IIs Expands Anatomical Customization Options A three-piece system that leverages the proven design of the Endurant II abdominal stent graft Enables in-situ sizing with select ipsilateral limbs, allowing a 3-5 stent overlap for adjustment during case Allows easier pre-case planning to simplify sizing Low Profile and Easy Access Low profile and hydrophilic coating enhances access and trackability Flexible, kink-resistant delivery system facilitates stent graft delivery Complete Conformability, Optimal Seal M-shaped proximal stents provide wall apposition and minimize infolding for a short sealing zone in the infrarenal aorta Laser cut suprarenal stent anchor pins provides secure fixation to mitigate migration Spacing between limb stents optimized to conform to anatomy to reduce kinking Total Control Provides Consistent Precision Tip capture mechanism allows for precise positioning and intraoperative adjustments. Backend thumb wheel provides controlled release of the suprarenal stent and anchor pins Improved radiopacity provides increased visibility Four proximal markers assist in accurate deployment e- shaped marker assists with A/P orientation Durable Design, Dependable Performance Ultra-high molecular weight polyethylene sutures are three times stronger than surgical sutures High-density multifilament polyester graft material provides low porosity Electropolished nitinol stents improve fatigue resistance * Test data on file at Medtronic. Bench test results may not be indicative of clinical performance. Contralateral gate marker. 2

5 ENDURANT II/IIS SHORT NECK. LONG HISTORY. 3

6 Endurant II / IIs AAA Stent System PRODUCT CODE DESCRIPTION ET B F C 124 E 18 Device Configuration B - Bifurcations L - Limbs E - Iliac Extension C - Extensions & Cuffs T - Extensions & Cuffs U - Aorto-uni-iliac (AUI) Product Name ET - Endurant II ES - Endurant IIs Proximal Proximal Design F - FreeFlo W- Open Web Total Covered Length Design C - Closed Web Catheter Outer Delivery System E - Endurant II 4 ENDURANT IIs BIFURCATIONS Proximal Product Code Design Total Covered Length Delivery System Catheter Outer (F) ESBF C 103 E 18 ESBF C 103 E 18 ESBF C 103 E 18 ESBF C 103 E 20 ESBF C 103 E 20

7 ENDURANT II BIFURCATIONS Product Code Proximal Design Total Covered Length Delivery System Catheter Outer (F) ETBF C 124 E 18 ETBF C 145 E 18 ETBF C 166 E 18 ETBF C 124 E 18 ETBF C 145 E 18 ETBF C 166 E 18 ETBF C 124 E 18 ETBF C 145 E 18 ETBF C 166 E 18 ETBF C 124 E 18 ETBF C 145 E 18 ETBF C 166 E 18 ETBF C 124 E 18 ETBF C 145 E 18 ETBF C 166 E 18 ETBF C 124 E 18 ETBF C 145 E 18 ETBF C 166 E 18 ETBF C 124 E 18 ETBF C 145 E 18 ETBF C 166 E 18 ETBF C 124 E 20 ETBF C 145 E 20 ETBF C 166 E 20 ETBF C 124 E 20 ETBF C 145 E 20 ETBF C 166 E 20 ETBF C 145 E 20 ETBF C 166 E 20 ETBF C 145 E 20 ETBF C 166 E 20 5

8 Endurant II / IIs AAA Stent System LIMBS* Proximal Product Code Design Total Covered Delivery Length System Catheter Outer (F) Total Contralateral Covered Length with EII/EIIs Bifurcated Total Ipsilateral Covered Length with EIIs Bifurcated ETLW C 82 E ETLW C 93 E ETLW C 124 E ETLW C 156 E ETLW C 199 E ETLW C 82 E ETLW C 93 E ETLW C 124 E ETLW C 156 E ETLW C 199 E ETLW C 82 E ETLW C 93 E ETLW C 124 E ETLW C 156 E ETLW C 199 E ETLW C 82 E ETLW C 93 E ETLW C 124 E ETLW C 156 E ETLW C 199 E ETLW C 82 E ETLW C 93 E ETLW C 124 E ETLW C 156 E ETLW C 199 E ETLW C 82 E ETLW C 93 E ETLW C 124 E ETLW C 156 E ETLW C 199 E * The limb mates with the AUI stent graft on the ipsilateral side. These calculations assume the minimum 30 mm overlap between the bifurcated stent graft and the contralateral iliac limb per the Endurant II Stent System Instructions For Use. When using the 124 mm length bifurcated stent graft, subtract 10 mm from Total Contralateral Covered Length with Bifurcated. The 3-5 stent overlap is available only with select limbs. Please refer to the Instructions For Use for more information. 6

9 ILIAC EXTENSIONS Proximal Product Code Design Total Covered Length Delivery System Catheter Outer (F) ETEW C 82 E 14 ETEW C 82 E 14 ETEW C 82 E 16 ETEW C 82 E 16 ETEW C 82 E 18 AORTIC EXTENSIONS Proximal Product Code Design Total Covered Length Delivery System Catheter Outer (F) ETCF C 49 E 18 ETCF C 49 E 18 ETCF C 49 E 18 ETCF C 49 E 20 ETCF C 49 E 20 ETTF C 70 E 18 ETTF C 70 E 18 ETTF C 70 E 18 ETTF C 70 E 20 ETTF C 70 E 20 AUI Proximal Product Code Design Total Covered Length Delivery System Catheter Outer (F) ETUF C 102 E 18 ETUF C 102 E 18 ETUF C 102 E 18 ETUF C 102 E 20 ETUF C 102 E 20 7

