1. Peripheral angioplasty Overview, Hardware
Frijo Jose A

2. Vascular Access Relatively disease-free, without signi Ca
Over a bony structure, if possible
Angle of entry- 30⁰-45⁰
If access vessel-small/potentially diseased- micropuncture tech preferred

3. Vascular Access sites
Retrograde Common Femoral Artery Access
Common access site used for peripheral diagnostic angiography and intervention
Prevent injury to the less diseased extremity

4. Vascular access sites Contralateral femoral retrograde access :
Internal iliac stenoses are best treated from a contralateral approach
SFA,PFA- lesions located within the CFA/involve SFA/PFA ostium -
Proximity to arterial puncture site, Bifurcation anatomy of CFA
Also allows treatment B/L disease with a single arterial puncture

6. Vascular Access site Required for infrainguinal proced
Antegrade Common Femoral Artery Access:
Required for infrainguinal proced
Approx 3cm CFA lies betw ligament & FA bifurcation
Inorder to access CFA, skin entry- prox to ing ligm
Access too close to F bifurc –inadeq working room to selectively cath SFA

7. Vascular access sites Ipsilateral popliteal retrograde access:
Useful in SFA occlusion with failure to cross from contralateral or antegrade
Ostial SFA/CFA lesions may also be approached via PA in acute angled terminal ao bifurc
CI- aneurysms of PA, pathology of popliteal fossa- Baker’s cyst

8. Brachial Artery Access
Pref access for visc arterial [CA, SMA] interventions
PC approach at BA can lead to a ↑compli rate
UL arts – smaller, prone to spasm
A small hematoma- Could lead to brachial plexopathy
Itv req >6F sheaths/smaller pt→open approach preferred
Left BA access pref over Rt- can avoid carotid origin
A micropuncture tech should be used for all PC BA intervention

9. Wire selection Many-Teflon/silicone :Some- hydrophilic
Hydr-stenosd/torturous+angle tip–Glidewire
Can be used for crossing tight lesions and can be advanced independent of a guidewire
014,018,025,035,038-for initial access, 038:18g needle, 018:21g needle

10. Estimated distances from FA access

11. Guidewire-Lesion Interaction
Floppy portion moving in a linear
Floppy portion piles up prox to lesion—no chance to cross- backup,redirect,if straight tip→steerable
Floppy tip bent with min R—Cautiously adv wire- once crossed, wire should straighten- advancing a “buckledup” wire- force→embolization
Floppy tip “buckledup” with R—backup,redirect,adv -dissect,embolz,wire damag

12. Catheter ( diagnostic/ guiding)
Length depends on location for using
a) abdominal aorta = 60 to 80 cm length
b) BTK,carotid or subclavian areas 100 to 125cm length
Polyethylene- ↓coef friction, pliable
Polyurethane- softer, even ↑pliable→ tracks wires better
Nylon- stiffer, can tolerate ↑flow rate- amenable to angio
Teflon- stiffest- used mainly for dilators & sheaths

13. ▫ ▫

15. ▫ ▫ ▫ ▫ ▫ ▫

18. 4F IMPRESS Simmons 1 Catheter 65cm..038
Side Ports:N/A
Catheter Shape:SIMMONS 1
French Size:4

19. 5F IMPRESS Simmons 2 Catheter 65cm..038
Side Ports:N/A
Catheter Shape:SIMMONS 2
French Size: 5

20. SOS Omni selective catheter
Soft, atraumatic, Super-radiopaque tip
Reforming in desc thoracic aorta – below great vessels rather than transverse arch –safety
The catheter should be pulled from the desc ao into abd ao with a floppy guidewire “leading,” sometimes with a rotating motion
The soft, flexible atraumatic tip can be placed deeper into the artery (>1 cm), ↓chance of “catheter kickout.”
The shaped tip allows the guidewire to flick into the origin of the RA

21. Omni Flush Angiographic Catheter
Designed as a single catheter to perform flush aortography, B/L“run off” studies of lower extremities and to cross ao bifurcation with ease for C/L diagnostics in interventional procedures.
Super-Radiopaque tip
Reforms and maintains shape—even under injection pressure—with less catheter whipping, resulting in less vessel wall injury
Less contrast reflux than other flush catheters, thus resulting in lower total contrast dose

