SFA lesion treatment: China experience. Wei Liang, MD

Size: px
Start display at page:

Download "SFA lesion treatment: China experience. Wei Liang, MD"

Transcription

1 SFA lesion treatment: China experience Wei Liang, MD

2 Disclosure I do not have any potential conflict of interest

3 Background PAD: 14% - 20% in adults Aorta & Iliac A: 30% Femoral & Pop A: 80-90% Tibial / peroneal A: 40-50% More than 80% of the lesions related SFA Harrison s Principles of Int Med

4 The challenge of SFA lesions

5 Treatment Choice? CX News: TASC guidelines set to recommend "endovascular first" for all lesions Saturday, 09 Apr :30 Endo or Bypass

6 Treatment Choice? We have recognized: TASC A&B are favored for Endo But, How about the TASC C & D?

7 Location and length TASC II 109 SFA stenting procedures (95 patients) Average treatment length 15.7 cm 36 M primary, primary-assisted, and secondary rates: 52%, 64%, and 59%, respectively. Limb salvage was 75% in CLI patients By Cox proportional hazards analysis: TASC D lesions (HR 5.5) significantly affected primary patency

8 J Vasc Surg 2008;48: The 12- and 24-month primary patency: TASCII C PTA/S 83% ± 6%, 80% ± 7% TASCII D PTA/S 54% ± 8%, 28% ±12% TASCII C+D AK-FPB 81% ± 6%, 75% ± 7% Endo-first for SFA TASC-II A,B,C lesions Bypass-first for TASC-II D lesions (unless in high-risk patients)

9 Treatment Choice? Considering the Experience/Cost Better education Better practice Less complications Better medical insurance More endo for SFA in China

10 Dose BMS have the meaning in SFA? Zone A Zone B Zone C Zone D Bend / Kink Compress / Slight curve Fixed Bend / Kink Lansky, A; Angiographic Analysis of Strut Fractures in the SIROCCO Trial. TCT 2004

11 PTA is not always perfect Before Stent After Stent

12 In the era of DCBs, SFA stents still have a place Medicare Part B claims indicate an SFA stent is used in NEARLY HALF of all SFA cases in U.S. SFA procedures. DCBs may not reduce the need for a stent: Calcific plaque resists balloon dilatation. Dissection: hold back intimal flap Recoil: persistent after prolonged PTA/DCB 1. Laird JR et al. J Am Coll Cardiol. 2015;66(21): Ansel, LINC Tepe, LINC LifeStent Solo Vascular Stent System [package insert]. Tempe, AZ: C.R. Bard, Inc.; Zilver PTX Drug-Eluting Peripheral Stent [package insert]. Limerick Ireland: Cook Ireland LTD; Medicare Part B claims indicate an SFA stent is used nearly half of the time. (PSPSF, 2013) 7. Fanelli F. Is there a role for DEB in calcified arteries? Presented at: LINC; January 25, 2013; Leipzig, Germany.

13 SFA stents: definitive therapy or useful adjunct SFA Stents are proven as a standalone therapy STUDY DEVICE A.L.L. PP FTLR 4EVER Pulsar cm 73.4% 85.2% PEACE Pulsar cm 79.5% 81.0% RESILIENT Lifestent 6.2 cm 81.3% 87.3% DURABILITY II EverFlex 8.9 cm 77.2% N/A SUPERB Supera 9.0 cm 84.7% N/A DURABILITY EverFlex 9.6 cm 72.2% 79.1% Stents complement DCB and are an alternative to DES DCB +/- Stent vs. DES Ability to spot stent rather than full metal burden associated with DES Provisional Stent choice based on lesion type Crush resistance in Ca +++ Low COF for dissection tacking

14 Primary Patency Properties of an ideal SFA stent Low Chronic Outward Force (COF) High multidirectional flexibility RRF (resistance to concentric compression) Sufficient Radial Resisitive Force (RRF) Sufficient Crush Resistance (CR) Accurate deployment Elongation/compression can impact patency CR (resistance to eccentric compression) SUPERB Study (Supera): Patency dependent on deployment accuracy 1 Source: SUPERB Study 12m data presented by Lawrence Garcia, MD at VIVA

15 Background: what is COF? COF = Chronic Outward Force Chronic force exerted by a nitinol stent on vessel wall COF related with restenosis COF depends on: Oversizing Stent material and design Irregularities in the lesion Source:IIB(P)

16 Lower COF Chronic Outward Force (COF) varies widely among SFA stents + sufficient crush resistance Source:IIB(P)

17 Lower COF appears to correlate with reduced area of stenosis 28 days FUP 90 days FUP Astron Pulsar 8.78 Astron Pulsar 6.9 Lifestent Lifestent Astron Pulsar (low COF) shows significantly smaller area stenosis than LifeStent Source: Presented by Funovic M. LINC 2017

18 Important considerations with low COF stents: Vessel preparation Good vessel prep addresses many key factors: Prepares the vessel with less/no overstretch May reduce need for provisional stent Preserves native vessel- less metal burden if shorter stented segment is achieved Prolonged inflation (180 sec) may assist dissection sealing Inflation times of 180 sec. improve immediate PTA results vs. a 30 sec. dilatation strategy Significantly fewer major dissections and a modest reduction of residual stenoses 1. N. Zorger et al. Peripheral Arterial Balloon Angioplasty: Effect of Short versus Long Balloon Inflation Times on the Morphologic Results. J Vasc Interv Radiol Adapted rom Blessing E. Presented at LINC 2017

19 BIOFLEX PEACE (interim) 4EVER (Pulsar- 18) TASC D "TASC D II" PEACE BERN "4F INTERVE NTION" Primary Patency/TLR (%) AV. Lesion Length (cm) Pulsar-18 Clinical Data 100% 25 90% 80% 20 70% 60% 15 50% 40% 10 30% 20% 10% 0% 5 0 Primary Patency TLR Av. Lesion length Pulsar SE Stent is clinically proven in several studies, demonstrating consistent outcomes even in longer lesion BIOFLEX PEACE (interim). Lichtenberg M. Presented at LINC EVER Bosiers M. JEVT 2013;20: ; PEACE Lichtenberg M. JEVT, 2014, 21: ; BERN registry Baumann F. JCS 2012:52;475-80; TASC D registrylichtenberg M. JCS 2013: 54; 433-9; "TASC D II" registry Lichtenberg M. Clin Med Insights 2014: 8; 37-42; 4F intervention" Sarkadi H, Eur J Vasc Endovasc Surg (2015) 49,

