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

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TCT2015 Presentation - Dean J. Kereiakes, M.D.

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

  1. 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. 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. 3. Tryton-The Vision: To treat spectrum of Bifurcation Lesions with the Same Predictability and Durability as Straight Lesions
  4. 4. Bifurcation Lesions • Bifurcation lesions are characterized by variable and complex anatomy: Focal Diffuse Angulated Calcified
  5. 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. 6. Bifurcation Stenting Techniques with Workhorse Stents T Stenting V Stenting Y Stenting Culotte * Crush* Kissing Stent* *”gap” coverage
  7. 7. Complex Bifurcation Disease: Addressing with workhorse DES makes one ‘MADS’! Catheter and Cardio Interventions 71:175–183 (2008)
  8. 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. 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. 10. Tryton Deployed - Side Branch Secured
  11. 11. Position Main Branch Stent
  12. 12. Complete Lesion Coverage
  13. 13. Tryton Sidebranch Stent
  14. 14. Symposium Agenda
  15. 15. Thank You

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