D2230 g v01 rev. 1 d.rizik, tryton breakfast symposium_real world applications

1. Scottsdale-LincolnHealthNetwork
Tryton Breakfast Symposium:
Real World Applications
David G. Rizik, M.D., F.A.C.C., F.S.C.A.I.
Chief Scientific Officer
Director of Structural & Coronary Interventions
HonorHealth and the Scottsdale-Lincoln
HealthNetwork
HonorHealth/Scottsdale-LincolnHealthNetwork

2. Scottsdale-LincolnHealthNetwork
Disclosure Statement
• Abbott Vascular: Medical Advisory
Board, Research & Education
Support.
• Boston Scientific: Executive
Physician Council, Research &
Education Support

3. Scottsdale-LincolnHealthNetwork
Tryton Side Branch Stent
“Save the Side Branch Strategy”
Open strut architecture

4. Scottsdale-LincolnHealthNetwork
Phantom Model Deployment
Tryton Side Branch Stent

5. Scottsdale-LincolnHealthNetwork
Tryton Deployment Sequence
1. Wire both vessels and pre-­dilate SB 2. Position Tryton
3. Perform P.O.T. 4. Position DES and remove ‘jailed’ wire
5. Deploy DES and re-­wire SB
6. Simultaneous Kissing Balloon

6. Scottsdale-LincolnHealthNetwork
Tryton Case

7. Scottsdale-LincolnHealthNetwork

8. Scottsdale-LincolnHealthNetwork

9. Scottsdale-LincolnHealthNetwork

10. Scottsdale-LincolnHealthNetwork
Dedicated SB Stent: ? Value
• Value: Bringing the predictability &
durability seen in straight lesions to
bifurcation lesions

11. Scottsdale-LincolnHealthNetwork
Provisional (n= 143)
Tryton (n= 146)
Dedicated Stent: Predictability
Near elimination of bailout stenting
Généreux et al. Catheter Cardiovasc Interv. 2015
Tryton IDE Trial Intended Population

12. Scottsdale-LincolnHealthNetwork
Which Lesion? Significant Side Branch
• Side Branch Size: Significant
• Angle: Narrow and Wide
• Step-­up: Large and Small

13. Scottsdale-LincolnHealthNetwork
Which Lesion? Significant
• Significant
– Appropriate for a 2.5 mm diameter stent
– >2.25 mm by visual estimate

14. Scottsdale-LincolnHealthNetwork

15. Scottsdale-LincolnHealthNetwork
Angle: Wide Angle: Narrow
Which Lesion? Angle

16. Scottsdale-LincolnHealthNetwork
SB-­MB Step-­up: Large SB-­MB Step-­up: Small
Which Lesion? SB-MB Step-up

17. Scottsdale-LincolnHealthNetwork
Conclusion
• When a dedicated SB Stent?
Bifurcation lesions with important Side
Branches
• Procedural Predictability
• Long term Durability