Straub Endovascular System &

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1 Straub Endovascular System & S t r a u b E n d o v a s c u l a r To o l s

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3 Straub Endovascular System Effective debulking in occluded arteries and veins

4 Effective debulking in many indications Rotarex S 10F Rotarex S 8F One device for acute, subacute and chronic arterial occlucions Native vessels Dialysis access Stents (In-stent reocclusion) Native and artificial bypasses Up to 1 cm/sec Four functions in one device Detachment of the occlusive material from the vessel (up to 1 cm/sec) Aspiration of detached material into the catheter head Fragmentation of the aspirated material Transportation out of the patient`s body

5 Case report Dr. Sven Bräunlich, Diakoniekrankenhaus, Halle, Germany Treatment of femoral artery and In-stent occlusion using the Straub Endovascular System. A 49 year old male presented with short distance claudication in the left leg (PAOD IIb). The initial angiogram revealed an occlusion in the left SFA, starting below the branch of the profound femoral artery and extending into the proximal popliteal artery. A stent in the distal segment of the SFA was occluded as well. Right side femoral approach was chosen, with a contralateral approach to the occlusion. Figure 1: Pre-procedure angiogram showing an occlusion of the SFA with further ISR in the distal segment. Figure 2: Debulking of the occlusion and the ISR with Rotarex S 8F 1 10cm. Figure 3: Result after Rotarex S Mechnical Debulking Figure 4: Final result after DEB Figure 5: Run-off

6 Efficient thrombectomy / embolectomy in many indications Aspirex S 10F Aspirex S 8F Aspirex S 6F Acute occlusions of Veins Arteries Dialysis access Three functions in one device Strong & continuous aspiration Aspiration of fresh thrombus and emboli Fragmentation of aspirated material Transportation out of the patient`s body

7 Case report Dr. Michael Lichtenberg, Angiology Department, Klinikum Arnsberg Recanalization of an acute ileofemoral deep vein thrombosis using the Aspirex S 10F system 4 1-year-old female, acute painful swelling of the left lower limb for two days. CT venography shows a descending thrombus from distal inferior caval vein to the distal external iliac vein (Figure 1). Intervention Access was gained through an antegrade puncture of the femoral vein under ultrasound guidance. A 10F sheath was placed units of heparin were administered. The first angiogram proved the complete thrombotic occlusion of the left iliac vein system (Figure 2). Then the external and common iliac vein was passed with an angled 5F catheter over a stiff hydrophilic guide wire. The guide wire was then exchanged to a guide wire provided for performing mechanical thrombectomy with the 10F Aspirex S system. After 3 runs with the Aspirex S system a quite effective outflow of the iliac vein (Figure 3) could be demonstrated. After this efficient thrombectomy a high grade stenosis of the left proximal Vena iliaca communis was obvious at the typical May-Thurner point. In the next step predilatation of this region was performed with a 1 4 x 60 mm balloon followed by stent implantation with a 16 x 120 mm venous stent. Post-dilatation a final angiogram showed optimal deployment and apposition of the stent (Figure 4). Post-interventional the patient was under vitamin K antagonist anticoagulation treatment for at least 6 months. A 3 month follow-up examination showed still a patent outflow situation on the left leg and significant improvement of complaints. The stented segments were patent without signs of luminal narrowing on duplex. Summary and critical evaluation The specific advantage of the Aspirex S mechanical thrombectomy is the lesser use of thrombolytic drug for effective thrombectomy. Ultimately, it is possible in individual cases to even completely dispense with local thrombolytic treatment and so avoiding ICU stay for prolonged local lysis delivery taking the patient to bleeding risk and increases perinterventional cost situation. Figure 1 Figure 3 Figure 2 Figure 4

8 DRIVE SYSTEM Safe and easy operation One system for all Rotarex S and Aspirex S catheters Easy set up Hand or footswitch operated Magnetic coupling to catheter Robust and safe

9 Straub Endovascular Tools The companions for your daily work

10 CAPTUREX Your safety net for venous interventions Peri-interventional Filter Catheter Pulmonary Embolism Protection (PEP) Self-expandable Nitinol Basket Immediate retrieval

11 GUIDEWIRE The wire for every day Core material nitinol extra lubricious coating Flexible tip gold-plated tungsten Shape angled, good crossing properties Hydrophilic coating distal end

12 Distributed by Rotarex S Aspirex S REF Catheter Sets Size Length REF Catheter Sets Size Length number number REF SET Rotarex S 6F cm REF SET Aspirex S 6F cm REF SET Rotarex S 6F 135 cm REF SET Aspirex S 6F 135 cm REF SET Rotarex S 8F 85 cm REF SET Aspirex S 8F 85 cm REF SET Rotarex S 8F cm REF SET Aspirex S 8F cm REF SET Rotarex S 10F 85 cm REF SET Aspirex S 10F cm SET includes catheter, guidewire, sterile drape and collecting bag Capturex REF Capturex SET SET includes filter catheter and delivery sheath Drive System REF / REF SRS-Set Drive System Guidewire REF Dimension Length Tip Flex Hydrophilic Packaging number configuration Tip coating REF Guidewire cm angled 40 mm 9.5 cm Pack of 5 REF Guidewire cm angled 40 mm 9.5 cm Pack of 5 REF Guidewire cm angled 40 mm 9.5 cm Pack of 5 REF Guidewire cm angled 60 mm 8.5 cm Pack of 5 REF Guidewire cm angled 60 mm 8.5 cm Pack of 5 Products not available in all markets. Rotarex, Aspirex, Capturex and Straub are registered trademarks of Straub Medical AG. Copyright Straub Medical AG. All rights reserved. Straub Medical AG Straubstrasse 12 CH-7323 Wangs Switzerland Phone: Fax: info@straubmedical.com Internet: ZE10662 A6 EN