22. Brachiocephalic Artery 1. Head Hunter 1 2. Sidewinder 1 3. Weinberg 4
Brachiocephalic Artery 1. Head Hunter 1 2. Sidewinder 1 3. Weinberg 4. Berenstein L and R External Carotid Artery 3. Hockey Stick 1 4. Weinberg 5. Berenstein 6. Sidewinder 2 L and R Internal Carotid Artery 5. Headhunter 3
L and R Subclavian Artery 1. Berenstein 2.Head Hunter 1 L and R Vertebral Artery 3. Vertebral L and R Common Carotid Artery 1. Head Hunter 1 2. Sidewinder 1 3.Weinberg 4. Berenstein 5. Vertebral 6. Head Hunter 3

23. Descending Aorta 1. Omni Flush 2. Pigtail Flush 3
Descending Aorta 1. Omni Flush 2. Pigtail Flush 3. Straight Flush Ascending Aorta Thoracic Aorta Abdominal Aorta
L and R Renal Artery 1. Sos Omni 1 2. Sos Omni 2 3. Cobra 1 4. MPA

24. L and R Common Iliac Artery 1. Sos Omni 1 2. Sos Omni 2 3. Cobra 1 4
L and R Common Iliac Artery 1. Sos Omni 1 2. Sos Omni 2 3. Cobra 1 4. Berenstein L and R Internal Iliac Artery 1. Sos Omni 1 L and R External Iliac Artery 3. Berenstein L and R Common Femoral Artery 5. MPA
L and R Deep Femoral Artery 1. Sos Omni 1 2. Sos Omni 2 3. Berenstein L and R Popliteal Artery 1. Berenstein 2. Straight Art L and R Anterior Tibial Artery L and R Posterior Tibial Artery L and R Peroneal Artery

25. Accesses and Selective Guiding Catheters for Some Basic Interventions

26. Carotid Artery Subclavian Artery Celiac or SMA
1.First choice access—either FA
2.Alternative access—left BA
3.Selective catheter—
Right carotid: H1,Simmons,Vick;
Left carotid : angled glidecath,H1,Simmons
Subclavian Artery
1.First choice—either FA
2.Alternative access—ipsilateral BA
3.Selective catheter– angled Glidecath,H1,Simmons,H3
Celiac or SMA
3.Selective catheter—RIM,Chuang-C,Chuang-3

27. Superior Femoral Artery
Renal Artery
1.First choice—contralateral FA
2.Alternative access—left BA
3.Selective catheter—C2,RDC,Sos-omni
Infrarenal Aorta
1.First choice —either FA
3.Selective catheter—omni-flush,RIM,C2
Superior Femoral Artery
2.Alternative—ipsi retro FA for run-off; ipsi antegrade for interv
3.Selective catheter—Berenstein,Kumpe,Vertebral
Tibial Arteries
3.Selective catheter—Kumpe,Vertebral

28. Kumpe catheter

32. Guiding Catheter vs Sheath
The use of a guide or sheath is determined by operator bias
Sheaths are designed with a simple diaphragm or a hemostatic valve, guiding catheters always require hemostatic valves be attached
During intervention, the guide catheter or sheath should be placed near the lesion to provide for better visualization and improved support

34. Balloons
In selecting a balloon, the following criteria should be considered:
a) Guidewire ( 0.014“, 0.018“, 0.035“)
b) over the wire (OTW) or monorail system
c) shaft length
0.014“ balloon system is usually for carotid, vertebral, renal, infrapopliteal arteries
0.035“ balloon system for subclavian, innominate, aortoiliac, superficial femoral artery
0.018“ balloon system also in SFA, infrapopliteal, depends on what the operator prefers

35. Law of Laplace
Circumfer force/tension (T) exerted on wall of an inflatd balln ~P within balln & R (T=P×R)
Balln twice R of a smaller balln- twice wall T for given inflation P→D kept constant, T on wall of balln will ↑linearly with ↑inflatn P
Larger ballns -require ↓P than smaller ballns to generate substantial dilating forces
Larger vessels (Ao) require ↓P to dilate & rupture

36. Balloon cath with a D matchng outflow vessel beyond lesion
Balloon length should be > lesion
Balloon centered on lesion & inflated slowly
Inflation maintained for 20s- deflated- reinflated 3 inflations of 20s

