ensure a perfect positioning and scaffolding at the sb ... · purpose of the devicepurpose of the...

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Purpose of the device Purpose of the device Ensure a perfect positioning and scaffolding at the SB ostium • Avoid wire wrap 6 F compatible

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Page 1: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

Purpose of the devicePurpose of the device

• Ensure a perfect positioning andscaffolding at the SB ostium

• Avoid wire wrap

• 6 F compatible

Page 2: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

Stent dedicated deviceStent dedicated device

Dolfin-Titan HexacatH

1- One stent for Main Branch (MB)With large cell to Side Branch (SB) access

2- Prior, guidewire pushed into SB

3- Stent approach only over a SB guidewire

Page 3: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

video

Dolfin dedicated stentconcept

Dolfin dedicated stentconcept

Page 4: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

Dolfin StentDolfin Stent

SB balloon Tip

Stent length 16mm; Profile 1.40 mm; 0.055 ‘’ (KT 6F 0.070 ‘’)Two independent balloons

Page 5: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

In VITRO TestsIn VITRO TestsSilicon tube, diameter 3.0 MB, 2.5 SB, angle 30°

1 2

3 4

0.014’’ guidewire into the SB

1 2

Stent positioning into the SB

MB Balloon tip released during the pull back of the MB wire, previouslyloaded into the SB - dedicated sheath

3

Positioning of MB wire

4

SB

MB

Page 6: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

In VITRO TestsIn VITRO Tests

First step Final step of the Dolfin stent into the bifurcation after rotation

allowing the perfect positioning of the larger dedicated cell in front

of the SB lumen

5 6

Stent positioning into the bifurcation

5

Rotation

6

Page 7: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

In VITRO TestsIn VITRO Tests

7 8

9 10

SB Balloon inflation

7

Kissing balloon

8

Deflation of both balloons

9 10

Stent in position into the bifurcationafter balloon withdrawal

Page 8: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

In VITRO TestsIn VITRO Tests

77 88

99 1010

Easy crossing through the SB lumen with a balloon.

Easy pull back of the balloon intothe SB lumen as well as into the larger SB -dedicated cell

Page 9: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

Animal ExperimentAnimal Experiment

Materials and Methods• Animal model: porcine (in GLP – compliant laboratory, Paris)

• Dedicated stent deviceTwo Dolfin sizing:Balloon Diameters (mm)

MB 3,0 SB 2,53,5 3,0

Balloon length (mm) 17.5 10.5

Page 10: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

Animal ExperimentAnimal Experiment

Technique

• Sheath: 6F femoral approach• AL2 guiding-catheter• Heparin:1mg /Kg; Clopidogrel 150mg• Angiogram:Vessel bifurcation LAD/Diagonal or

CX/Marginal branch-MB minimum diameter 3,0 mm-SB minimum diameter 2,5 mm

Page 11: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

Animal ExperimentAnimal Experiment

Dolfin stent Implantation• First: 0.014’’ guidewire is placed into SBThe MB Guidewire is trapped into the SB balloon tip, in order to avoid wire-wrap

Image ou séq coros

Page 12: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

Animal ExperimentAnimal Experiment

Dolfin stent Implantation• First: 0.014’’ guidewire is placed into SBThe MB Guidewire is trapped into the SB balloon tip, in order to avoid wire-wrap

Image ou séq coros

Page 13: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

Animal ExperimentAnimal Experiment

Dolfin stent Implantation

• Second: Dolfin system is only pushedover SB guidewire.Then, MB guidewire is whithdrawn and pushed in the MB.

• Third: the stent is positioned at the carinabefore balloon inflation

Page 14: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

Animal ExperimentAnimal ExperimentDolfin stent Implantation

Image coro 3 Image coro 4

Page 15: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

AngiogramAngiogram

Page 16: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

IVUS controlIVUS control

SB

SB

Stent into MB

Ostium scaffolding

SB

bifurcation

Page 17: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

Animal ExperimentAnimal ExperimentResultsDolfin tested n = 8Dolfin size used: 3.0 x 2.5 – 16mm n = 7

3.5 x 3.0 – 16mm n = 1

Successful implantation n = 8

SB ostium recrossing successfulSB ostium patency in all casesAdditional standard SB stenting n = 4

Page 18: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

AdvantagesAdvantages

•Safe procedure• Easy to use• No risk of Wire wrap• 6F compatible device

• Perfect positioning of the dedicatedcell in front of SB ostium

• SB ostium widely patent …• …enabling easy « Provisional T stenting »

Page 19: Ensure a perfect positioning and scaffolding at the SB ... · Purpose of the devicePurpose of the device • Ensure a perfect positioning and scaffolding at the SB ostium • Avoid

Dolfin Next stepDolfin Next step

Continue animal trial, with 3 months FU

Obtain CE marked

Tentative First in Man 1st quarter 2009

Thank you for your attention