10 Endurant II / IIs AAA Stent System PLACEMENT AND SIZING GUIDELINES Use the proximal radiopaque markers to position the top edge of the graft material. e-shaped MARKER ASSISTS WITH A/P ORIENTATION RADIOPAQUE MARKERS For the contralateral side: The radiopaque markers at the proximal limb should be aligned with the radiopaque markers at the flow divider of the Endurant II or Endurant IIs bifurs. For the ipsilateral side: Depending on the limb configuration used, the radiopaque markers at the proximal end of the limb should be aligned to the distal radiopaque marker on the ipsilateral leg or the flow divider marker of the Endurant IIs bifur. Select limbs will allow a 3-5 stent overlap adjustment during the case. Please refer to the Instructions for Use for more information as needed. 8

11 Each Endurant II/Endurant IIs AAA stent graft must be ordered in a size that is appropriate to fit the patient s anatomy. Proper sizing of the Endurant II/Endurant IIs AAA stent graft is the responsibility of the physician. The following suggestions for stent graft diameters are based on vessel inner wall measurements. BIFURCATIONS, AUI AND AORTIC EXTENSIONS Native Vessel Recommended Endurant II ILIAC EXTENSIONS Native Vessel Recommended Endurant II LIMBS Native Vessel Recommended Endurant II

12 Endurant II / IIs AAA Stent System COMPONENT PLACEMENT GUIDE * ENDURANT II 23, 25, 28, 32, 36 mm BIFURCATED PROXIMAL MARKERS 16 mm LIMBS PROXIMAL MARKERS BIFURCATED GRAFT 124, 145, 166 mm 12, 14 mm ALIGN MARKERS 13, 16, 20 mm LIMBS 82, 93, 124, 156, 199 mm 10, 13, 16, 20, 24, 28 mm 10

13 ENDURANT IIs 23, 25, 28, 32, 36 mm BIFURCATED PROXIMAL MARKERS LIMBS PROXIMAL MARKERS LIMBS PROXIMAL MARKERS 16 mm 16 mm BIFURCATED GRAFT 103 mm 14 mm 14 mm LIMBS 82, 93, 124, 156, 199 mm LIMBS 82, 93, 124, 156, 199 mm 10, 13, 16, 20, 24, 28 mm DISTINCT RADIOPAQUE MARKERS Radiopaque markers e-shaped proximal markers Internal ring marker only seen under fluoroscopy 10, 13, 16, 20, 24, 28 mm * Reference product codes for available size combinations. The 3-5 stent overlap is available only with select limbs. Please refer to the Instructions for Use for more information. 11

14 Endurant II / IIs AAA Stent System COMPONENT PLACEMENT GUIDE The only device with an FDA-approved AUI Indication * 23, 25, 28, 32, 36 mm AUI PROXIMAL MARKERS LIMBS PROXIMAL MARKERS 16 mm AUI GRAFT 102 mm ALIGN MARKERS 14 mm LIMBS 82, 93, 124, 156, 199 mm 10, 13, 16, 20, 24, 28 mm 12

15 AORTIC EXTENSION PROXIMAL MARKERS ILIAC EXTENSION PROXIMAL MARKERS 23, 25, 28, 32, 36 mm 10, 13, 20, 24, 28 mm ILIAC EXTENSION 82 mm AORTIC EXTENSION 49, 70 mm 23, 25, 28, 32, 36 mm 10, 13, 20, 24, 28 mm DISTINCT RADIOPAQUE MARKERS Radiopaque markers e-shaped proximal markers * As of April The limb mates with the AUI stent graft on the ipsilateral side. Requires minimum 3 stent overlap. See Instructions for Use for more information. 13

16 Endurant II / IIs AAA Stent System 23, 25, 28, 32, 36 mm PROXIMAL DIAMETERS B C TOTAL COVERED LENGTH D A 13, 16 mm ENDURANT II BIFURCATIONS STRAIGHT LIMBS 14

17 ENDURANT II BIFURCATIONS STRAIGHT LIMBS Proximal Product Code Design Total Covered Length Delivery System Dimensions A B C D ETBF C 124 E ETBF C 145 E ETBF C 166 E ETBF C 124 E ETBF C 145 E ETBF C 166 E ETBF C 124 E ETBF C 145 E ETBF C 166 E ETBF C 124 E ETBF C 145 E ETBF C 166 E ETBF C 124 E ETBF C 145 E ETBF C 166 E ETBF C 124 E ETBF C 145 E ETBF C 166 E ETBF C 145 E ETBF C 166 E

18 Endurant II / IIs AAA Stent System 23, 28, 32, 36 mm PROXIMAL DIAMETERS B TOTAL COVERED LENGTH D E A C F 16, 20 mm ENDURANT II BIFURCATIONS-FLARED LIMBS 16

19 ENDURANT II BIFURCATIONS FLARED LIMBS Product Code Proximal Design Total Covered Delivery Length System Dimensions A B C D E F ETBF C 124 E ETBF C 145 E ETBF C 166 E ETBF C 124 E ETBF C 145 E ETBF C 166 E ETBF C 124 E ETBF C 145 E ETBF C 166 E ETBF C 145 E ETBF C 166 E

20 Endurant II / IIs AAA Stent System 23, 25, 28, 32, 36 mm PROXIMAL DIAMETERS TOTAL COVERED LENGTH D B C A 14 mm ENDURANT IIs BIFURCATIONS 18

21 ENDURANT IIs BIFURCATIONS Proximal Product Code Design Total Covered Delivery Length System Dimensions A B C D ESBF C 103 E ESBF C 103 E ESBF C 103 E ESBF C 103 E ESBF C 103 E

22 Endurant II / IIs AAA Stent System TAPERED LIMBS Proximal Product Code Design Total Covered Length Delivery System Dimensions A B ETLW C 82 E ETLW C 93 E ETLW C 124 E ETLW C 156 E ETLW C 199 E ETLW C 82 E ETLW C 93 E ETLW C 124 E ETLW C 156 E ETLW C 199 E mm PROXIMAL DIAMETER TOTAL COVERED LENGTH A B 10, 13 mm 20 TAPERED LIMBS

