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    Solutions to drive clinical efficiency for complex PCI challenges

    Need more information on complex PCI?
    Need more information on complex PCI?

    Defining complex PCI characteristics

     

    Complex PCI cases are increasingly more common, leading to an increased risk of adverse events. Certain lesion characteristics present common technical difficulties regardless of the lesion’s anatomic location or type. Complex PCI cases have defining characteristics such as restenosis, severe calcification, extensive thrombotic burden, extreme tortuosity and chronic total occlusion. Philips coronary portfolio provides comprehensive imaging and therapy tools to clearly assess complex clinical scenarios to treat patients. Clear procedural guidance and optimal vessel preparation can help you achieve better patient outcomes. Explore the different challenges seen in complex PCI cases and how Philips’ specialty tools can help.

    Learn more about ultra-low contrast PCI here.

    Resistant or restenotic lesions


    Resistant and restenotic lesions exhibit characteristics making them challenging to dilate and treat with conventional tools. Learn more about how our products, ELCA coronary laser atherectomy catheter, AngioSculpt Evo Rx PTCA scoring balloon catheter and IVUS imaging help you achieve optimal results in your treatment decisions.

    Anatomically complex lesions


    Anatomically complex lesions exhibit challenging characteristics complicating visualization, crossing and treatment planning. Learn the challenges of treating anatomically complex lesions and how our products ELCA coronary laser atherectomy, AngioSculpt Evo Rx PTCA scoring balloon catheter and IVUS imaging may assist in treatment.

    Advanced physiologic guidance, imaging and vessel prep for PCI planning

    IntraSight product image
    Multiple modalities (iFR, FFR, IVUS) on a single platform.
    IntraSight Interface
    Multiple modalities (iFR, FFR, IVUS) on a single platform.
    IntraSight interface with diameter measurements
    Provides area/diameter measurements for accurate stent sizing.
    OmniWire device
    Solid core workhorse design for flexibility.
    AngioSculpt Evo RX PTCA scoring balloon catheter
    Highly deliverable scoring balloon, with the power to safely dilate resistant lesions.1,2,3
    ELCA coronary laser atherectomy catheter
    Indicated for occluded saphenous vein, ostial lesions, moderately calcified stenosis, total occlusions, and more.

    Plan, land and expand stents optimally

    Dr. Jimmy Kerrigan optimizes stents with IVUS
    Learn how Dr. Kerrigan defines stent optimization
    Enable improved outcomes and fewer complications. The treatment of coronary lesions with DES is complicated by the challenges of suboptimal post stent results, such as stent under expansion, incomplete stent apposition, edge dissection and geographic miss, which may contribute to increased risk of stent failure. 
    Vessel stent graphic

    Maximize gain. Minimize risk.

    Maximize luminal gain with Philips’ most deliverable specialty balloon1 redesigned from tip to tail for superior deliverability.

    When selecting a balloon for complex PCI cases, deliverability, crossability, and dilatation power are key factors. The Philips Scoring Balloon Catheter – AngioSculpt Evo – is designed for exceptional performance in all three factors. Experience the combined power, safety and deliverability that AngioSculpt Evo provides during your next treatment plan.

    Explore the new features of AngioSculpt Evo below:
    Angiosculpt MOA video
    Super deliverability, controlled power and a strong safety profile
    AngioSculpt close-up of device in desktop view
    AngioSculpt close-up of device in mobile view2

    Combine the power of our therapeutics for optimal vessel preparation

    Successful coronary stent placement and treatment in complex cases needs proper vessel preparation. However, traditional balloon angioplasty may lead to unpredictable results and has a high rate of uncontrolled dissections. By combining the power of our Philips Coronary Laser Atherectomy System and Catheter and our AngioSculpt Evo Scoring Balloon, you can efficiently and effectively prepare vessels for optimal stent placement within a variety of lesion morphologies or case complexities. Our coronary laser atherectomy solutions and scoring balloon result in:

    Efficiency

    Plaque that is modified for optimal stent delivery, expansion and apposition.

    Flexibility

    Treat a wide variety of lesion complexities, types and morphologies.

    Outcomes

    Properly modified plaque leads to better stent delivery, expansion and apposition, increasing the chances of better long-term outcomes.
    See how our laser atherectomy solutions and scoring balloon can help in your next complex PCI case:

    Physician and product videos


    Enable improved outcomes and fewer complications. The treatment of coronary lesions with DES is complicated by the challenges of suboptimal post stent results, such as stent under expansion, incomplete stent apposition, edge dissection and geographic miss, which may contribute to increased risk of stent failure.
    Professionals discussing use of iFR
    Use of iFR and IVUS Co-Registration to simplify PCI decision-making
    Expert discussing how laser atherectomy works
    How does laser atherectomy actually work?
    Graphic of AngioSculpt Evo
    New AngioSculpt Evo - see the power and safety of a scoring balloon

    IVUS apps designed for interventional cardiologists

    Tablet with IVUS
    Check out the IVUS App for interactive workflow and image interpretation practice
    Cardio Ex on mobile
    Learn IVUS virtually with the Cardio Ex app
    Philips Elite Academy logo

    Philips ELIITE Academy is focused on delivering high value and real-time strategic educational programs that meet the evolving needs of our customers.


