Live Cases from San Camillo Hospital, Rome Operators:Alexander Avran (Valenciennes - F), Nicolas Boudou (Bordeaux - F), Francesco De Felice (Rome) Live Cases from Catholic University, Rome Operators: Alfredo Ruggero Galassi (Palermo), Sevket Gorgulu (Istanbul - TR), Francesco Burzotta (Rome) Flash Highlights New wires in CTO recanalization Masahisa Yamane (Tokyo - J) ________________________________________ PARALLEL SESSION Live Cases from Rome + Flash Highlights Auditorium Zubin Mehta - Friday 9:00 - 10:30 Chairpersons: Omer Goktekin (Istanbul - TR), Gabriele Gasparini (Milan) Coordinator: Roberto Garbo (Turin) Discussants: Zisis Dimitriadis (Wiesbaden - D), Kadriye Orta Kilickesmez (Istanbul - TR), Stylianos Pyxaras (Furth - D) Challengers: Claudia Cosgrove (London - UK), Juan Luis Gutierrez Chico (Marbella - E) _______________________

1. New wires in CTO recanalization
Masahisa Yamane MD, FACC
Saitama Sekishinkai Hospital

2. Conflict of Interest
Masahisa Yamane, MD, FACC
I have a financial interest/arrangement or affiliation with one or more organizations that could be
perceived as a real or apparent conflict of interest in the context of the subject of this presentation.
Asahi Intec Consultant
Nippro Company Honorarium

3. Ant UB3 >CP12>GN4
Retro Sion black
Ant Gaia Next 4
Retro Gladius MG
Guide Extension
XCART
CTO-PCI 2022
PCap Ambiguity +
Length > 20mm
Calcification +
Prior attempt +

4. Calcified
Osteal
LAD CTO
Sion Black
Sion Black to Gradius
IVUS couldn’t locate retro wire
Antegrade Gaia3
Antegrade CP12
Antegrade Hornet 14
Antegrade Gaia Next4

5. Gaia Next 4
Tip load

6. ASAHI Gaia series
Consist of Explanation
Outer coil ●
Single wire coil
Single wire
forms a coil
Core wire ●
ACT ONE ● ASAHI brand multi wire coil provides torque force, torque
response, anti-kinking, precise roundness, durability and
flexibility.
Twist wire × Composite guide wire (SION TECC)
BASICS 2023 April 26-27, Belgrade, SERBIA

7. ASAHI Gaia Next series
Composite
guide wire Consist of Explanation
Outer coil ●
1 2 3 4 5 6 … 1 2 3 4 5 6 …1 2
XTRAND
Multi wire rope coil
Multi wire ropes form a coil
Core wire ●
ACT ONE ● ASAHI brand multi wire coil provides torque force, torque
response, anti-kinking, precise roundness, durability and
flexibility.Composite guide wire (SION TECC)
7

8. ⚫ Length ：190cm
⚫ Hydrophilic coating length ： 40cm
⚫ Coil length ： 15cm
⚫ Radiopaque length ： 15cm
SLIP-COAT® Hydrophilic coating： 40cm
ASAHI Gaia Next 1 0.36mm/0.27mm (0.014inch/0.011inch)
ASAHI Gaia Next 2 0.36mm/0.30mm (0.014inch/0.012inch)
ASAHI Gaia Next 3 0.36mm/0.30mm (0.014inch/0.012inch)
Line-up & Technical Specs
Coated with Slipcoat® Coating

9. XTRAND coil (cross section)
XTRAND coil
ACT ONE
Core wire
✓ Avoid coil damage/snatching
✓ Avoid kinking of the core wire
✓ High torque performance
XTRAND coil features
ACT ONE (Asahi Cable Technology)= Enhanced wire makeup, gained by stranded wires
XTRAND (Rope coil structure) = Enhanced wire makeup, gained by rope coil wires

10. @Proximal Cap
Gaia Next 4 ◯ Gaia Next 3 ×
Test Model
Conquest Pro 12 ◯
Gaia Next 4 Paraffin

11. RCA
CTO LVEF=25%
Suoh 03
XT-R
UB3
Gladius MG

12. Assessment
Proximal Cap tapered
Length >20mm
Distal small
Collateral +
Septal/Epicardial
Ca --
Bend +
Plan
RDR
Branch protection
Suoh 03 on Corsair Pro XS
Gladius EX on Corsair Pro XS
Antegrade Gaia Next3
Guide Extension X CART
RCA CTO

13. Gladius MG (ASAHI)
Diameter ： 0.36mm(0.014inch)
Tip load ： 3.0 gf
Radiopaque : 30 mm
Coating length ： 500 mm
Usable length ： 200/300 cm
❊Coated with SLIP-COAT® coating
Product specification: Gladius Mongo (MG)
** Gladius EX ( Peripheral ) : without Polymer Jacket coating

14. ⚫ Stainless core＋Tip load: 3.0 gf
✓Adaptable for tough CTO-PCI Intermediate type with stainless core
⚫ Hydrophilic coating 500 mm
✓Polymer Jacket and long hydrophilic coating provides excellent lubricity.
⚫ ACT ONE ＋ Balanced support shaft design
✓Contains high controllability even with polymer jacket GW.
New option for CTO-PCI
High lubricity, controllability inside the lesion
ASAHI’s Intermediate type polymer GW
14
Product specification: Gladius Mongo (MG)

15. ASAHI Gladius Mongo ES PILOT200
The prolapse is less likely to be enlarged relative to the products of other manufacturers.
This can suppress kinking and maintain the GW performance even after the GW has passed though the lesion.
<Using the ETOSS to prolapse and observe the GW tip>
Simulated lesion with a
double-layer structure
GW Push
4mm
Benefit: Tip durability and Agility in limited space
8
BASICS 2023 April 26-27, Belgrade, SERBIA

16. New wires
• There are still room for technological improvements in device
development
• Torque, slight tag of the wire and adequate pause provide excellent
trackability and cross ability of current microcatheter
• Gaia Next series, especially GN 4, defines the next stage of deflectable,
penetration wire
• Gladius MG is a new class of middle-weight wire, in both directive
wiring and knuckling to cross the CTO body
• When trying to preserve a bifurcation, try directive wiring for directive
XCART (inside CTO) than conventional XCART