37. Subintimal angioplasty
Hydrophilic wire not passng
Carefully adv into subintimal plane- if not spontaneously, gentle inflation of balloon at edge of the plaque
Wire traversed the lesion subintimaliy
Hydrophilic catheter or other re-entry device passed OTW to guide it back into lumen
Standard angioplasty of subintimal plane performed, with stent placement

38. Femoropopliteal Artery Intervention
Subintimal angioplasty

39. Stents The types of stent used in peripheral interventions:
Balloon-expandable
Self-expandable
Stent graft

40. Balloon-expandable stents
Require positive pressure for expansion
Typically rigid with high radial force
Size of the balloon-expandable stent equals to the size of the reference vessel diameter
Ideal for immobile parts of the body-ie, subclavian, renal, mesenteric, iliac arteries and at ostial locations

41. Self-expandable Stents
Deployed in vessels that are flexible or twist during movement of neck, shoulder or leg
carotid, axillary, superficial femoral artery, popliteal artery
Nitinol - best flexibility and memory
Stent compressed over a delivery cath & covered with sheath
Stent deployment achieved by pulling back the sheath
Stent diameter should be 1-2mm > ref vessel D→ adeq stent apposition

42. Self-expandable Stents
Some degree of foreshortening- to be taken into account when choosing
More difficult to place with absolute precision
Generally comes in longer length than BES
Their ability to continually expand after delivery allows them to accommodate adjacent vessels of different size

43. Stents
Demonstrating the Nitinol self-expandable stent deployment

44. Stent Grafts
Used to exclude aneurysm, treat perforations when prolonged balloon inflation failed
Wallgraft and Viabahn are two options

45. Decision between SE or BE stents in Iliac Lesions
Balloon expandable
Aortoiliac bifurcation
Common iliac
Calcified lesions
Chronic occlusions (?)
Self expanding
Vessels flexible/twist during movement
Tortuous vessels
Distal external iliac artery
Contralateral approach
Long diffuse lesions
Aortoiliac bifurcation (long lesions)

46. Techniques
Retrograde Iliac stent placement

47. Techniques
Cross-over technique

48. A patient’s complaint of low back pain during balloon inflation may be a warning sign of adventitial stretch, which may occur before aortic rupture

49. Femoropopliteal Artery Intervention
Balloon size & length matched to the size ( ~5-6mm) & lesion length( ~ mm) of SFA
↑ angiographic results may be accomplished with prolonged inflation times ( 3-5 minutes)
Dissections are commonly seen after balloon dilation ( due to heavy calcification)

50. Femoropopliteal Artery Intervention
Stentimplantion ( always SX-Stents):
Sizing the SX- stent ~ 1mm > SFA
Postdilation with mm diameter balloon
Popliteal artery -> avoid stent = high risk of stent compression or fracture

51. Infrapopliteal Interv
Knee-to-foot patency of one of the three branches is usually sufficient to prevent critical lower-limb ischemia
Claudication is rarely the result of isolated disease of the infrapopliteal arteries
Re-stenosis after intervention in these vessels is typically the highest among the lower limb sites
Obstructive disease in these arteries is often occlusive, diffuse and complicated by heavy calcific deposits

52. Infrapopliteal Interv- wire selection
Only atraumatic 0.014“ / 0.018“ guide wires should be used-0.014“ prefered due to vessel diameter
Type selection ( floppy, medium,stiff) will be driven by the type of disease

53. Infrapopliteal -Balloon Angioplasty
Low profile balloon with high pushability and trackability to easy cross the lesion
Flexibility in small collateral branches
0.014”/ 0.018" wire compatibility
Diameter 1.5mm-4.0mm
Long ( mm) to reduce procedure times and dissection

54. Infrapopliteal- Balloon Angioplasty
Long balloons (210mm/ tapered)
Reduced risk of dissections
( no balloon overlap)
Total intervention /revascularization
time significantly shorter
Reduced X-ray dose for patients, operators
as well as for the assistants

55. Renal artery stenosis Usually occurs in the proximal 2 cm
~75% of lesions are caused by atherosclerosis
Lesions can be single or multiple, unilateral or bilateral (~25%)
Diameter: mm for men
mm for women
Length 3-7 cm
Discuss plaque in aorta – draw

56. Renal artery-Equipment
Diagnostic
Wires
0.035” for catheter placement
Diagnostic catheter
Intervention
Wires
0.014”
0.035” for catheter placement
Guiding Sheath
Guide Catheter
Balloons ( 0.014” compatible)
Low profile
Undersized for pre-dilation
BE-Stents