    To initiate your clinical pathway or register for one our cardiovascular US medical educational programs, please contact your local Philips representative.


    For more information on the available courses, please visit www.philipseliiteacademy.com.

    1. Costa JR, Mintz GS, Carlier SG, et al. Nonrandomized comparison of coronary stenting under intravascular ultrasound guidance of direct stenting without predilation versus conventional predilation with a semi-compliant balloon versus predilation with a new scoring balloon. Am J Cardiol. 2007;100:812-817.
    2. Costa RA, Mooney MR, Teirstein PS, et al. Final results from the multi-center trial of the angiosculpt scoring balloon catheter for the treatment of complex coronary artery lesions Cardiovascular Revascularization Medicine 7 (2006)81–126.
    3. AngioSculpt Test Report SR-1571 (2008).
    4. Zhang J et al. The ULTIMATE trial. Journal of the American College of Cardiology (2018), doi.org/10.1016/j.jacc.2018.09.013
    5. D051336 AngioSculpt Evo Marketing Claims Report.
    6. D059995 Customer Preference Study Report Evo Claims validated by clinician feedback on clinical cases performed with AngioSculpt EVO, with a sample size of 39 physicians using AngioSculpt EVO on 105 cases. Clinicians participating in the survey compared AngioSculpt EVO’s deliverability against the deliverability of their most used non-compliant balloon. 
       

    ELCA important safety information indications: 
    The laser catheters are intended for use either as a stand-alone modality or in conjunction with percutaneous transluminal coronary balloon angioplasty (PTCA) in patients who are acceptable candidates for coronary artery bypass graft (CABG) surgery. The following indications for use, contraindications and warnings have been established through multicenter clinical trials. The Philips CVX-300 Excimer laser system and the multi-fiber laser catheter models are safe and effective for the following indications: occluded saphenous vein bypass grafts, ostial lesions, long lesions (greater than 20mm in length), moderately calcified stenosis, total occlusions traversable by a guidewire, lesions which previously failed balloon angioplasty, restenosis in 316L stainless steel stents, prior to the administration of intravascular brachytherapy. These lesions must be traversable by a guidewire and composed of atherosclerotic plaque and/or calcified material. The lesions should be well defined by angiography. Contraindications: Lesion is in an unprotected left main artery. Lesion is beyond acute bends or is in a location within the coronary anatomy where the catheter cannot traverse. Guidewire cannot be passed through the lesion. Lesion is located within a bifurcation. Patient is not an acceptable candidate for bypass graft surgery. Potential adverse events: Use of the Philips CVX-300 Excimer laser system may contribute to the following complications: dissection of the arterial wall, perforation, acute reclosure, embolization, aneurysm formation, spasm, coronary artery bypass graft surgery, thrombus, myocardial infarction, arrhythmia, filling defects, death. No long term adverse effects of ELCA are known at this time. Risks: The primary endpoint defined in the laser angioplasty of restenosis stents (LARS) randomized trial was the absence of major adverse cardiac events (MACE) at 6 months: Death; myocardial infarction; coronary artery bypass surgery. Procedural complications include: any dissection, acute thrombus, haziness, no reflow, arrhythmia, acute vessel closure, occlusion of side branch, occlusion non-target, coronary spasm, coronary embolism, coronary perforation, laser/stent damage, balloon/stent damage, 
    and other serious. Caution: Federal law restricts this device to sale by or on the order of a physician. 
     
    Summary of safety and effectiveness – PTCA catheter AngioSculpt Evo PTCA important safety information 
     
    The AngioSculpt Evo scoring balloon catheter is indicated for use in the treatment of hemodynamically significant coronary artery stenosis, including in-stent restenosis and 
    complex type C lesions, for the purpose of improving myocardial perfusion.  
     
    The AngioSculpt Evo catheter should not be used for coronary artery lesions unsuitable for treatment by percutaneous revascularization, and coronary artery spasm in the absence of a significant stenosis. 
     
    Possible adverse effects include, but are not limited to: death; heart attack (acute myocardial infarction); embolism, total occlusion of the treated coronary artery; coronary artery dissection, perforation, rupture, or injury; pericardial tamponade; no/slow reflow of treated vessel; emergency coronary artery bypass (CABG); emergency percutaneous coronary intervention; CVA/stroke/ embolic stroke; pseudoaneurysm; restenosis of the dilated vessel; unstable angina; thromboembolism or retained device components; irregular heart rhythm (arrhythmias, including life-threatening ventricular arrhythmias); severe low (hypotension)/high (hypertension) blood pressure; coronary artery spasm; hemorrhage or hematoma; need for blood transfusion; surgical repair of vascular access site; creation of a pathway for blood flow between the artery and the vein in the groin (arteriovenous fistula); drug reactions, allergic reactions to x-ray dye (contrast medium); and infection. This information is not intended to replace a discussion with your healthcare provider on the benefits and risks of this procedure to you. 
     
    Caution: 
    Federal law restricts this device to sale by or on the order of a physician.

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