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