57. Reanal artery stenting
1. Catheter or sheath placement 2. Guide wire (0.014“) insertion. Rosen wire has soft curled end- ideal- prevents perforating small renal branch vessels 3.Stent placement -> as soon as the tip reach the lesion GC is pulled back into the Aorta 4.Stent deployment, proximal struts should protrude 1-2mm into the aorta 5. Flaring the ostium of the stent ( optional), opens the way for re-intervention and covers the plaque in the aorta

58. Subclavian PTA
Femoral access used except for TO/severely angulated – BA preferred
LSCA – FA- direct take-off : RSCA because of its angulated take-off from inno A- ipsi BA
Ostial RSCA, FA can protect the right CCA
Total occlusions- combined approach
Usually pre-dilated with a slightly undersized balloon
BES sized 1:1 with ref D
Ao-ostial lesions - stent protrude (1–2mm) into Ao
BES - Ao-ostial locations
SES- long segment/more flexibility needed/lesions beyond IMA→external compression

59. COOK

60. Catheters Slip-Cath Beacon Tip Catheters
Beacon Tip Torcon NB Advantage Caths
Torcon NB Advantage Catheters
CXI Support Catheters
Beacon Tip Royal Flush Plus High-Flow Catheters
Royal Flush II Nylon Catheters

61. Slip-Cath Beacon Tip Catheters
Hydrophilic Coating
Enhanced radiopaque Beacon tip
Sixteen stainless steel wire braid imparts 1:1 torque control to catheter tip & ↑pushability
Nylon material resists softening during prolonged catheter manipulation

62. Slip-Cath Beacon Tip Catheters

63. Beacon Tip Torcon NB Advantage Caths
Enhanced radiopaque Beacon tip
Gradual transition of radiopaque Beacon tip to catheter shaft
Sixteen stainless steel wire braid
Nylon material

64. Torcon NB Advantage Catheters
Sixteen stainless steel wire braid
Nylon material
Short, flexible atraumatic catheter tip

66. Beacon Tip Royal Flush Plus High-Flow Catheters
Royal Flush II Nylon Catheters

67. CXI Support Catheters
For use in small vessel/superselective anatomy for diagn & interv procedures, incl peripheral use
Low profile from tip to hub ensures smooth transition through small vessels
Shaft's polymer material offers desired flexibility
Braided SS entire length -pushability
Hydrophilic coating
Embedded radiopaque markers -size the vessel segment length

69. ATB ADVANCE PTA Dilatation Catheter
Advance 14LP
Advance 18LP
Advance 35LP

70. ATB ADVANCE PTA Dilatation Catheter
Designed for iliac, renal, popliteal, infrapopliteal, femoral and iliofemoral
Also intended for postdilatation of balloon-expandable peripheral vascular stents
40,80,120

71. Advance 14LP
Low Profile
Provides the trackability and pushability to reach even the most remote infrapopliteal lesions
Hydrophilic coating on balloon and distal shaft, along with a smooth tip transition
Maintains super-low profile after inflation
4 Fr sheath compatibility for all sizes
20 to 200 mm  in 2, 2.5, 3, 4 mm D
170

72. Advance 18LP Low Profile PTA Balloon Dilatation Catheters
Super-flexible tip
Advanced rewrap technology
80,135

73. Advance 35LP first 8 mm x 8 cm 5 Fr sheath
Low-profile design tightly tapers to the wire
Double-lumen D-shaped design allows rapid inflate/deflate
80,135

74. Amplatz Stiff Wire Guides
The wire guide has a stiff shaft and a gradual transition to a very flexible distal tip
TFE Coated Stainless Steel-035,038: 145,180,260-straight
TFE Coated Stainless Steel with Heparin Coating-035: 145,180,260-straight
8cm-flexi tip

75. Amplatz Extra-Stiff Wire Guides
The increased inner diameter of the wire guide coil allows utilization of an extra-stiff mandril while maintaining tip flexibility.
TFE Coated Stainless Steel-025,035,038: 80,145,180,260-straight & curved: 300-straight
TFE Coated Stainless Steel with Heparin Coating-035: 80,145,180,260-straight & curved

