www.metcardio.org new generation devices for the femoro-popliteal district giuseppe biondi zoccai...

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www.metcardio.org New generation New generation devices for the devices for the femoro-popliteal femoro-popliteal district district Giuseppe Biondi Zoccai Giuseppe Biondi Zoccai University of Modena and Reggio University of Modena and Reggio Emilia Emilia [email protected] [email protected]

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Page 1: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

www.metcardio.org

New generation devices for New generation devices for the femoro-popliteal districtthe femoro-popliteal district

Giuseppe Biondi ZoccaiGiuseppe Biondi ZoccaiUniversity of Modena and Reggio EmiliaUniversity of Modena and Reggio Emilia

[email protected]@gmail.com

Page 2: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

www.metcardio.org

LEARNING GOALS

• Scope of the problem• Devices to increase success• Devices to increase patency• Other devices

Page 3: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

www.metcardio.org

LEARNING GOALS

• Scope of the problem• Devices to increase success• Devices to increase patency• Other devices

Page 4: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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SCOPE OF THE PROBLEM: SUCCESS

Sangiorgi et al, submitted

Page 5: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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SCOPE OF THE PROBLEM: PATENCY

Schillinger et al, New Engl J Med 2006

Page 6: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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WHEN MORE IS LESS?

Rogers et al, Circulation 2007

Page 7: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

www.metcardio.org

LEARNING GOALS

• Scope of the problem• Devices to increase success• Devices to increase patency• Other devices

Page 8: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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DEVICES TO INCREASE SUCCESS

• Outback• Pioneer• Frontrunner• Crosser• Scoring/cutting balloons• Directional atherectomy• Laser

Page 9: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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OUTBACK

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PIONEER

Page 11: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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FRONTRUNNER

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CROSSER

Page 13: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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VASCUTRAK

Page 14: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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TURBOHAWK ATHERECTOMY

Page 15: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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PATHWAY ATHERECTOMY

Page 16: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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TURBO BOOSTER LASER

Page 17: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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LEARNING GOALS

• Scope of the problem• Devices to increase success• Devices to increase patency• Other devices

Page 18: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

www.metcardio.org

DEVICES TO INCREASE PATENCY

• Bare-metal stents• Stent-grafts• Cryoplasty• Drug-coated balloons• Drug-eluting stents

Page 19: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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SUPERA STENT

SUPERA SMART

SUPERA

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STENT GRAFT

Page 21: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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CRYOPLASTY

Page 22: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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DRUG-COATED BALLOON

Werk et al, Circulation 2008

Page 23: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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ZILVER PTX STENT

Page 24: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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LEARNING GOALS

• Scope of the problem• Devices to increase success• Devices to increase patency• Other devices

Page 25: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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CARDIATIS MULTILAYER STENT

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TAKE HOME MESSAGES

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TAKE HOME MESSAGES• Several devices are available to increase success

or patency rates for femoro-popliteal interventions

• Most devices are limited by substantial costs and limited evidence base

• We recommend to pick a few of these devices (if any at all) and develop a specific expertise in order to maximize safety and efficacy in niche applications

Page 28: Www.metcardio.org New generation devices for the femoro-popliteal district Giuseppe Biondi Zoccai University of Modena and Reggio Emilia gbiondizoccai@gmail.com

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For these and further slides on these topics please feel free to visit the

metcardio.org website:

http://www.metcardio.org/slides.html