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Tryton: Addressing the Challenge of
Bifurcation Stenting
Dean J. Kereiakes, M.D.
Medical Director, The Christ Hospital Heart
and Vascular Center and the Lindner Research
Center , Cincinnati, Ohio
Professor of Medicine, Ohio State University
• Modest Consulting Fees
• Significant Consulting Fees
• Significant Consulting Fees
• Significant Consulting Fees
• Significant Consulting Fees
• Significant Consulting Fees
• Major Stock Shareholder/Equity
• HCRI
• Boston Scientific
• Abbott Vascular
• Svelte Medical Systems, Inc.
• Janssen Research & Development LLC
• Sanofi-Aventis U.S. LLC
• Ablative Solutions, Inc.
Affiliation/Financial Relationship Company
Disclosure Statement of Financial Interest
Within the past 12 months, I or my spouse/partner have had a financial
interest/arrangement or affiliation with the organization(s) listed below.
Tryton-The Vision:
To treat spectrum of Bifurcation Lesions with the Same
Predictability and Durability as Straight Lesions
Bifurcation Lesions
• Bifurcation lesions are characterized by
variable and complex anatomy:
Focal
Diffuse Angulated
Calcified
Clinical Segmentation
- Plaque Distribution
Classifications -
Duke Plaque Distribution Classification
-
Type F:
Pre-Branch & Ostial
Type A:
Pre-Branch
(ICPS Type 3)
Type B:
Post-Branch
(ICPS Type 4a)
Type C:
Parent Vessel Only
(ICPS Type 2)
Type D:
Bifurcation
(ICPS Type 1)
Type E:
Ostial
(ICPS Type 4b)
Sources: Popma 1994; Baim TCT 2003
True
Bifurcation
ICPS
*
*
Bifurcation Disease Strategy, Morice, TCT 2005
*
Bifurcation Stenting Techniques with
Workhorse Stents
T Stenting V Stenting Y Stenting Culotte * Crush*
Kissing Stent* *”gap” coverage
Complex Bifurcation Disease:
Addressing with workhorse DES makes one ‘MADS’!
Catheter and Cardio Interventions 71:175–183 (2008)
Unstented Vessel area versus
Bifurcation angle
0
5
10
15
20
25
30
35
0 10 20 30 40 50 60 70 80 90
Bifurcation Angle (degrees)
Unstentedvesselarea
(mm^2)
As bifurcation angle changes
from 90º, unstented vessel area
increases rapidly with
“workhorse stents”
Suboptimal Coverage & Drug delivery with
Workhorse Stents
0 10 20 30 40 50 60 70 80 .
Bifurcation Angle (degrees)
Unstented
Vessel Area
90
Tryton Side Branch Stent
Transition
Zone
Side Branch
Zone
Main Branch
Zone
8 mm 4.5 mm 6.5 mm
For Investigational Use Only in the United States
For Investigational Use Only in the United States
Tryton Deployed - Side Branch Secured
Position Main Branch Stent
Complete Lesion Coverage
Tryton Sidebranch Stent
Symposium Agenda
Thank You

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Tryton - Addressing the Challenge of Bifurcation Stenting | Dean J. Kereiakes, M.D.

  • 1. Tryton: Addressing the Challenge of Bifurcation Stenting Dean J. Kereiakes, M.D. Medical Director, The Christ Hospital Heart and Vascular Center and the Lindner Research Center , Cincinnati, Ohio Professor of Medicine, Ohio State University
  • 2. • Modest Consulting Fees • Significant Consulting Fees • Significant Consulting Fees • Significant Consulting Fees • Significant Consulting Fees • Significant Consulting Fees • Major Stock Shareholder/Equity • HCRI • Boston Scientific • Abbott Vascular • Svelte Medical Systems, Inc. • Janssen Research & Development LLC • Sanofi-Aventis U.S. LLC • Ablative Solutions, Inc. Affiliation/Financial Relationship Company Disclosure Statement of Financial Interest Within the past 12 months, I or my spouse/partner have had a financial interest/arrangement or affiliation with the organization(s) listed below.
  • 3. Tryton-The Vision: To treat spectrum of Bifurcation Lesions with the Same Predictability and Durability as Straight Lesions
  • 4. Bifurcation Lesions • Bifurcation lesions are characterized by variable and complex anatomy: Focal Diffuse Angulated Calcified
  • 5. Clinical Segmentation - Plaque Distribution Classifications - Duke Plaque Distribution Classification - Type F: Pre-Branch & Ostial Type A: Pre-Branch (ICPS Type 3) Type B: Post-Branch (ICPS Type 4a) Type C: Parent Vessel Only (ICPS Type 2) Type D: Bifurcation (ICPS Type 1) Type E: Ostial (ICPS Type 4b) Sources: Popma 1994; Baim TCT 2003 True Bifurcation ICPS * * Bifurcation Disease Strategy, Morice, TCT 2005 *
  • 6. Bifurcation Stenting Techniques with Workhorse Stents T Stenting V Stenting Y Stenting Culotte * Crush* Kissing Stent* *”gap” coverage
  • 7. Complex Bifurcation Disease: Addressing with workhorse DES makes one ‘MADS’! Catheter and Cardio Interventions 71:175–183 (2008)
  • 8. Unstented Vessel area versus Bifurcation angle 0 5 10 15 20 25 30 35 0 10 20 30 40 50 60 70 80 90 Bifurcation Angle (degrees) Unstentedvesselarea (mm^2) As bifurcation angle changes from 90º, unstented vessel area increases rapidly with “workhorse stents” Suboptimal Coverage & Drug delivery with Workhorse Stents 0 10 20 30 40 50 60 70 80 . Bifurcation Angle (degrees) Unstented Vessel Area 90
  • 9. Tryton Side Branch Stent Transition Zone Side Branch Zone Main Branch Zone 8 mm 4.5 mm 6.5 mm For Investigational Use Only in the United States For Investigational Use Only in the United States
  • 10. Tryton Deployed - Side Branch Secured