76. Amplatz Ultra-Stiff Wire Guides
The increased inner diameter of the wire guide coil allows utilization of an ultra-stiff mandril while maintaining tip flexibility.
TFE Coated Stainless Steel-035,038: 80,145,180-straight
TFE Coated Stainless Steel with Heparin Coating-035: 145,180-straight
8cm-flexi tip

77. Roadrunner Extra-Support Wire
Complex diagnostic/interventions where extra support needed for cath exchange/manipulation of devices
Heavy-duty nitinol alloy mandril provides support while imparting 1:1 torque response to distal platinum spring coil tip
Angled tip facilitates directional control
Lubricious TFE coating -low coefficient of friction
014,018
180,270,300

78. Cope Mandril Wire Guides I
Stainless Steel
Platinum coil ↑visualization and an angled floppy tip for precise directional control
018
40,60,100,125
Standard taper-7cm coil

79. Cope Mandril Wire Guides II
Nitinol mandril kink resistant and provides 1:1 torque control
Platinum coil ↑visualization and an angled floppy tip for precise directional control
018
60,100,125
Standard taper-7cm coil, short taper-7cm coil

80. Rosen Curved Wire Guides
The heavy-duty mandril, 2 cm flexible tip and tightened “J” configuration
TFE Coated Stainless Steel-035: 80,145,180,220,260
TFE Coated Stainless Steel with Heparin Coating-035: 145,180,260

81. The Graduate Measuring Wire Guides
Used to determine accurate sizing of vessel lumen prior
Gold radiopaque markers delineate 25 cm in length for precise measuring accuracy.
Six distal markers are spaced 1 cm apart.
Four proximal markers are spaced at 5 cm increments.
035
145,180

83. Reuter Tip Deflecting Wire Guide
Used with Reuter Tip Deflecting Handle for curving or deflecting catheter tips during selective and superselective angiography
Facilitates catheter tip movement by controlling the deflection of the wire guide tip within catheter lumen
Distal tip of wire guide must never extend beyond tip

85. Double Flexible Tipped Wire Guides
Permits alternative use of both ends of wire guide, depending on procedural needs

86. Zilver 518 Vascular Self-Expanding nitinol Stent- iliac arteries
Recomm 5.0 Fr sheath/7.0 Fr guiding cath
Accepts .018 inch wire

87. Zilver 518 RX
Vascular Self-Expanding Nitinol Stent – Rapid Exchange-iliac
Recommended 5.0 Fr sheath/7.0 Fr guiding catheter
Accepts .018 inch diameter wire guide.

88. Zilver 635 Vascular Self-Expanding Nitinol Stent
Recommended 6.0 Fr sheath/8.0 Fr guiding catheter size
Accepts .035 inch diameter wire guide

89. TERUMO

90. Guiding Sheaths (5-8 Fr) Pinnacle Destination
45,65,90
Hydrophilic coating
All dilators are 0.038" wire compatible

92. glidewire Peripheral Guidewires (0.032"-0.038")
Standard Glidewire
Shapeable Tip Glidewire
Long Taper Glidewire
Stiff Shaft Glidewire
Stiff Shaft Long Taper Glidewire
1 cm Taper Glidewire
J-Tip Glidewire
Bolia Curve Glidewire
Glidewire Advantage™
Small Vessel Guidewires (0.018"-0.025")
Glidewire Standard and Shapeable Tip
Glidewire GT Super-Selective
Glidewire Gold

96. Hydrophilic Coated Catheters
Glidecath (4 Fr)-65,100,
Glidecath XP (5 Fr)-65, (↑flow rate)
Glidecath (5 Fr)-65,

98. Microcatheters
Progreat™ (2.4 Fr, 2.7 Fr)- 110/130- OD:0.97/0.9=2.9/2.7 -ID:0.57/0.65
Progreat™Ω (2.8 Fr)- 110/130- OD:1/0.93=3/2.8 -ID:0.7

100. ABBOT

101. Veripath Peripheral Guiding Catheter
Three-Layer Construction
50 cm length
5 catheter shapes
6,7,8 F
014/018

103. Hi-Torque Steelcore Peripheral Guide Wire
Hi-Torque Spartacore Peripheral Guide Wire
Hi-Torque Supra Core Peripheral Guide Wire
Hi-Torque Versacore Guide Wire System