23 STRAIGHT LIMBS Proximal Product Code Design Total Covered Length Delivery System ETLW C 82 E ETLW C 93 E ETLW C 124 E ETLW C 156 E ETLW C 199 E 16 mm PROXIMAL DIAMETER TOTAL COVERED LENGTH 16 mm STRAIGHT LIMBS 21

24 Endurant II / IIs AAA Stent System 16 mm PROXIMAL DIAMETER TOTAL COVERED LENGTH A B 20, 24, 28 mm FLARED LIMBS 22

25 FLARED LIMBS Proximal Product Code Design Total Covered Length Delivery System Dimensions A B ETLW C 82 E ETLW C 93 E ETLW C 124 E ETLW C 156 E ETLW C 199 E ETLW C 82 E ETLW C 93 E ETLW C 124 E ETLW C 156 E ETLW C 199 E ETLW C 82 E ETLW C 93 E ETLW C 124 E ETLW C 156 E ETLW C 199 E

26 Endurant II / IIs AAA Stent System ILIAC EXTENSIONS Proximal Product Code Design Total Covered Length Delivery System ETEW C 82 E ETEW C 82 E ETEW C 82 E ETEW C 82 E ETEW C 82 E 10, 13, 20, 24, 28 mm PROXIMAL DIAMETERS TOTAL COVERED LENGTH 10, 13, 20, 24, 28 mm ILIAC EXTENSIONS 24

27 AUI Proximal Product Code Design Total Covered Length Delivery System Dimensions ETUF C 102 E ETUF C 102 E ETUF C 102 E ETUF C 102 E ETUF C 102 E A B 23, 25, 28, 32, 36 mm PROXIMAL DIAMETERS TOTAL COVERED LENGTH A B 14 mm AUI 25

28 Endurant II / IIs AAA Stent System 23, 25, 28, 32, 36 mm PROXIMAL DIAMETERS TOTAL COVERED LENGTH 23, 25, 28, 32, 36 mm AORTIC EXTENSIONS 26

29 AORTIC EXTENSIONS Proximal Product Code Design Total Covered Length Delivery System ETCF C 49 E ETCF C 49 E ETCF C 49 E ETCF C 49 E ETCF C 49 E ETTF C 70 E ETTF C 70 E ETTF C 70 E ETTF C 70 E ETTF C 70 E 27

30 Talent Occluder with Occluder Delivery System FEATURES Double spring configuration securely anchors in the iliac artery to seal the lumen and to prevent retrograde blood flow. COMPONENT PLACEMENT GUIDE PRODUCT CODE DESCRIPTION OCL 8 US Catheter Total Length Proximal / Device Configuration OCL - Occluder TALENT OCCLUDER mm 8 24 mm Radiopaque markers 28

31 OCCLUDER TALENT OCCLUDER Product Code Proximal Total Length Catheter (F) OCL 8 US OCL 10 US OCL 12 US OCL 14 US OCL 16 US OCL 18 US OCL 20 US OCL 22 US OCL 24 US

32 Valiant Thoracic Stent Captivia Delivery System FEATURES Conformability Delivered Sinusoidal shape and placement of nitinol springs provide flexibility and conformability Super-elastic nitinol springs exert active radial force to enhance seal and conformability Settle for Nothing Less Tip capture provides controlled deployment and precise placement in the thoracic aorta Tip capture release handle provides simple turn-and-pull motion to release proximal stents Advanced Design * Proximal 8-Peak FreeFlo configuration evenly distributes radial force over multiple apices Platinum iridium Figur8 markers provide high visibility and assist deployment Broad selection of proximal and distal components treats a variety of patients Optimized Access Hydrophilic coating facilitates stent graft delivery Easy three-step deployment process * Test data on file at Medtronic. Bench test results may not be indicative of clinical performance. 30

33 COMPONENT PLACEMENT GUIDE mm mm FREEFLO STRAIGHT (PROXIMAL COMPONENT) mm mm FREEFLO TAPERED (PROXIMAL COMPONENT) mm mm ~12 mm 8-Peak CLOSED WEB STRAIGHT (DISTAL COMPONENT) mm mm mm mm CLOSED WEB STRAIGHT (DISTAL COMPONENT) mm mm DISTAL BARE SPRING STRAIGHT (DISTAL COMPONENT) mm mm mm 8 0 VALIANT CAPTIVIA ~12 mm 8-Peak DISTINCT RADIOPAQUE MARKERS 8 Figur8 marker 0 Zer0 marker 31

34 Valiant Thoracic Stent Captivia Delivery System Medtronic recommends that the Valiant thoracic stent graft with the Captivia delivery system be used according to the sizing guidelines contained in the IFU. Proper sizing of the Valiant thoracic stent graft is the responsibility of the physician. Aneurysms, Penetrating Ulcers and Traumatic Ruptures: Full sizing guidelines are detailed in the instructions for use (IFU). Additional oversizing should not be incorporated. Please visit manuals.medtronic. com for more detailed sizing information. FUSIFORM & SACCULAR ANEURYSMS AND PENETRATING ULCERS SIZING GUIDELINES Native Vessel Suggested FreeFlo Straight Stent 18, , , , , 26, , 28, , 30, , , , , , , Dissection: For Dissections, appropriate oversizing has already been incorporated into the recommended sizes. Additional oversizing should not be incorporated. Oversizing of the stent graft to the vessel >10% may be unsafe in the presence of dissecting tissue or intramural hematoma. For Additional Sections: When multiple stent grafts are needed to exclude the target lesion, and the component junction or overlapping connection is not supported by the aorta, the diameter of the inside component should be oversized by 4 mm relative to the outside component. If it is supported by the vessel, oversizing to the supporting native vessel should be used. 32

35 BLUNT TRAUMATIC AORTIC INJURY SIZING GUIDELINES Native Vessel Suggested Stent DISSECTION SIZING GUIDELINES Native Vessel Suggested Stent