20 Evidence-based SFA algorithm: Focus BMS Pre-dilatation PTA DCB for 3' Severe Ca+ Thrombus? FLD/RS >30% FLD/RS>30%? YES BMS/ Debulking (Ca+) NO BMS Full/partial lesion coverage Adjunctive full lesion DCB? Mission accomplished Combination Therapy DCB + BMS

21 Our Experience cases SFA-POP TASCII C 9 (36%), D 16 (64%) Mean lesion length 250±106 mm Pulsar-18 stents: 1.7±0.7 /Case 273±126 mm/case

22 Outcomes Primary patency FTLR Primary patency(%) FTLR(%) Time(months) Time(months) 6 M 12M Primary Patency 88% 80% FTLR 92% 88% Patency: PSVI <2.5

23 Typical Case-1 Male, 66yrs Left R4 DM Retrograde Puncture Calcium

24 Typical Case-1 PTX Pulsar Pulsar mm Post 12M CTA

25 Typical Case-2 Male, 80yrs Right R5 DM Smoker Ca : LIA, CFA & SFA stent

26 Typical Case-2 Antegrade recanalizing R PFA L. Brachial A Access Passeo Post PTA

27 Typical Case-2 SFA CTO & Calcium

28 Typical Case-2 Recanalizing SFA Reconstruction SFA & PFA bifurcation Retrograde cross SFA CTO Retrograde Stenting SFA: Pulsar *2 Kissing stent: SFA & PFA Bifurcation

29 Conclusions The SFA lesion is a challenge in China Endovascular treatment becomes the first choice to treat SFA lesion BMS is needed for SFA lesion The low COF stent has the beneficial to treat complex SFA lesions

30 Better Endo, Better Life

31 SFA lesion treatment: China experience Wei Liang, MD

Minimizing Burden, the effect of thin strut and low Chronic Outward Force SE stents

Minimizing Burden, the effect of thin strut and low Chronic Outward Force SE stents Minimizing Burden, the effect of thin strut and low Chronic Outward Force SE stents Prof. Yong LIU The affiliated hospital of southwest medical university LINC AP 2018, Hong Kong 13-15 th March Disclosure

More information

Clinically proven. ordering info. Vascular Intervention // Peripheral Self-Expanding Stent System/0.018 /OTW. Pulsar-18

Clinically proven. ordering info. Vascular Intervention // Peripheral Self-Expanding Stent System/0.018 /OTW. Pulsar-18 140 μm thin struts Clinically proven 4F low profile Vascular Intervention // Peripheral Self-Expanding Stent System/0.018 /OTW Pulsar-18 Technical data / ordering info 140 μm thin struts - thinner than

More information

Pulsar stent technology

Pulsar stent technology Pulsar stent technology Michael K. W. Lichtenberg Vascular Center Arnsberg Disclosures Speaker name: Michael Lichtenberg... I have the following potential conflicts of interest to report: X Consulting

More information

BIOFLEX PEACE Registry

BIOFLEX PEACE Registry BIOFLEX PEACE Registry Pulsar Efficacy: an All Comers Registry INTERIM ANALYSIS Michael K. W. Lichtenberg On behalf of the BIOFLEX-PEACE study group Definition and understanding of various radial forces

More information

Which Stent Is Best for Various Femoropopliteal Anatomy? 2018 Pacific Northwest Endovascular Conference June 15-26, 2018 Seattle, WA

Which Stent Is Best for Various Femoropopliteal Anatomy? 2018 Pacific Northwest Endovascular Conference June 15-26, 2018 Seattle, WA Which Stent Is Best for Various Femoropopliteal Anatomy? 2018 Pacific Northwest Endovascular Conference June 15-26, 2018 Seattle, WA Brian DeRubertis, MD, FACS Associate Professor of Surgery UCLA Division

More information

Could a combination of DCB + stent be the answer in complex SFA lesions

Could a combination of DCB + stent be the answer in complex SFA lesions Could a combination of DCB + stent be the answer in complex SFA lesions Sven Bräunlich, MD Division of Interventional Angiology University-Hospital Leipzig, Germany Disclosure Speaker name: Sven Bräunlich

More information

Christian Wissgott MD, PhD Assistant Director, Radiology Westküstenkliniken Heide

Christian Wissgott MD, PhD Assistant Director, Radiology Westküstenkliniken Heide 2-Year Results Of The Tack Optimized Balloon Angioplasty (TOBA) Trial For Fem- Pop Lesions Demonstrates Safety and Efficacy Of The Tack Endovascular System In Repairing Focal Post-PTA Dissections Christian

More information

MEET M. Bosiers K. Deloose P. Peeters. SFA stenting in 2009 : The good and the ugly What factors influence patency?

MEET M. Bosiers K. Deloose P. Peeters. SFA stenting in 2009 : The good and the ugly What factors influence patency? MEET 2009 SFA stenting in 2009 : The good and the ugly What factors influence patency? M. Bosiers K. Deloose P. Peeters 1 TASC II 2007 vs TASC 2000 Type A Type B Type C Type D 2000 < 3 cm 3-5 cm < 3 cm

More information

Disclosures. In the DCB Era, How Do I Choose To Use a Stent? When to Stent and What Devices to Use in the SFA

Disclosures. In the DCB Era, How Do I Choose To Use a Stent? When to Stent and What Devices to Use in the SFA In the DCB Era, How Do I Choose To Use a Stent? When to Stent and What Devices to Use in the SFA Disclosures No financial disclosures. Cameron M. Akbari, MD, MBA, FACS Site Director, Vascular Surgery Medstar

More information

REACT Treatment Rationale and Clinical Evidence. ICI Meeting 5th of December 2017

REACT Treatment Rationale and Clinical Evidence. ICI Meeting 5th of December 2017 REACT Treatment Rationale and Clinical Evidence ICI Meeting 5th of December 2017 The SFA is a challenging vessel to treat Shortening 23-25%1 Compression > 1kg2 Torsion 60 3 Bending 64 4 SFA, superficial

More information

BioMimics 3D in my Clinical Practice

BioMimics 3D in my Clinical Practice BioMimics 3D in my Clinical Practice M Lichtenberg M.D. Vascular Centre Arnsberg / German Venous Centre Arnsberg CAUTION: Investigational Device. Limited by Federal (or United States) Law to Investigational

More information

Future Algorithm for Lower Extremity Revascularization: Where Does Vessel Prep Fit?