104. Hi-Torque Steelcore Peripheral Guide Wire

105. Hi-Torque Spartacore Peri Wire
 Excellent .014" Support with Superb Steerability and a Soft Shapeable Tip
Core-to-tip design
High-support.014" stainless steel shaft
MICROGLIDE Coating
PTFE Coating up to distal 7 cm
Available in 5 and 10 cm Intermediate Segment Lengths

107. Hi-Torque Supra Core Peri Wire
One-to-one torque response designed for exceptional steerability
MICROGLIDE coating
Radiopaque tip designed for visibility during guide wire placement
035" shaft
Soft Shapeable tip

108. Hi-Torque Versacore Guide Wire
Torqueable wire for deliverability through tortuous or challenging lesions
Soft shapeable tip designed to for lesion access

109. FoxCross .035 PTA Cath
D-(3-14 mm), L-( mm), and cath L (50, 80 &135 cm)-OTW
50,80,135
5-7 F
Guide wire compatibility: 035
Nylon Polymer
JETCOAT coating

110. Fox sv PTA Catheter
OTW designed for challenging small vessel procedures
Range of BTK and SFA sizes (2-6 mm) 90,150
Sheath Compatibility:4F for all sizes
Guide wire compatibility:.014"/.018"

111. Fox Plus PTA Catheter Low Profile
Compatible with a 5 French sheath up to 7mm balloons.
Excellent rewrapping
Shaft Technology-Adv shaft technology dual lumen - Rapid inflation and deflation
JET coated shaft, tip and guidewire lumen. Reduces friction and facilitates access and crossing of target lesions

112. Jostent Peripheral Bare Stent System
SS Bare balloon-expandable stent
Rec min sheath size: 1F >balloon
Slotted tube with closed cell design
Six in one: Every bare stent expandable to 6 different D Post-adjustment of stent size possible
Standard version: 4-9 mm Large version: 6-12 mm Length: mm

113. Omnilink Elite Peripheral Stent System
Iliac
compatibility with 6F sheaths across all sizes
Cobalt Chromium

114. Absolute Pro LL Peripheral Self-Expanding Stent
035
designed to treat longer SFA lesions
120,150

115. Xpert Self-Expanding Stent
4F compatible -speci designed for small vessels 
Peri vessels from D 2-7 mm
018
Nitinol
low strut profile
Conformability

116. BOSTON SCIENTIFIC

118. Amplatz Super Stiff Guide Wire
For stiffness, strength and stability during catheter placement and exchange.
Diameters: 0.035", 0.038"
Lengths: 145cm,180cm, 260cm
Tips Styles: Straight, J, Short
Core Material: Stainless steel
Coating: PTFE

119. Magic Torque Guide Wire
Magic Markers spaced at 1cm increments designed for enhanced visualization and excellent torque control to meet the challenges of difficult anatomy  Diameters: 0.035"
Lengths:180cm, 260cm
Tips Styles: Straight (shapeable)
Core Material: Stainless steel
Coating: Glidex Hydrophilic Coating (tip)

120. Meier Guide Wire
Stiff shaft engineered for excellent support, while flexible tip is designed to reduce the risk of vessel trauma during diagnostic and interventional procedures including AAA endovascular graft procedures. Diameters: 0.035"
Lengths: 185cm, 260cm, 300cm
Tips Styles: J, C
Core Material: Stainless steel
Coating: PTFE

121. Platinum Plus Guide Wire
Designed for negotiation of tortuous anatomy and contralateral approaches. Also available in short taper configuration for access in anatomy with short distal Diameters: 0.014", 0.018", 0.025"
Lengths (cm): 60, 145, 180, 260, 300
Tips Styles: Straight – Long or short taper
Core Material: Stainless steel
Coating: Glidex Hydrophilic

122. Thruway Guide Wire
Designed for excellent performance in acutely angled vessels, such as renals and other peripheral interventions  Diameters: 0.014", 0.018"
Lengths (cm): 130, 190, 300
Tips Styles: Straight, J
Core Material: Stainless steel
Coating: Silicone

123. Sterling ES Balloon Dilatation Cath
0.014" balloon cath
Ultra-low profile balloon
Both OTW and rapid exchange platforms
.017" tip entry profile
140

124. Sterling SL Balloon Dilatation Cath
 now in long lengths for below-the-knee - specifically designed to meet the challenges of infrapopliteal procedures
014,018
available in both Over-the-Wire and Monorail platform
90,150