36 Valiant Thoracic Stent Captivia Delivery System VALIANT CAPTIVIA PRODUCT CODE DESCRIPTION VA M F C 100 TU Delivery System TU - Thoracic Stent Covered Length Catheter Outer Nominal Stent Covered Length Design C - Closed Web 1 B - Bare Spring mm Proximal Proximal Design C - Closed Web 1 F - FreeFlo Device Configuration M - Main Stent Product Name VA - Valiant TOTAL COVERED LENGTH mm mm 1. Proximal end of closed web also includes a mini support spring, while the distal end does not have a mini support spring. PROXIMAL FREEFLO STRAIGHT 34

37 PROXIMAL FREEFLO STRAIGHT Proximal Product Code Design Catheter Outer (F) Stent Covered Length VAMF C 100 TU VAMF C 100 TU VAMF C 100 TU VAMF C 100 TU VAMF C 100 TU VAMF C 100 TU VAMF C 100 TU VAMF C 100 TU VAMF C 100 TU VAMF C 100 TU VAMF C 100 TU VAMF C 100 TU VAMF C 100 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 200 TU VAMF C 200 TU VAMF C 200 TU VAMF C 200 TU VAMF C 200 TU VAMF C 200 TU VAMF C 200 TU VAMF C 200 TU VAMF C 200 TU

38 Valiant Thoracic Stent Captivia Delivery System mm TOTAL COVERED LENGTH mm mm PROXIMAL FREEFLO TAPERED 36

39 PROXIMAL FREEFLO TAPERED Product Code Proximal Design Nominal Stent Covered Length Delivery System Catheter Outer (F) Stent Covered Length VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU VAMF C 150 TU

40 Valiant Thoracic Stent Captivia Delivery System mm TOTAL COVERED LENGTH mm mm CLOSED WEB STRAIGHT 38

41 CLOSED WEB STRAIGHT Proximal Product Code Design Catheter Outer (F) Stent Covered Length VAMC C 100 TU VAMC C 100 TU VAMC C 100 TU VAMC C 100 TU VAMC C 100 TU VAMC C 100 TU VAMC C 100 TU VAMC C 100 TU VAMC C 100 TU VAMC C 100 TU VAMC C 100 TU VAMC C 100 TU VAMC C 100 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 200 TU VAMC C 200 TU VAMC C 200 TU VAMC C 200 TU VAMC C 200 TU VAMC C 200 TU VAMC C 200 TU VAMC C 200 TU VAMC C 200 TU

42 Valiant Thoracic Stent Captivia Delivery System mm TOTAL COVERED LENGTH mm mm CLOSED WEB TAPERED 40

43 CLOSED WEB TAPERED Product Code Proximal Design Nominal Stent Covered Length Delivery System Catheter Outer (F) Stent Covered Length VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU VAMC C 150 TU

44 Valiant Thoracic Stent Captivia Delivery System mm TOTAL COVERED LENGTH mm mm DISTAL BARE SPRING STRAIGHT 42

45 DISTAL BARE SPRING STRAIGHT Proximal Product Code Design Nominal Stent Covered Length (mm Delivery System Catheter Outer (F) Stent Covered Length VAMC B 100 TU VAMC B 100 TU VAMC B 100 TU VAMC B 100 TU VAMC B 100 TU VAMC B 100 TU VAMC B 100 TU VAMC B 100 TU VAMC B 100 TU VAMC B 100 TU VAMC B 100 TU VAMC B 100 TU VAMC B 100 TU

46 Aptus Heli-FX EndoAnchor System FEATURES Enhance outcomes and durability Designed to bring the stability of a surgical anastomosis to endovascular aneurysm repair Enhances the inherent sealing and fixation mechanisms of an endograft Simplifies revision surgery for endograft migration and Type I endoleak Tailor seal and fixation in primary and revision EVAR and TEVAR Steerable guide for precise and accurate EndoAnchor implant placement Motorized, intuitive controls for precise placement of EndoAnchors Allow safe and effective treatment of more complex anatomies Maximize outcomes in complex cases Confidently and rapidly target and seal type I endoleaks Ancillary EndoAnchor Cassette addresses needs of complex EVAR and TEVAR EVAR ORDERING INFORMATION AAA Components Deflected Tip Reach Recommended Neck Working Length (cm) OD (F) Catalog Number Heli-FX Guide, SG-64 Heli-FX Guide, HG Heli-FX Applier and EndoAnchor Cassette (w/10 EndoAnchors) Ancillary EndoAnchor Cassette (w/5 EndoAnchors) NA NA SA-85 NA NA NA NA EC-05 44

47 HELI-FX GUIDE HELI-FX APPLIER ENDOANCHOR CASSETTE TIP DEFLECTION LENGTH APTUS TEVAR ORDERING INFORMATION TAA Components Deflected Tip Reach Recommended Neck Working Length (cm) OD (F) Catalog Number Heli-FX Guide, HG Heli-FX Guide, HG Heli-FX Guide, HG Heli-FX Applier and EndoAnchor Cassette (w/10 EndoAnchors) Ancillary EndoAnchor Cassette (w/5 EndoAnchors) NA NA 114cm 12 HA NA NA NA NA EC-05 45

48 TourGuide Steerable Sheath FEATURES PRECISELY GUIDE YOUR NEXT INTERVENTION * Quickly Access Indicated Anatomy with the TourGuide Steerable Sheath. * Dilator & Tip * Facilitates sheath trackability, enabling the TourGuide to advance through indicated anatomy. * Advanced Catheter Technology Provides the strength and conformability needed to pass through various interventional devices. Curve Retention * Maintains desired deflection angle, providing a stable platform for delivering devices to its desired destination. Radiopaque Tip * Provides excellent visualization during positioning, enabling accurate vessel access and potentially less manipulation. Hemostatic Seal and Flush Port Maintains hemostasis and allows for manual fluid injection. 180 Tip Deflection * Physician-directed to deliver products to a wide variety of vessel take offs, delivering diagnostic and therapeutic devices to difficult anatomic areas. 46 * Bench Test Data on file at Medtronic. Test data not indicative of clinical performance.