Future Algorithm for Lower Extremity Revascularization: Where Does Vessel Prep Fit? Future Algorithm for Lower Extremity Revascularization: Where Does Vessel Prep Fit? John R. Laird Adventist Heart and Vascular Institute St. Helena, CA Disclosure Speaker name: John R. Laird... I have

More information

Is a Stent or Scaffold Necessary in The SFA?

Is a Stent or Scaffold Necessary in The SFA? 1 2 3 Is a Stent or Scaffold Necessary in The SFA? Stents were developed to optimize acute results after angioplasty Specifically, stents are universally accepted to manage flow limiting dissections and

More information

Clinical Data Update for Drug Coated Balloons (DCB) Seung-Whan Lee, MD, PhD

Clinical Data Update for Drug Coated Balloons (DCB) Seung-Whan Lee, MD, PhD Clinical Data Update for Drug Coated Balloons (DCB) Seung-Whan Lee, MD, PhD Asan Medical Center, Heart Institute, University of Ulsan College of Medicine, Werk et al. Circulation Cardiovasc Intervent 2012

More information

Lessons learnt from DES in the SFA is there any ideal concept so far?

Lessons learnt from DES in the SFA is there any ideal concept so far? Wednesday, January 25, 2017 - Time: 11:49-11:55 DEEP DIVE SESSION: Lower limb interventions (part II) Lessons learnt from DES in the SFA is there any ideal concept so far? S.Müller-Hülsbeck, MD, EBIR,

More information

4/14/2016. Faculty Disclosure. Drug-eluting technology in the SFA and Popliteal. Typical SFA Disease Pattern. Why Peripheral Artery Disease Matters

4/14/2016. Faculty Disclosure. Drug-eluting technology in the SFA and Popliteal. Typical SFA Disease Pattern. Why Peripheral Artery Disease Matters Drug-eluting technology in the SFA and Popliteal David Paul Slovut, MD, PhD Associate Professor of Medicine and Surgery Co-director of TAVR program Director of Advanced Intervention Faculty Disclosure

More information

Efficacy of DEB in Calcification and Subintimal Angioplasty

Efficacy of DEB in Calcification and Subintimal Angioplasty Efficacy of DEB in Calcification and Subintimal Angioplasty Seung-Woon Rha, MD, PhD, FACC, FAHA, FSCAI, FESC, FAPSIC Div of Cardiovascular Intervention and Research Cardiovascular Center, Korea University

More information

Update in femoral angioplasty & stenting PRO

Update in femoral angioplasty & stenting PRO MEET 2008 Update in femoral angioplasty & stenting Will extra-long stents be a solution for SFA disease? PRO Patrick Peeters, MD Chief department Cardiovascular & Thoracic Surgery, Imelda Hospital, Bonheiden,

More information

Drug-coated balloons in BTK:

Drug-coated balloons in BTK: Drug-coated balloons in BTK: Where do we stand and what are the open questions? Dr. Marc Bosiers LINC 2019 - Leipzig My disclosures x o I do not have any potential conflicts of interest to report o I have

More information

Superficial Femoral Artery Intervention: The gift that keeps on giving! Wm. Britton Eaves,MD WKHSC Bossier City, LA

Superficial Femoral Artery Intervention: The gift that keeps on giving! Wm. Britton Eaves,MD WKHSC Bossier City, LA : The gift that keeps on giving! Wm. Britton Eaves,MD WKHSC Bossier City, LA Peripheral arterial disease (PAD) of the superficial femoral artery (SFA) is the most common cause of intermittent claudication

More information

Disclosures. In-Stent Restenosis: The Tail IS Wagging the Dog 4/15/2016. Restenosis: The Continuing Challenge for Peripheral Vascular Intervention

Disclosures. In-Stent Restenosis: The Tail IS Wagging the Dog 4/15/2016. Restenosis: The Continuing Challenge for Peripheral Vascular Intervention In-Stent Restenosis: The Tail IS Wagging the Dog Disclosures NONE Michael S. Conte MD Division of Vascular and Endovascular Surgery UCSF Heart and Vascular Center UCSF Vascular Symposium 2016 IF YOU WERE

More information

TOBA Trial 12 months Results

TOBA Trial 12 months Results Tack Optimized Balloon Angioplasty: TOBA Trial 12 months Results New Paradigm for Managing Post PTA Dissections Marc Bosiers, MD A.Z. St. Blasius Hospital, Belgium Disclosure Speaker name: Dr. Marc Bosiers

More information

DCB level 1 evidence review

DCB level 1 evidence review DCB level 1 evidence review Raphaël COSCAS Vascular Surgery Department Ambroise Paré Hospital, AP-HP and Paris-Ouest University Boulogne-Billancourt, France Disclosure Speaker name: Raphael COSCAS I have

More information

Clinical benefits on DES Patient s perspectives

Clinical benefits on DES Patient s perspectives Clinical benefits on DES Patient s perspectives Dr. Skyi Pang Vascular Surgeon Department of Surgery Pamela Youde Nethersole Eastern Hospital Hong Kong Disclosure Speaker name: Skyi Pang... I have the

More information

Disclosures. Rational Selection of Endovascular Options for the SFA and Popliteal: What Works Where and for How Long?

