SPIRATION VALVE SYSTEM For the Treatment of Emphysema or Air Leaks. 0000
ENGINEERED FOR AIRWAY MANAGEMENT Inspired by aerodynamics, the Spiration Valve redirects air away from diseased or damaged lung to healthier tissue, all while allowing trapped air and secretions to escape, so that patients may breathe easier. Unlike a stent, the unique design of the Spiration Valve minimizes contact with the bronchial wall, maintains position to redirect air even in complex patients, and facilitates removal when needed. The Spiration Valve System is intended to treat severely diseased lung in patients with heterogeneous emphysema and evidence or markers of low collateral ventilation such as complete fi ssures, or damaged lung resulting in air leaks by limiting airfl ow to selected areas. The procedure is considered minimally invasive and can be performed through a fl exible bronchoscope. On inhalation, the Spiration Valve conforms to the airway and redirects air to healthier tissues of the lung. On exhalation, the Spiration Valve fl exibly constricts with the airways, allowing trapped air and secretions to escape naturally along the bronchial wall between the umbrella struts.
Stays in Place The first and only valve with anchors for 0% migration and expectoration. 2,14,15 Redirects Air The first and only valve with umbrella struts to minimize tissue contact and allow secretions to escape naturally along the bronchial wall. Greater Airway Access Catheters for 2.0mm and 2.6mm working channels. Removable The first and only valve with a center rod to facilitate removal. Largest Range of Valve Sizes Now available in 9mm size for large airways. 5mm 6mm 7mm 9mm 10mm 11mm 12mm 12mm 8mm 9mm 10mm 12mm
FOR THE TREATMENT OF EMPHYSEMA THE CONFIDENCE YOU NEED FOR THE OUTCOMES YOU WANT. Target lobe will have severe, highly heterogeneous emphysema with complete fissures. 1,2,3 Multiple valves are placed to occlude all the airways leading to the targeted lobe and enable atelectasis or significant lobar reduction. Significant lobar reduction can relieve hyperinflation, enable healthier tissue to expand, and make breathing easier. 3
THE RIGHT PATIENT. THE RIGHT PRODUCT. THE RIGHT OUTCOMES. by From reliable, non invasive evidence of low collateral ventilation... SeleCT enables clinicians to submit HRCTs and receive quantitative measures of fi ssure integrity. More accurate and reproducible than visual CT analysis. 16 Comparable accuracy to Chartis. 16 Avoids an invasive procedure just to confirm collateral ventilation. 16 Not dependent on anatomy, coughing, or mucus where direct bronchoscopic measure may be unreliable or not possible. 16 Provides useful measures beyond complete fissures such as emphysema severity, heterogeneity and lobar volume that may improve the prediction of lung volume reduction. 16...to 0% migration or expectoration 2,14,15 for effective lobar occlusion Complete occlusion is a prerequisite for signifi cant volume reduction, which correlates with improvement in clinical outcomes. 17 FEV 1 was improved by 21.4% at 90 days, with statistically significant differences also seen across IVC, RV, RV/TLC, 6MWD, mmrc, SGRQ, BODE and ADO. 17 99% technical success. 2,14 Now available in 9mm size for large airways.
FOR THE TREATMENT OF AIR LEAKS THE PRECISION YOU NEED FOR THE OUTCOMES YOU WANT. Persistent air leaks impact inpatient and outpatient resources utilization, cost, and morbidity. 4,5,6,7 An air leak present by day 5 should be considered for thoracic surgical consultation or treatment. 5,8,9,10 A substantial reduction in an air leak using Spiration Valves may accelerate the resolution of an air leak. Complete cessation of an air leak may not be achievable, or necessary, for successful treatment. 9,11,12,13
THE RIGHT PATIENT. THE RIGHT PRODUCT. THE RIGHT OUTCOMES. A proven isolation technique 9,18 to identify the source of air leak(s)... From the leader in valve therapy for air leaks with over two thousand procedures supported worldwide. Reassess 1. Assess Block main bronchus to determine if the leak can be stopped or reduced and the length of time it takes to see a change in the water seal monitor. 2. Isolate Systematically work from proximal to distal. Spiration Isolation Method 3. Place Valve Once an airway is identified, size the airway and place a valve. 4. Reassess Repeat process to isolate additional leaks as dynamics may have changed since valve placement.*...to a minimally invasive solution with a center rod to facilitate removal upon resolution of the air leak. Treatment with the Spiration Valve System has demonstrated a favorable responder rate. 12,13,18 100% (n=9/9) of treated patients met the primary endpoint, as identified as air leak cessation allowing chest tube removal. 13 77% (n=10/13) of treated patients were responders, as identified as successful chest tube removal without the need for further interventions. 12 100% (n=7/7) of treated patients had improvement in the air leak, as defined as improvement allowing Heimlich valve use, improvement of 1 Cerfolio classification, or complete cessation of the air leak. 18 *Treatment should be limited to no more than 3 segments by placing valves in segmental or sub-segmental bronchi in the target lung to avoid excessive isolation of tissues from ventilation.