49 Adjustable Tip Deflection * May reduce overall procedure time by minimizing multiple exchanges associated with different catheter selections. 9 mm 17 mm 22 mm Two Working Lengths Designed to access indicated areas to perform interventions. Inner Compatibility For use with interventional devices. 45 cm 55 cm 6.5 F 7 F 8.5 F Dilator With French size and guidewire indicator. ORDERING INFORMATION Catalog Number Inner Size (F) Usable Working Length (cm) Deflection 180 TG TG TG TG TG TG TG TG TG TG TG TG

50 Sentrant Introducer Sheath with Hydrophilic Coating ENSURE SEAL Superior Hemostasis * Optimal seal versus other available sheaths Enhanced Trackability Hydrophilic coating and optimum flexibility for easier tracking through tortuous calcified iliacs Procedural Confidence Reinforced coil for kink resistance Radiopaque marker band for easy visibility Dilator locking mechanism secures desired position SUPERIOR LEAK RESISTANCE VERSUS COOK CHECK-FLO PERFORMER AND GORE DRYSEAL P-value< ml/hr Leak resistance with 0.035"/0.89mm guidewire inserted ml/hr P-value< ml/hr 25 ml/hr 17 ml/hr Lower Is Better 10 0 ml/hr 0 Medtronic Sentrant 12 F Cook Medical Check-Flo Performer Gore Medical DrySeal 0 ml/hr Medtronic Sentrant 18 F Cook Medical Check-Flo Performer Gore Medical DrySeal * Bench Test Data on file at Medtronic. Test data not indicative of clinical performance. Bench Test compared Cook Check-Flo Performer and Gore DrySeal 12 F and 18 F to Sentrant 12 F and 18 F. Medtronic Sheath had zero leakage on 0.035"/0.89 mm guidewire. 48

51 THE CHOICE FOR SUPERIOR HEMOSTASIS* RADIOPAQUE MARKER BAND REINFORCED COILED TUBING HYDROPHILIC COATING WORKING LENGTH: 28 cm GUIDEWIRE DIAMETER: 0.035"/0.89 mm LOCKING MECHANISM ON DILATOR HANDLE PRODUCT ORDERING INFORMATION Model Number Size (F) Working Length (cm) SENSH1228W SENSH1428W SENSH1628W SENSH1828W SENTRANT SENSH2028W SENSH2228W SENSH2428W SENSH2628W

52 Reliant Stent Balloon Catheter FEATURES Expand Possibilities A single-solution balloon catheter for your stent graft procedure needs Clinical uses include: Abdominal and thoracic use Endograft modeling Endoleak sealing support Widest Range of Balloon Inflation s BALLOON INFLATION TABLE 46 mm Balloon Ml (cc) * 60 CAUTION: This table is only a guide. Balloon expansion should be carefully monitored under fluoroscopy. Do not exceed maximum inflation diameter (46 mm). Rupture of balloon may occur. PRODUCT INFORMATION RELIANT STENT GRAFT BALLOON CATHETER Product Code Inflation Shaft Size (F) Usable Length (cm) Sheath Compatibility (F) REL Please reference appropriate product Instructions for Use for a more detailed list of indications, warnings, precautions and potential adverse events. * Maximum inflation diameter. Does not contain latex. 50

53 MULTIPLE PURPOSES, SINGLE SOLUTION INTRODUCER SHEATH: COMPATIBLE WITH 12 F MATERIAL TYPE: COMPLIANT POLYURETHANE (NON-LATEX) INFLATION DIAMETER: mm SHAFT SIZE: 8 F USABLE LENGTH: 100 cm GUIDEWIRE DIAMETER: 0.038" / mm OR SMALLER RELIANT 51

54 52 Endurant II / IIs AAA Stent System Indications The Endurant II/Endurant IIs bifurcated stent graft is indicated for the endovascular treatment of infrarenal abdominal aortic or aorto-iliac aneurysms. The Endurant II aorto-uniiliac (AUI) stent graft is indicated for the endovascular treatment of infrarenal abdominal aortic or aortoiliac aneurysms in patients whose anatomy does not allow the use of a bifurcated stent graft. The Endurant II/Endurant IIs stent graft system is indicated for use in patients with the following characteristics: Adequate iliac/femoral access that is compatible with vascular access techniques, devices and/or accessories Proximal neck length of 10 mm Infrarenal neck angulation of 60 Aortic neck diameters with a range of 19 to 32 mm fixation length(s) of 15 mm Iliac diameters with a range of 8 to 25 mm Morphology suitable for aneurysm repair Contraindications The Endurant II/Endurant IIs Stent System is contraindicated in: Patients who have a condition that threatens to infect the graft. Patients with known sensitivities or allergies to the device materials. Warnings and Precautions The long-term safety and effectiveness of the Endurant II/Endurant IIs Stent System has not been established. All patients should be advised that endovascular treatment requires lifelong, regular follow-up to assess the health and the performance of the implanted endovascular stent graft. Patients with specific clinical findings (e.g., endoleaks, enlarging aneurysms or changes in the structure or position of the endovascular graft) should receive enhanced follow-up. Specific follow-up guidelines are described in the Instructions for Use. Patients experiencing reduced blood flow through the graft limb, aneurysm expansion, and persistent endoleaks may be required to undergo secondary interventions or surgical procedures. The Endurant II/Endurant IIs Stent System is not recommended in patients unable to undergo or who will not be compliant with the necessary preoperative and postoperative imaging and implantation studies as described in the Instructions for Use. Renal complications may occur: 1) From an excess use of contrast agents. 2) As a result of emboli or a misplaced stent graft. The radiopaque marker along the edge of the stent graft should be aligned immediately below the lower-most renal arterial origin. Studies indicate that the danger of micro-embolization increases with increased duration of the procedure. The safety and effectiveness of the Endurant II/Endurant IIs Stent System has not been evaluated in some patient populations. Please refer to the product Instructions for Use for details. MRI Safety and Compatibility: Nonclinical testing has demonstrated that the Endurant II/Endurant IIs Stent is MR Conditional. It can be scanned safely in both 1.5T & 3.0T MR systems under certain conditions as described in the product Instructions for Use. For additional information regarding MRI please refer to the product Instructions for Use. Adverse Events Potential adverse events include (arranged in alphabetical order): amputation; anesthetic complications and subsequent attendant problems (e.g., aspiration), aneurysm enlargement; aneurysm rupture and death; aortic damage, including perforation, dissection, bleeding, rupture and death; arterial or venous thrombosis and/or pseudoaneurysm; arteriovenous fistula; bleeding, hematoma or coagulopathy; bowel complications (e.g., ileus, transient ischemia, infarction, necrosis); cardiac complications and subsequent attendant problems (e.g., arrhythmia, myocardial infarction, congestive heart failure, hypotension, hypertension); claudication (e.g., buttock, lower limb); death; edema; embolization (micro and macro) with transient or permanent ischemia or infarction; endoleak; fever and localized inflammation; genitourinary complications and subsequent attendant problems (e.g., ischemia, erosion, femoral-femoral artery thrombosis, fistula, incontinence, hematuria, infection); hepatic failure; impotence; infection of the aneurysm, device access site, including abscess formation, transient fever and pain; lymphatic complications and subsequent attendant problems (e.g., lymph fistula); neurologic local or systemic complications and subsequent attendant problems (e.g., confusion, stroke, transient ischemic attack, paraplegia, paraparesis, paralysis); occlusion of device or native