Disclosures. Rational Selection of Endovascular Options for the SFA and Popliteal: What Works Where and for How Long? Rational Selection of Endovascular Options for the SFA and Popliteal: What Works Where and for How Long? UCSF Vascular Symposium 2017 April 6-8, 2017 San Francisco, CA Disclosures Consulting, Speakers

More information

Update on Tack Optimized Balloon Angioplasty (TOBA) Below the Knee. Marianne Brodmann, MD Medical University Graz Graz, Austria

Update on Tack Optimized Balloon Angioplasty (TOBA) Below the Knee. Marianne Brodmann, MD Medical University Graz Graz, Austria Update on Tack Optimized Balloon Angioplasty (TOBA) Below the Knee Marianne Brodmann, MD Medical University Graz Graz, Austria Critical Limb Ischemia Infrapopliteal arterial disease is a leading source

More information

Long Lesions: Primary stenting or DCB first? John Laird MD Adventist Heart and Vascular Institute, St. Helena, CA

Long Lesions: Primary stenting or DCB first? John Laird MD Adventist Heart and Vascular Institute, St. Helena, CA Long Lesions: Primary stenting or DCB first? John Laird MD Adventist Heart and Vascular Institute, St. Helena, CA Disclosures John R. Laird Within the past 12 months, I or my spouse/partner have had a

More information

Why and how to prep the vessel

Why and how to prep the vessel Why and how to prep the vessel Drug elution in the SFA: Leave the right thing behind. Debating evidence to provide an answer Erwin Blessing, MD, FESC SRH Klinikum Karlsbad-Langensteinbach Germany Disclosure

More information

DCB + BMS is not a DES

DCB + BMS is not a DES DCB + BMS is not a DES Fabrizio Fanelli, MD, EBIR Professor of Radiology Director Vascular and Interventional Radiology Department "Careggi " University Hospital Florence - Italy Disclosures Consultant

More information

Atherectomy is Still Live and Effective. John R. Laird, MD Professor of Medicine Medical Director of the Vascular Center UC Davis Health System

Atherectomy is Still Live and Effective. John R. Laird, MD Professor of Medicine Medical Director of the Vascular Center UC Davis Health System Atherectomy is Still Live and Effective John R. Laird, MD Professor of Medicine Medical Director of the Vascular Center UC Davis Health System Why is Atherectomy Still Alive? Improved devices Better data

More information

Does stent design influence the results of SFA stenting?

Does stent design influence the results of SFA stenting? LINC 2015, Leipzig A.Z. Sint-Blasius, Dendermonde Marc Bosiers Koen Deloose Joren Callaert Imelda Hospital, Bonheiden Patrick Peeters Jürgen Verbist OLV Hospital, Aalst Does stent design influence the

More information

Vessel Preparation: What does it mean and what are the current tools? Lawrence Garcia, MD St. Elizabeth s Medical Center Boston, MA, USA

Vessel Preparation: What does it mean and what are the current tools? Lawrence Garcia, MD St. Elizabeth s Medical Center Boston, MA, USA Vessel Preparation: What does it mean and what are the current tools? Lawrence Garcia, MD St. Elizabeth s Medical Center Boston, MA, USA Disclosure Statement of Financial Interest Within the past 12 months,

More information

Interventional Radiology in Peripheral Vascular Disease: How Far Can We Go? Dr. L. F. CHENG Department of Radiology Princess Margaret Hospital

Interventional Radiology in Peripheral Vascular Disease: How Far Can We Go? Dr. L. F. CHENG Department of Radiology Princess Margaret Hospital Interventional Radiology in Peripheral Vascular Disease: How Far Can We Go? Dr. L. F. CHENG Department of Radiology Princess Margaret Hospital History The era of innovation in image-guided intervention

More information

CHALLENGES IN FEMORO-POPLITEAL STENTING

CHALLENGES IN FEMORO-POPLITEAL STENTING CHALLENGES IN FEMORO-POPLITEAL STENTING Karathanos C MD, MSc, PhD, Athanasoulas A, Rousas N, Spanos K, Giannoukas A Department of Vascular Surgery, University Hospital of Larissa, Faculty of Medicine,

More information

Do we really need a stent in long SFA lesions? No: DEB is the answer

Do we really need a stent in long SFA lesions? No: DEB is the answer Do we really need a stent in long SFA lesions? No: DEB is the answer Thomas Zeller, MD University Heart-Center Freiburg-Bad Krozingen Bad Krozingen Germany My Disclosures: Advisory Board: Medtronic-Invatec,

More information

Drug eluting stents and balloons in peripheral arterial disease A.T.O. ABDOOL-CARRIM UNIVERSITY OF WITWATERSRAND

Drug eluting stents and balloons in peripheral arterial disease A.T.O. ABDOOL-CARRIM UNIVERSITY OF WITWATERSRAND Drug eluting stents and balloons in peripheral arterial disease A.T.O. ABDOOL-CARRIM UNIVERSITY OF WITWATERSRAND Drug eluting stents and balloons Endovascular treatment now becoming more popular for treatment

More information

Update on the Levant 2 Clinical Trial Programme. Dierk Scheinert, MD University Hospital Leipzig Leipzig, Germany

Update on the Levant 2 Clinical Trial Programme. Dierk Scheinert, MD University Hospital Leipzig Leipzig, Germany Update on the Levant 2 Clinical Trial Programme Dierk Scheinert, MD University Hospital Leipzig Leipzig, Germany Disclosure Speaker name: Dierk Scheinert I have the following potential conflicts of interest

More information

RANGER SFA REGISTRY Interim Analysis. Bernd Gehringhoff, MD On behalf the Ranger SFA Registry Investigators

RANGER SFA REGISTRY Interim Analysis. Bernd Gehringhoff, MD On behalf the Ranger SFA Registry Investigators RANGER SFA REGISTRY Interim Analysis Bernd Gehringhoff, MD On behalf the Ranger SFA Registry Investigators Conflict of Interest - Disclosure Within the past 12 months, I or my spouse/partner have had a

More information

Interventional options with modern 4F nitinol stents in SFA lesions

Interventional options with modern 4F nitinol stents in SFA lesions Interventional options with modern 4F nitinol stents in SFA lesions Michael Lichtenberg, FESC Vascular Center Sauerland TYPICAL VASCULAR PATIENT Multi vessel disease Diabetes, obese Age Diffuse sclerotic

More information

Latest Insights from the LEVANT II study and sub-group analysis

Latest Insights from the LEVANT II study and sub-group analysis Latest Insights from the LEVANT II study and sub-group analysis Prof. Dr. med. Dierk Scheinert Division of Interventional Angiology University-Hospital Leipzig, Germany Conflicts of Interest Advisory Board