SPIRATION VALVE SYSTEM TECHNOLOGY Deployment Catheter and Loader Bronchoscope Model Name Article Number Catheter Working Length Channel Inner Diameter Valve Size Compatibility IBV-C26N N5381300 1020mm 2.6mm or greater For 5, 6, 7 and 9mm Valves IBV-C20 N3521830 1140mm 2.0mm or greater For 5, 6 and 7mm Valves Spiration Valves Model Name Article Number Valve Size Cartridge Color Number Required Per Procedure IBV-V5 N3495330 5mm Blue IBV-V6 N3495430 6mm Yellow IBV-V7 N3495530 7mm Green Determined by number of target locations IBV-V9 N5381200 9mm Grey Airway Sizing Kit Model Name Article Number Gauge Hole Glass Syringe Number Required Per Procedure IBV-VSK N5534500 Sized for appropriate valve selection 500 microliters 1 Required Ancillary Equipment Needed for Each Procedure Flexible bronchoscope with a working channel inner diameter of 2.0mm or greater Olympus balloon catheter B5-2C Bronchoscopy forceps appropriate for valve removal Standard 10cc sterile syringe with Luer-lock for use in preparing the balloon catheter Sterile saline References 1. Scuriba. NEJM 2010; 363: 1233-1244. 2. Springmeyer. Thorac Surg Clin 2009; 19(2):247-253. 3. Eberhardt. Chest 2012; 142(4): 900-908. 4. Brunelli. Ann Thorac Surg 2004; 77:1205-1210. 5. Schoenenberger. Arch Surg 1991; Vol 126. 6. Varela. Eur J Cardiothoracic Surg 2005; 27:329-33. 7. Brunelli. Chest 2006; 130:1150-6. 8. Cerfolio. Ann Thorac Surg 1998; 66: 1726-1730. 9. Mahajan. J Thorac Cardiovasc Surg 2013; 145:626-630. 10. Yarmos. Chest 2012; 141(4):1098-105. 11. Instructions for use, Humanitarian Use Device (HDE), Spiration Valve System. 12. Firlinger. Ann Thorac Surg 2013 Apr; 95(4):1243-9. 13. Dooms. Eur Respir J Epub Nov 14, 2013; doi: 10.1183/09031936.00117613. 14. Elstad. Am J Respir Crit Care Med 2012; 185:A1112. 15. Ninane. Eur Respir J 2012; 39:1319 1325. 16. Schuhmann. Am J Respir Crit Care Med 2015; Jan 30 [Epub ahead of print]; doi: 10.1164/rccm.201407-1205OC. 17. Eberhardt. Chest Epub March 29, 2012; doi:10.1378/chest.11-2886. 18. Gillespie. Ann Thorac Surg 2011; 91:270-3. OLIT-03560-03 Rev AA E0428590 Copyright 2015 Spiration, Inc. d/b/a Olympus Respiratory America ARTG Identifiers: 188455, 182553, 181950 WAND Reference Nos: 110725-WAND-6BJ53E, 110505-WAND-6B1TDA, 110509-WAND-6B2O34 OLYMPUS RESPIRATORY AMERICA 6675 185th Ave NE, Redmond, Washington 98052 USA OLYMPUS EUROPA SE & CO. KG Wendenstrasse 14-18, 20097 Hamburg, Germany KEYMED LTD. KeyMed House, Stock Road, Southend-on-Sea, Essex, SS2 5QH, UK OLYMPUS AUSTRALIA PTY. LTD. 3 Acacia Place, Notting Hill, VIC 3168 Australia