55 vessel; pulmonary complications and subsequent attendant problems; renal complications and subsequent attendant problems (e.g., artery occlusion, contrast toxicity, insufficiency, failure); stent graft: improper component placement; incomplete component deployment; component migration; suture break; occlusion; infection; stent fracture; graft twisting and/or kinking; insertion and removal difficulties; graft material wear; dilatation; erosion; puncture and perigraft flow; surgical conversion to open repair; vascular access site complications, including infection, pain, hematoma, pseudoaneurysm, arteriovenous fistula, dissection; vascular spasm or vascular trauma (e.g., iliofemoral vessel dissection, bleeding, rupture, death); vessel damage; wound complications and subsequent attendant problems (e.g., dehiscence, infection, hematoma, seroma, cellulitis) Please reference product Instructions for Use for more information regarding indications, warnings, precautions, contraindications and adverse events. CAUTION: Federal (USA) law restricts this device to sale by or on the order of a physician. Talent Occluder with Occluder Delivery System Indications The Talent Occluder with Occluder Delivery system is intended for endoluminal occlusion of the common iliac artery in order to prevent retrograde blood into the aneurysm sac when used in conjunction with a fem-fem bypass (for example, the Talent Occluder can be used in combination with the Talent Converter Stent ). The anatomical considerations are as follows: Iliac/femoral access vessel morphology that is compatible with vascular access techniques and a delivery system profile of 17.5 French Common iliac vessel diameters between 6 mm and 20 mm Contraindications The Talent Occluder is contraindicated in: Patients who have a condition that threatens to infect the graft Patients with sensitivities or allergies to the device materials Warnings and Precautions The long-term performance of the Talent Occluder has not yet been established. All patients receiving the Talent Occluder should receive enhanced follow-up. Specific followup guidelines are described in the Instructions for Use. Renal complications may occur: 1) From an excess use of contrast agents 2) As a result of emboli. Studies indicate that the danger of micro-embolization increases with increased duration of the procedure. The safety and effectiveness of the Talent Occluder System has not been evaluated in some patient populations. Please refer to the product Instructions for Use for details. MRI Safety and Compatibility: Nonclinical testing has demonstrated that the Talent Occluder is MR Conditional. It can be scanned safely in both 1.5T & 3.0T MR systems under certain conditions as described in the product Instructions for Use. For additional information regarding MRI please refer to the product Instructions for Use. Potential Adverse Events Potential adverse events include (not arranged in any particular order): Aneurysm enlargement; aneurysm rupture and death; aortic damage (including perforation, dissection, bleeding, rupture and death); arterial or venous thrombosis and/or pseudoaneurysm; bleeding, hematoma or coagulopathy; cardiac complications and subsequent attendant problems; claudication; dislodgement of preexisting graft (for example, a Talent Converter); death; embolization (micro and macro) with transient or permanent ischemia or infarction; endoleak; fever and localized inflammation; pulmonary/ respiratory complications; renal complications; surgical conversion to open repair; vascular access site complications ;vascular spasm or vascular trauma; vessel damage; wound complications and subsequent attendant problems; stent graft complications: improper component placement, incomplete component deployment, component migration, suture break, occlusion, infection, stent fracture, graft twisting and/or kinking, insertion and removal difficulties, graft material wear, dilatation, erosion, puncture, and perigraft flow. Please reference product Instructions for Use for more information regarding indications, warnings, precautions, contraindications and adverse events. CAUTION: Federal (USA) law restricts this device to sale by or on the order of a physician. 53