More information

Fabrizio Fanelli, MD, EBIR Director Vascular and Interventional Radiology Department "Careggi " University Hospital Florence - Italy

Fabrizio Fanelli, MD, EBIR Director Vascular and Interventional Radiology Department Careggi  University Hospital Florence - Italy Don t Use Risky and Embolizing Drug Coated Balloons Below The Knee! Fabrizio Fanelli, MD, EBIR Director Vascular and Interventional Radiology Department "Careggi " University Hospital Florence - Italy

More information

The essentials for BTK procedures: wires, balloons, what else

The essentials for BTK procedures: wires, balloons, what else A comprehensive approach to diabetic patient Tx The essentials for BTK procedures: wires, balloons, what else Dai-Do Do Clinical and Interventional Angiology Cardiovascular Department Disclosure Speaker

More information

Tools and options for recanalisation of long-femoro-popliteal segments

Tools and options for recanalisation of long-femoro-popliteal segments Tools and options for recanalisation of long-femoro-popliteal segments Pr E Ducasse Unit of Vascular Surgery University of Bordeaux ESVB 2011-may 14th E Ducasse, G Sassoust, D Midy THE ACCESS!! Retrograde

More information

Recent Advances in Peripheral Salvage

Recent Advances in Peripheral Salvage Recent Advances in Peripheral Salvage Dr Shaiful Azmi Yahaya, MD, MMed, FNHAM, FAsCC, FAPSIC Consultant Cardiologist and Peripheral Interventionist, Institut Jantung Negara Disclosure I am proctoring for

More information

Merits and demerits of DES, DEB or covered stent in lower extremity arterial occlusive disease 성균관의과대학삼성서울병원순환기내과최승혁

Merits and demerits of DES, DEB or covered stent in lower extremity arterial occlusive disease 성균관의과대학삼성서울병원순환기내과최승혁 Merits and demerits of DES, DEB or covered stent in lower extremity arterial occlusive disease 성균관의과대학삼성서울병원순환기내과최승혁 Contents DES in SFA DES in BTK DEB in SFA DEB in BTK Current status of covered stent

More information

12-Month and preliminary 24-month outcomes of combining a DCB with a modern generation of nitinol stent in fem-pop lesions. BIOLUX 4EVER study

12-Month and preliminary 24-month outcomes of combining a DCB with a modern generation of nitinol stent in fem-pop lesions. BIOLUX 4EVER study 12-Month and preliminary 24-month outcomes of combining a DCB with a modern generation of nitinol stent in fem-pop lesions BIOLUX 4EVER study Dr. Lieven Maene OLV Aalst, Belgium Disclosure slide Speaker

More information

Accurate Vessel Sizing Drives Clinical Results. IVUS In the Periphery

Accurate Vessel Sizing Drives Clinical Results. IVUS In the Periphery Accurate Vessel Sizing Drives Clinical Results IVUS In the Periphery Discussion Iida O, et. al. Study Efficacy of Intravascular Ultrasound in Femoropopliteal Stenting for Peripheral Artery Disease With

More information

Advancing treatment in highly complex lesions evidence and practice. Arne Schwindt St. Franziskushospital Münster

Advancing treatment in highly complex lesions evidence and practice. Arne Schwindt St. Franziskushospital Münster Arne Schwindt St. Franziskushospital Münster Disclosure Speaker name: Arne Schwindt I have the following potential conflicts of interest to report: x Consulting: Avinger, Biotronik, Cordis, Covidien, Jotec,

More information

Robert W. Fincher, DO The Ritz-Carlton, Dove Mountain Marana, Arizona February 7th, 2015

Robert W. Fincher, DO The Ritz-Carlton, Dove Mountain Marana, Arizona February 7th, 2015 Robert W. Fincher, DO The Ritz-Carlton, Dove Mountain Marana, Arizona February 7th, 2015 Disclosure I have nothing to disclose Randomized Controlled Studies In SFA Technology: What s The Best Tool For

More information

ISR-treatment The Leipzig experience with purely mechanical debulking. Sven Bräunlich Department for Angiology University-Hospital Leipzig, Germany

ISR-treatment The Leipzig experience with purely mechanical debulking. Sven Bräunlich Department for Angiology University-Hospital Leipzig, Germany ISR-treatment The Leipzig experience with purely mechanical debulking Sven Bräunlich Department for Angiology University-Hospital Leipzig, Germany Disclosure Speaker name: Sven Bräunlich I have the following

More information

ESVB State of the art: DES, DCB and the role of debulking. Gunnar Tepe, Rosenheim

ESVB State of the art: DES, DCB and the role of debulking. Gunnar Tepe, Rosenheim ESVB 2013 State of the art: DES, DCB and the role of debulking Gunnar Tepe, Rosenheim DES I Sirocco Sirolimus coating, quick release Duda et al., J Vasc Surg 2002; 106: 1505-1509 20 DES II Strides Everolimus

More information

Is combination therapy with directional atherectomy followed by DCB the answer to challenges in treating SFA disease?

Is combination therapy with directional atherectomy followed by DCB the answer to challenges in treating SFA disease? Is combination therapy with directional atherectomy followed by DCB the answer to challenges in treating SFA disease? The REALITY trial G. Torsello Münster Disclosure Speaker name: G. Torsello... I have

More information

Making BTK Interventions more Durable: Are DES and DCB the answer? Thomas Zeller, MD

Making BTK Interventions more Durable: Are DES and DCB the answer? Thomas Zeller, MD Making BTK Interventions more Durable: Are DES and DCB the answer? Thomas Zeller, MD Faculty Disclosure Thomas Zeller, MD For the 12 months preceding this presentation, I disclose the following types of

More information

Drug- Coated Balloons for the SFA: Overview of Technology and Results

Drug- Coated Balloons for the SFA: Overview of Technology and Results Drug- Coated Balloons for the SFA: Overview of Technology and Results NCVH Latin American 2015 Bogota, Colombia April 9-11, 2015 Brian G. DeRubertis, M.D. Associate Professor of Surgery Division of Vascular

More information

Evidence-Based Optimal Treatment for SFA Disease

Evidence-Based Optimal Treatment for SFA Disease Evidence-Based Optimal Treatment for SFA Disease Endo first Don t burn surgical bridge Don t stent if possible Javairiah Fatima, MD Assistant Professor of Surgery Division of Vascular and Endovascular

More information

A Data-driven Therapeutic Algorithm For Choosing Among Currently Available Tools For SFA Intervention

A Data-driven Therapeutic Algorithm For Choosing Among Currently Available Tools For SFA Intervention A Data-driven Therapeutic Algorithm For Choosing Among Currently Available Tools For SFA Intervention William A. Gray MD Director of Endovascular Services Associate Professor of Clinical Medicine Columbia

More information

Vessel Preparation Prior to DCB and Stenting: How to Do It.