125. Sterling Balloon Dilatation Catheters
Breakthrough 4F Profile
Both Over-the-Wire and rapid exchange
40,80,135
Specifically designed for use in renal and lower extremity arteries

126. Sterling Monorail Balloon Dil Cath
Breakthrough 4F Profile.
carotid, renal and lower extremity
40,80,135

127. Renegade HI-FLO Microcatheter

128. Express LD Iliac Premounted Stent System
035

129. Express SD Renal Monorail Premounted Stent System
014/018
Low profile; 6F guide catheter-compatible up to 6.0mm

130. WALLSTENT Endoprosthesis
recapturable even when up to 87% deployed

131. CORDIS

133. EMERALD Guidewires
Fixed-Core, PTFE Coated Wires
025,035,038
150,180

134. PTA Dilatation
Catheters

135. PALMAZ Bal-Exp Stent (unmounted)
Closed cell SS
Stent D (Expanded) 4-8mm
Stent L (Unexpanded) 10,15,20,29,39mm
Sheath Introducer 6F, 7F

136. Self-Ex: S.M.A.R.T. CONTROL Iliac
MicroMesh Geometry, Segmented Design
Nitinol
Stent D 6-10, 12, 14mm (should be 1-2mm >vessel D)
80,120 cm
Maximum Guidewire .035"
Sheath Compatibility 6F (6-10mm), 7F (12-14mm)
Guide Compatibility 8F (6-10mm), 9F (12-14mm)

137. Self-Ex: PRECISE Carotid Stent System
MicroMesh Geometry, Segmented Design
Nitinol
Stent D 5-10mm
135cm, Over-the-Wire
Maximum Guidewire .018"
Sheath Compatibility 5.5F (5-8mm diameters), 6F (9-10mm diameters)
Guide Compatibility 7F (5-8mm diameters), 8F (9-10mm diameters)

138. Self-Ex: PRECISE PRO RX Carotid Stent
MicroMesh Geometry, Segmented Design
Nitinol
Stent Diameters 5-10mm
135cm, Rapid Exchange
Maximum Guidewire .014"
Sheath Compatibility 5F (5-8mm diameters), 6F (9-10mm diameters)
Guide Compatibility 7F (5-8mm diameters), 8F (9-10mm diameters

139. OUTBACK Re-Entry Catheter
Enables fast, simple true lumen re-entry without need for IVUS
Low profile, 6F sheath compatible
Highly visible "L" and "T" markers- Orient re-entry cannula towards true lumen easily, eliminating need for IVUS

140. The cannula (large black arrow) is deployed and the 0. 014–in
The cannula (large black arrow) is deployed and the 0.014–in. guidewire (small black arrow) advanced through it. The nose cone (large white arrow) has the radio-opaque
‘‘LT’’ orientation marker. Catheter shaft (small white arrow)

143. BIOTRONIK

144. Cruiser Guide Wire
0.014“
L: 190 cm
Tip Shape: Straight and J

145. Cruiser-18 Hi-support Guide Wire 0.018”
Stiff: 195 cm and 300 cm Medium: 195 cm and 300 cm

146. Passeo-18 Balloon Catheter 0.018” / OTW
Hydrophobic patchwork coated balloon ensures a smooth crossing through tortuous vessels and across high grade stenosis whilst minimising the risk of slippage during inflation experienced using hydrophilic coated balloons

147. Passeo-35 Balloon Catheter 0.035” / OTW
Hydrophobic patchwork coated balloon ensures a smooth crossing through tortuous vessels and across high grade stenosis whilst minimising the risk of slippage during inflation experienced using hydrophilic coated balloons

148. Elect Explorer Balloon Catheter 0.014” / Rx
EFT (Enhanced Force Transmission) increases pushability whilst coating improves trackability and crossability
Dedicated and unique dimensions for treatment of infrapopliteal disease.

149. Dynamic
Balloon-Expandable Stainless Steel Stent 0.035” / OTW

150. Dynamic Renal
Balloon-Expandable Cobalt Chromium Stent 0.014” / Rx

151. Astron
Self-Expanding Nitinol Stent 0.035” / OTW 

152. Astron Pulsar Self-Expanding Nitinol Stent OTW
Dedicated and unique dimensions for treatment of diseases of femoral and infrapopliteal arteries.

153. Thank You…