56 Valiant Captivia Thoracic Stent Delivery System Indications The Valiant Thoracic Stent with the Captivia Delivery System is intended for the endovascular repair of all lesions of the descending thoracic aorta (DTA) in patients having appropriate anatomy, including: iliac/femoral access vessel morphology that is compatible with vascular access techniques, devices, and/or accessories; nonaneurysmal aortic diameter in the range of 18 mm to 42mm (fusiform and saccular aneurysms/penetrating ulcers), 18 mm to 44 mm (blunt traumatic aortic injuries), or 20 mm to 44 mm (dissections); and nonaneurysmal aortic proximal and distal neck lengths 20mm (fusiform and saccular aneurysms/penetrating ulcers), landing zone 20 mm proximal to the primary entry tear (blunt traumatic aortic injuries, dissections). The proximal extent of the landing zone must not be dissected. Contraindications The Valiant Thoracic Stent with the Captivia Delivery System is contraindicated in: Patients who have a condition that threatens to infect the graft. Patients with known sensitivities or allergies to the device materials. Warnings and Precautions The long-term safety and effectiveness of the Valiant Thoracic Stent with the Captivia Delivery System has not been established. All patients should be advised that endovascular treatment requires lifelong, regular follow-up to assess the integrity and performance of the implanted endovascular stent graft. Patients with specific clinical findings (for example, enlarging aneurysm, endoleaks, migration, inadequate seal zone, or continued flow into the false lumen in the case of a dissection) should receive enhanced follow-up. Specific follow-up guidelines are described in the Instructions for Use. The Valiant Thoracic Stent with the Captivia Delivery System is not recommended in patients who cannot undergo, or who will not be compliant with, the necessary preoperative and postoperative imaging and implantation procedures as described in the Instructions for Use. Strict adherence to the Valiant Thoracic Stent sizing guidelines as described in the Instructions for Use is expected when selecting the device size. Sizing outside of this range can potentially result in endoleak, fracture, migration, infolding, or graft wear. As cautioned in the Instructions for Use, a balloon should never be used when treating a dissection. The safety and effectiveness of the Valiant Thoracic Stent with the Captivia Delivery System has not been evaluated in some patient populations. Please refer to the product Instructions for Use for details. MRI Safety and Compatibility Non-clinical testing has demonstrated that the Valiant Thoracic Stent is MR Conditional. It can be scanned safely in both 1.5T and 3.0T MR systems under specific conditions as described in the product Instructions for Use. For additional information regarding MRI please refer to the product Instructions for Use. Adverse Events Potential adverse events include, but are not limited to access failure, access site complications (e.g. spasm, trauma, bleeding, rupture, dissection), adynamic ileus, allergic reaction (to contrast, antiplatelet therapy, stent graft material), amputation, anaesthetic complications, aortic expansion (e.g. aneurysm, false lumen), aneurysm rupture, angina, arrhythmia, arterial stenosis, atelectasis, blindness, bowel ischemia/infarction, bowel necrosis, bowel obstruction, branch vessel occlusion, buttock claudication, cardiac tamponade, catheter breakage, cerebrovascular accident (CVA) / stroke, change in mental status, coagulopathy, congestive heart failure, contrast toxicity, conversion to surgical repair, death, deployment difficulties / failures, dissection / perforation / rupture of the aortic vessel and/or surrounding vasculature, embolism, endoleak(s), excessive or inappropriate radiation exposure, extrusion / erosion, failure to deliver stent graft, femoral neuropathy, fistula (including aortobronchial, aortoenteric, aortoesophageal, arteriovenous, and lymph), gastrointestinal bleeding /complications, genitourinary complications, hematoma, hemorrhage / bleeding, hypotension / hypertension, infection or fever, insertion or removal difficulties, intercostal pain, intramural hematoma, leg /foot edema, lymphocele, myocardial infarction, neuropathy, occlusion venous or arterial, pain / reaction at catheter insertion site, paralysis, paraparesis, paraplegia, paresthesia, perfusion of the false lumen, peripheral 54

57 ischemia, peripheral nerve injury, pneumonia, post-implant syndrome, procedural / post-procedural bleeding, prosthesis dilatation / infection / rupture / thrombosis, pseudoaneurysm, pulmonary edema, pulmonary embolism, reaction to anaesthesia, renal failure, renal insufficiency, reoperation, respiratory depression / failure, sepsis, seroma, shock, spinal neurological deficit, stent graft material failure (including breakage of metal portion of device) / migration / misplacement / occlusion / twisting / kinking, transient ischemic attack (TIA), thrombosis, tissue necrosis, vascular ischemia, vascular trauma, wound dehiscence, wound healing complications, wound infection. Please reference product Instructions for Use for more information regarding indications, warnings, precautions, contraindications and adverse events. CAUTION: Federal (USA) law restricts this device to sale by or on the order of a physician. Aptus Heli-FX EndoAnchor System Indications for Use: The Aptus Heli-FX EndoAnchor System is intended to provide fixation and sealing between endovascular aortic grafts and the native artery. The Aptus Heli-FX EndoAnchor System is indicated for use in patients whose endovascular grafts have exhibited migration or endoleak, or are at risk of such complications, in whom augmented radial fixation and/or sealing is required to regain or maintain adequate aneurysm exclusion. The EndoAnchor may be implanted at the time of the initial endograft placement, or during a secondary (i.e. repair) procedure. Contraindications: Treatment with the Aptus Heli-FX EndoAnchor System is contraindicated for use in the following circumstances: In patients with known allergies to the EndoAnchor Implant material (MP35N-LT) In conjunction with the Endologix Powerlink endograft Warnings: The long term performance of the EndoAnchor has not been established. All patients should be advised endovascular aneurysm treatment requires long-term, regular follow-up to assess the patient s health status and endograft performance, and the EndoAnchor does not reduce this requirement. The EndoAnchor implant and the Aptus Heli-FX EndoAnchor System have been evaluated via in vitro testing and determined to be compatible with the Cook Zenith, Cook Zenith TX2, Gore Excluder, Gore TAG, Medtronic AneuRx, Medtronic Endurant, Medtronic Talent, and Medtronic Valiant endografts. Use with endografts other than those listed above has not been evaluated. The performance of the EndoAnchor has not been evaluated for securing multiple endograft components to one another. Without EndoAnchor securement into aortic tissue, this could result in graft fabric damage, component separation, and resultant Type III endoleaks. The performance of the EndoAnchor has not been evaluated in vessels other than the aorta. Use of the EndoAnchor to secure endografts to other vessels may result in adverse patient consequences such as vascular perforation, bleeding, or damage to adjacent structures. The Aptus EndoAnchor has not been evaluated for securing multiple anatomical structures together. Such use could result in adverse patient consequences such as vascular perforation, bleeding, or embolic events. MRI Safety and Compatibility: The EndoAnchors have been determined to be MR Conditional at 3T or less when the scanner is in Normal Operating Mode with whole body averaged SAR of 2 W/kg, or in First Level Controlled Mode with a maximum whole body averaged SAR of 4 W/kg. Please refer to documentation provided by the endograft system manufacturer for MR safety status of the endograft system with which the EndoAnchors are being used. Potential Adverse Events: Possible adverse events associated with the use of Aptus Heli-FX EndoAnchor include, but are not limited to: Aneurysm rupture Death EndoAnchor embolization Endoleaks (Type III) Enteric fistula Failure to correct/prevent Type I endoleak Failure to prevent endograft migration Infection 55