Vessel Preparation Prior to DCB and Stenting: How to Do It. Vessel Preparation Prior to DCB and Stenting: How to Do It. LINC 2018 January 30 February 2, 2018 Leipzig, Germany Brian DeRubertis, MD, FACS Associate Professor of Surgery UCLA Division of Vascular Surgery

More information

Dealing with Calcification in BTK Arteries: Is Lithoplasty the Answer?

Dealing with Calcification in BTK Arteries: Is Lithoplasty the Answer? Dealing with Calcification in BTK Arteries: Is Lithoplasty the Answer? Andrew Holden, MBChB, FRANZCR, EBIR Director of Interventional Radiology Auckland, New Zealand LINC 2017 January 25 th 2017 Disclosure

More information

Promise and limitations of DCB in long lesions What Have we Learned from Clinical Trials? Ramon L. Varcoe, MBBS, MS, FRACS, PhD

Promise and limitations of DCB in long lesions What Have we Learned from Clinical Trials? Ramon L. Varcoe, MBBS, MS, FRACS, PhD Promise and limitations of DCB in long lesions What Have we Learned from Clinical Trials? Ramon L. Varcoe, MBBS, MS, FRACS, PhD Associate Professor of Vascular Surgery University of New South Wales Sydney,

More information

Experience With Atherectomy and DCBs

Experience With Atherectomy and DCBs Experience With Atherectomy and DCBs The merits of a two-part approach in the SFA and popliteal artery. BY ULRICH SUNDERDIEK, MD, PHD In patients with chronic peripheral artery disease (PAD), the options

More information

Stents for The Common Femoral Artery: The Good, The Bad and The Ugly

Stents for The Common Femoral Artery: The Good, The Bad and The Ugly Stents for The Common Femoral Artery: The Good, The Bad and The Ugly Salman Arain, MD, FACC Assistant Professor of Medicine - Cardiology University of Texas Health Sciences Center Houston Texas, USA Disclosure

More information

Present & future of below the knee stenting

Present & future of below the knee stenting Session 5 Below the knee arteries & limb salvage Present & future of below the knee stenting M. Bosiers K. Deloose P. Peeters 1 PRESENT Clinical perspective whom to treat CRITICAL LIMB ISCHEMIA (CLI) 0

More information

Device Evolution. Atherectomy: Where Do We Stand After 12 Years Since FDA Clearance. Where Do We Stand? 4/18/2015

Device Evolution. Atherectomy: Where Do We Stand After 12 Years Since FDA Clearance. Where Do We Stand? 4/18/2015 Disclosure Statement of Financial Interest Atherectomy: Where Do We Stand After 12 Years Since FDA Clearance Within the past 12 months, I or my spouse/partner have had a financial interest/arrangement

More information

Evolving Role of Drug-Eluting Stents In Complex SFA - Majestic Trial Data

Evolving Role of Drug-Eluting Stents In Complex SFA - Majestic Trial Data Evolving Role of Drug-Eluting Stents In Complex SFA - Majestic Trial Data Ralf Langhoff, MD Center for Vascular Medicine Berlin-Wilmersdorf St. Gertrauden Hospital Charité, CC11 Academic Teaching Hospitals

More information

Step by Step : How I treat SFA lesions

Step by Step : How I treat SFA lesions BASIC TECHNIQUES IN PERIPHERAL INTERVENTIONS Step by Step : How I treat SFA lesions Koen Deloose, MD Vascular Surgery, AZ Sint Blasius Dendermonde, Belgium Access to the lesion Common femoral art. Superficial

More information

Or is the ivolution stent a better alternative? EVOLUTION 12-month data

Or is the ivolution stent a better alternative? EVOLUTION 12-month data Or is the ivolution stent a better alternative? EVOLUTION 12-month data Dr. Marc Bosiers LINC 2018, Leipzig Conflict of interest have the following potential conflicts of interest to report: Consulting

More information

Utility of Image-Guided Atherectomy for Optimal Treatment of Ambiguous Lesions by Angiography

Utility of Image-Guided Atherectomy for Optimal Treatment of Ambiguous Lesions by Angiography Utility of Image-Guided Atherectomy for Optimal Treatment of Ambiguous Lesions by Angiography Jon C. George, MD; Vincent Varghese, DO From the Deborah Heart and Lung Center, Browns Mills, New Jersey. ABSTRACT:

More information

BIOLUX 4EVER : Combining Passeo-18 Lux DCB and Pulsar-18 BMS : 12 month results of full cohort

BIOLUX 4EVER : Combining Passeo-18 Lux DCB and Pulsar-18 BMS : 12 month results of full cohort BIOLUX 4EVER : Combining Passeo-18 Lux DCB and Pulsar-18 BMS : 12 month results of full cohort Koen Deloose, MD Head Dept Vascular Surgery AZ Sint-Blasius Dendermonde, Belgium Disclosure slide Speaker

More information

Long-term results with interwoven nitinol stents vs. BMS vs. DCB

Long-term results with interwoven nitinol stents vs. BMS vs. DCB Long-term results with interwoven nitinol stents vs. BMS vs. DCB Dierk Scheinert, MD Division of Interventional Angiology University Hospital Leipzig, Germany Disclosure Advisory Board /Consultant: Abbott,