58 Renal complications (renal artery occlusion/dissection or contrastinduced AKI) Stroke Surgical conversion to open repair Vascular access complications, including infection, pain, hematoma, pseudoaneurysm, arteriovenous fistula Vessel damage, including dissection, perforation, and spasm Please reference product Instructions for Use for more information regarding indications, warnings, precautions, contraindications and adverse events. CAUTION: Federal (USA) law restricts these devices to sale by or on the order of a licensed healthcare practitioner. See package inserts for full product information. CAUTION: EndoAnchor implant locations should be based upon a detailed examination of the preoperative CT imaging in cases involving irregular or eccentric plaque in the intended sealing zone(s). EndoAnchors should be implanted only into areas of aortic tissue free of calcified plaque or thrombus, or where such pathology is diffuse and less than 2mm in thickness. Attempting to place EndoAnchors into more severe plaque or thrombus may be associated with implantation difficulty and suboptimal endograft fixation and/ or sealing. TourGuide Steerable Sheath The following disclosures must be on all promotional/advertising materials. CAUTION: Federal Law restricts this device to sale by or on the order of a physician (U.S.A.). Please refer to the Instructions for Use for a complete listing of the indications, contraindications, precautions and warnings, where applicable. Important Information: Prior to use, refer to the Instructions for Use supplied with these devices for indications, contraindications, suggested procedure, warnings and precautions. Failure to properly follow the instructions for use, warnings, and precautions may lead to serious consequences or injury to the patient. If the indications for use of the device are discussed, the following statement must appear: Indications for Use: The steerable sheath, model TourGuide is intended for the introduction of diagnostic and therapeutic devices into the human vasculature, including but not limited to intracardiac, renal or other peripheral placements. Do not use this device for neural placements. Contraindications: Known active or systemic local infection Known inability to obtain vascular access Patients with atrial thrombosis or myxoma, or interatrial baffle or patch Use of a steerable sheath is contraindicated in patients with obstructive or inadequate vasculature Potential Adverse Events: Possible adverse events associated with the use of TourGuide Steerable Sheath include, but are not limited to: Air Embolism Allergic reaction to contrast media Aortic puncture Arrhythmias Arteriovenous fistula formation Atrial septal defect Bleeding plexus injury Catheter entrapment Cardiac tamponade Coronary artery spasm and/or damage Dislodgement Dissection Endocarditis Heart Block Hematoma formation Hemorrhage Hemothorax Infection Intimal tear Irregular heart beat Local nerve damage Mediastinal widening Myocardial infarction Pacemaker/defibrillator lead displacement Perforation Pericardial/pleural effusion Pneumothorax Pseudoaneurysm formation Pulmonary edema Stroke Subclavian artery puncture Thromboembolic events Thrombophlebitis Valve damage Vascular occlusion Vasovagal reaction Vessel damage/vessel trauma Vessel spasm 56

59 PRECAUTION: Transvenous device compatibility: Use the steerable sheath only with compatible transvenous devices. Use the appropriate size sheath for the size of the transvenous device being utilized. Consequences of using the steerable sheath with incompatible devices may include the inability to deliver the transvenous device or damage to the transvenous device during delivery. WARNING: If the patient has left bundle branch block, back up pacing should be readily available during insertion of the steerable sheath assembly. Use of the steerable sheath assembly may cause heart block. Sentrant Introducer Sheath with Hydrophilic Coating Important Information: Prior to use, refer to the Instructions for Use supplied with these devices for indications, contraindications, suggested procedure, warnings and precautions. Indications for Use: The Medtronic Sentrant Introducer Sheaths with Hydrophilic Coating are intended to provide a conduit for the insertion of diagnostic or endovascular devices into the vasculature and to minimize blood loss associated with such insertions. CAUTION: Federal (USA) law restricts these devices to sale by or on the order of a licensed healthcare practitioner. See package inserts for full product information. Reliant Stent Balloon Catheter Important Information: Prior to use, refer to the Instructions for Use supplied with these devices for indications, contraindications, suggested procedure, warnings and precautions. Indications for Use: The Reliant Stent Balloon Catheter is intended for temporary occlusion of large vessels or to expand vascular prostheses. CAUTION: Federal (USA) law restricts these devices to sale by or on the order of a licensed healthcare practitioner. See package inserts for full product information. 57

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64 Aortic Peripheral endovenous 3576 Unocal Place Santa Rosa, CA USA 24-hour Technical Support Toll free: medtronic.com/aortic Orders Toll free: Fax: CardioVascular LifeLine Customer Support Tel: Toll free: UC EN Medtronic All rights reserved. Medtronic, Medtronic logo and Further, Together are trademarks of Medtronic. All other brands are trademarks of a Medtronic company. Printed in the USA. For distribution in the USA only. 4/16