More information

New Data to Shape the Era of Drug Elution in Peripheral Interventions

New Data to Shape the Era of Drug Elution in Peripheral Interventions New Data to Shape the Era of Drug Elution in Peripheral Interventions William A. Gray MD Director of Endovascular Services Columbia University Medical Center New York Lower Extremity Endovascular - Interventions

More information

Treatment Strategies for Long Lesions of greater than 20 cm

Treatment Strategies for Long Lesions of greater than 20 cm Treatment Strategies for Long Lesions of greater than 20 cm Donald L. Jacobs, MD C. Rollins Hanlon Professor and Chair Chair of the Department of Surgery Saint Louis University Disclosure Speaker name:

More information

Drug Elution, Data, and Decisions

Drug Elution, Data, and Decisions Drug Elution, Data, and Decisions What the data tell us about how to integrate drug-eluting technology into our daily practice. BY GARY ANSEL, MD, AND JOHN A. PHILLIPS, MD The use of drug-eluting technology

More information

The Utility of Atherectomy and the Jetstream Atherectomy System

The Utility of Atherectomy and the Jetstream Atherectomy System The Utility of Atherectomy and the Jetstream Atherectomy System William A. Gray, MD Columbia University Medical Center 2014 Boston Scientific Corporation or its affiliates. All rights reserved. IMPORTANT

More information

Update on the role of drug eluting balloons

Update on the role of drug eluting balloons Update on the role of drug eluting balloons William A. Gray MD Director of Endovascular Services Associate Professor of Clinical Medicine Columbia University Medical Center The Cardiovascular Research

More information

The Final Triumph Of Endovascular Therapy In SFA Treatment

The Final Triumph Of Endovascular Therapy In SFA Treatment The Final Triumph Of Endovascular Therapy In SFA Treatment MEET 07 Mark W. Mewissen, M.D. Director, St Lukes Vascular Center Milwaukee, WI Endovascular Therapy In SFA Treatment: Works In Progress! Mark

More information

SUPERSUB Trial: 1-yr outcomes of SUPERa SUBintimal stenting in CLI Patients

SUPERSUB Trial: 1-yr outcomes of SUPERa SUBintimal stenting in CLI Patients SUPERSUB Trial: 1-yr outcomes of SUPERa SUBintimal stenting in CLI Patients Dr. L.M. Palena, MD Interventional Radiology Unit Foot & Ankle Clinic Policlinico Abano Terme (PD), ITALY Disclosure I have the

More information

Outcomes Of DCB Use In Real World Registries: 2 Year Results From The INPACT Global Registry

Outcomes Of DCB Use In Real World Registries: 2 Year Results From The INPACT Global Registry Outcomes Of DCB Use In Real World Registries: 2 Year Results From The INPACT Global Registry Marianne Brodmann, MD Head of the Clinical Division of Angiology Department of Internal Medicine Medical University

More information

The Crack and Pave technique for highly resistant calcified lesions. Manuela Matschuck MD University Hospital Leipzig Department Angiology

The Crack and Pave technique for highly resistant calcified lesions. Manuela Matschuck MD University Hospital Leipzig Department Angiology The Crack and Pave technique for highly resistant calcified lesions Manuela Matschuck MD University Hospital Leipzig Department Angiology Disclosure Speaker name: Dr. med. Manuela Matschuck I have the

More information

Current Status and Limitations in the Treatment of Femoropopliteal In-Stent Restenosis

Current Status and Limitations in the Treatment of Femoropopliteal In-Stent Restenosis Current Status and Limitations in the Treatment of Femoropopliteal In-Stent Restenosis Osamu Iida, MD From the Kansai Rosai Hospital Cardiovascular Center, Amagasaki City, Japan. ABSTRACT: Approximately

More information

Step by step Hybrid procedures in peripheral obstructive disease. Holger Staab, MD University Hospital Leipzig, Germany Clinic for Vascular Surgery

Step by step Hybrid procedures in peripheral obstructive disease. Holger Staab, MD University Hospital Leipzig, Germany Clinic for Vascular Surgery Step by step Hybrid procedures in peripheral obstructive disease Holger Staab, MD University Hospital Leipzig, Germany Clinic for Vascular Surgery Disclosure Speaker name: H.H. Staab I have the following

More information

Comparison Of Primary Long Stenting Versus Primary Short Stenting For Long Femoropopliteal Artery Disease (PARADE)

Comparison Of Primary Long Stenting Versus Primary Short Stenting For Long Femoropopliteal Artery Disease (PARADE) Comparison Of Primary Long Stenting Versus Primary Short Stenting For Long Femoropopliteal Artery Disease (PARADE) Young-Guk Ko, M.D. Severance Cardiovascular Hospital, Yonsei University Health System,

More information

Turbo-Power. Laser atherectomy catheter. The standard. for ISR

Turbo-Power. Laser atherectomy catheter. The standard. for ISR Turbo-Power Laser atherectomy catheter The standard for ISR Vaporize the ISR challenge In-stent restenosis (ISR) Chance of recurring 7 115,000 + /year (U.S.) 1-6 Repeated narrowing of the arteries after

More information

Safety and Feasibility of Intravascular Lithotripsy for Treatment of Common Femoral Artery Stenoses

Safety and Feasibility of Intravascular Lithotripsy for Treatment of Common Femoral Artery Stenoses Safety and Feasibility of Intravascular Lithotripsy for Treatment of Common Femoral Artery Stenoses Pr Marianne Brodmann, MD Univ. Klinik für Innere Medizin Medizinische Universtität Graz 1 Disclosure

More information

Management of In-stent Restenosis after Lower Extremity Endovascular Procedures

Management of In-stent Restenosis after Lower Extremity Endovascular Procedures Management of In-stent Restenosis after Lower Extremity Endovascular Procedures Piotr Sobieszczyk, MD Associate Director, Cardiac Catheterization Laboratory Cardiovascular Division and Vascular Medicine

More information

Michael K.W. Lichtenberg, MD

Michael K.W. Lichtenberg, MD Ranger All-Comer Registry Treatment of femoropopliteal atherosclerotic lesions using the Drug eluting Balloon Ranger: An All Comers Registry Michael K.W. Lichtenberg, MD Klinikum Arnsberg Arnsberg, Germany

More information

Future of stenting in the. Koen Deloose, MD Head Dept Vascular Surgery AZ Sint Blasius Dendermonde, Belgium

Future of stenting in the. Koen Deloose, MD Head Dept Vascular Surgery AZ Sint Blasius Dendermonde, Belgium Future of stenting in the current DCB world Koen Deloose, MD Head Dept Vascular Surgery AZ Sint Blasius Dendermonde, Belgium Disclosure slide Speaker name: Koen Deloose, MD I have the following potential

More information

Surgical Bypass vs. Zilver PTX stent for long SFA lesions : Interim results of the ZilverPass Trial

Surgical Bypass vs. Zilver PTX stent for long SFA lesions : Interim results of the ZilverPass Trial Surgical Bypass vs. Zilver PTX stent for long SFA lesions : Interim results of the ZilverPass Trial Dr. Koen Deloose Head of Vascular Surgery AZ Sint-Blasius Dendermonde Belgium Disclosure slide Speaker

More information

Drug-Coated Balloon Treatment for Patients with Intermittent Claudication: Insights from the IN.PACT Global Full Clinical Cohort

Drug-Coated Balloon Treatment for Patients with Intermittent Claudication: Insights from the IN.PACT Global Full Clinical Cohort Drug-Coated Balloon Treatment for Patients with Intermittent Claudication: Insights from the IN.PACT Global Full Clinical Cohort a.o. Univ. Prof. Dr. Marianne Brodmann Medical University of Graz Graz,

More information

Calcium Removal and Plaque Modification in the Era of DEB and Contemporary Stenting for Femoro- Popliteal Disease

Calcium Removal and Plaque Modification in the Era of DEB and Contemporary Stenting for Femoro- Popliteal Disease Calcium Removal and Plaque Modification in the Era of DEB and Contemporary Stenting for Femoro- Popliteal Disease Thomas M. Shimshak, MD Heart and Vascular Center Florida Hospital Heartland Medical Center

More information

DCB in my practice: How the evidence influences my strategy. Yang-Jin Park

DCB in my practice: How the evidence influences my strategy. Yang-Jin Park DCB in my practice: How the evidence influences my strategy Yang-Jin Park Associate Professor Division of Vascular Surgery, Department of Surgery Samsung Medical Center Sungkyunkwan University School of

More information

Endovascular Therapy vs. Open Femoral Endarterectomy Rationale and Design of the Randomized PESTO Trial

Endovascular Therapy vs. Open Femoral Endarterectomy Rationale and Design of the Randomized PESTO Trial Endovascular Therapy vs. Open Femoral Endarterectomy Rationale and Design of the Randomized PESTO Trial Prof. Thomas Zeller, MD Department Angiology Clinic for Cardiology and Angiology II University Heart-Center

More information

The present status of selfexpanding. for CLI: Why and when to use. Sean P Lyden MD Cleveland Clinic Cleveland, Ohio

The present status of selfexpanding. for CLI: Why and when to use. Sean P Lyden MD Cleveland Clinic Cleveland, Ohio The present status of selfexpanding and balloonexpandable tibial BMS and DES for CLI: Why and when to use Sean P Lyden MD Cleveland Clinic Cleveland, Ohio Disclosure Speaker name: Sean Lyden, MD I have

More information

Expanding to every demand: The GORE VIABAHN VBX Stent Graft

Expanding to every demand: The GORE VIABAHN VBX Stent Graft Expanding to every demand: The GORE VIABAHN VBX Stent Graft GORE, VIABAHN, and designs are trademarks of W. L. Gore & Associates. 2017 W. L. Gore & Associates, Inc. Program Faculty Martin Austermann, MD

More information

How do I use mechanical debulking for the treatment of arterial occlusions

How do I use mechanical debulking for the treatment of arterial occlusions How do I use mechanical debulking for the treatment of arterial occlusions Sven Bräunlich, MD Division of Interventional Angiology University-Hospital Leipzig, Germany Disclosure Speaker name: Sven Bräunlich

More information

When Outcomes Matter, Design Matters

When Outcomes Matter, Design Matters to receive our latest news and key activities. Cordis S.M.A.R.T. Self-Expanding Nitinol Lower Extremity Solutions When Outcomes Matter, Design Matters For superficial femoral artery (SFA) and iliac lesions.

More information

Klinikum Rosenheim Department of Diagnostic and Interventional Radiology

Klinikum Rosenheim Department of Diagnostic and Interventional Radiology Klinikum Rosenheim Department of Diagnostic and Interventional Radiology Is Directional Atherectomy (Silverhawk Or Turbohawk) With DEB, Better Than DEB Alone: Based On The DEFINITIVE AR RCT: 1-Year Results

More information

Is there a place for very distal BTK stenting? What are the options for acute PTA failure?

Is there a place for very distal BTK stenting? What are the options for acute PTA failure? Is there a place for very distal BTK stenting? What are the options for acute PTA failure? Dr. E. Puras Mallagray Hospital Universitario Quirón Madrid SPAIN Faculty disclosure Enrique Puras I disclose

More information

Cutting/scoring balloon Cryoplasty Drug-eluting balloon Brachytherapy Debulking Restent (BMS or DES) John R. Laird, MD

Cutting/scoring balloon Cryoplasty Drug-eluting balloon Brachytherapy Debulking Restent (BMS or DES) John R. Laird, MD Current Treatment of Femoropopliteal Instent Restenosis Professor of Medicine Medical Director of the Vascular Center UC Davis Medical Center SFA In-stent Restenosis Common: 18%- 40% at 12 months in recent

More information

Plaque scoring in calcified lesions

Plaque scoring in calcified lesions Plaque scoring in calcified lesions Advancing DCB therapy in complex SFA lesions Erwin Blessing, MD, FESC SRH Klinikum Karlsbad- Langensteinbach, Germany Disclosure Speaker name: Erwin Blessing I have

More information

Maximizing Outcomes in a complex population with Drug-coated balloon

Maximizing Outcomes in a complex population with Drug-coated balloon Maximizing Outcomes in a complex population with Drug-coated balloon March 13, 2018 Chumpol Wongwanit, MD Siriraj Hospital, Mahidol University, Bangkok, Thailand LINC Asia-Pacific 2018, Hong Kong Disclosure

More information