ILIAC EXTENSIONS Multiple Options for Unique Patient Customization WITH THE XCELERANT® HYDRO DELIVERY SYSTEM Product Code For Medtronic ordering information contact your Medtronic Field Representative. IXW1010C81XH IXW1208C75XH IXW1212C81XH IXW1410C75XH IXW1414C80XH IXW1612C75XH IXW1616C80XH IXW1812C140XH IXW1812C80XH IXW1814C140XH IXW1814C75XH IXW1816C140XH IXW1816C80XH IXW1818C140XH IXW1818C80XH IXW1820C80XH IXW1822C80XH IXW1824C80XH IXW2016C74XH IXW2020C79XH IXW2218C74XH IXW2222C79XH BIFURCATED Product Code Aortic Extension 22-36 mm Bifurcated Graft 22-36 mm ~15 mm ~15 mm ~15 mm Align radiopaque markers for maximum extension 60 mm 26-30 mm 50 mm Contralateral Limb Flow divider 30 mm Radiopaque markers 15 mm Align radiopaque markers to ensure 30 mm overlap 14 mm 14 mm Connecting bars Iliac Extension AB2212C140XH AB2212C155XH AB2214C140XH AB2214C155XH AF2412C140XH AF2412C170XH AF2414C140XH AF2414C170XH AF2612C140XH AF2612C170XH AF2614C140XH AF2614C170XH AF2616C140XH AF2616C170XH AF2618C140XH AF2618C170XH AF2814C140XH AF2814C170XH AF2816C140XH AF2816C170XH AF2818C140XH AF2818C170XH AF2820C140XH AF2820C170XH AF3014C140XH AF3014C170XH AF3016C140XH AF3016C170XH AF3018C140XH AF3018C170XH AF3020C140XH AF3020C170XH AF3214C155XH AF3214C170XH AF3216C155XH AF3216C170XH AF3218C155XH AF3218C170XH AF3220C155XH AF3220C170XH AF3416C155XH AF3416C170XH AF3418C155XH AF3418C170XH AF3420C155XH AF3420C170XH AF3618C155XH AF3618C170XH AF3620C155XH AF3620C170XH Distal Diameter (mm) 12 12 14 14 12 12 14 14 12 12 14 14 16 16 18 18 14 14 16 16 18 18 20 20 14 14 16 16 18 18 20 20 14 14 16 16 18 18 20 20 16 16 18 18 20 20 18 18 20 20 Graft Covered Length (mm) 140 155 140 155 140 170 140 170 140 170 140 170 140 170 140 170 140 170 140 170 140 170 140 170 140 170 140 170 140 170 140 170 155 170 155 170 155 170 155 170 155 170 155 170 155 170 155 170 155 170 Stent Graft Total Length (mm) 155 170 155 170 155 185 155 185 155 185 155 185 155 185 155 185 155 185 155 185 155 185 155 185 155 185 155 185 155 185 155 185 170 185 170 185 170 185 170 185 170 185 170 185 170 185 170 185 170 185 Catheter Diameter (F) 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 22 24 24 24 24 24 24 24 24 24 24 24 24 24 24 24 24 24 24 24 24 24 24 24 24 24 24 Distal Diameter (mm) 8 10 12 12 12 14 14 14 16 16 16 18 18 18 20 20 20 22 22 22 24 24 24 Graft Covered Length (mm) 105 105 105 75 90 105 75 90 105 75 90 105 75 90 105 75 90 105 75 90 105 75 90 Stent Graft Total Length (mm) 120 120 120 90 105 120 90 105 120 90 105 120 90 105 120 90 105 120 90 105 120 90 105 Catheter Diameter (F) 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 18 20 20 20 20 20 20 Distal Diameter (mm) 22 24 26 28 30 32 34 36 Graft Covered Length (mm) 30 30 30 29 28 28 28 26 Stent Graft Total Length (mm) 60 60 60 60 60 60 60 60 Catheter Diameter (F) 20 20 20 20 22 22 22 22 CONTRALATERAL LIMBS Product Code 10-22 mm 30 mm Align radiopaque markers to ensure 30 mm minimum overlap Proximal Diameter (mm) 22 22 22 22 24 24 24 24 26 26 26 26 26 26 26 26 28 28 28 28 28 28 28 28 30 30 30 30 30 30 30 30 32 32 32 32 32 32 32 32 34 34 34 34 34 34 36 36 36 36 8-24 mm 12-20 mm IW1408C105XH IW1410C105XH IW1412C105XH IW1412C75XH IW1412C90XH IW1414C105XH IW1414C75XH IW1414C90XH IW1416C105XH IW1416C75XH IW1416C90XH IW1418C105XH IW1418C75XH IW1418C90XH IW1420C105XH IW1420C75XH IW1420C90XH IW1422C105XH IW1422C75XH IW1422C90XH IW1424C105XH IW1424C75XH IW1424C90XH Proximal Diameter (mm) 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 14 AORTIC EXTENSIONS 8-24 mm Product Code F–FreeFlo B–Bare spring W–Open web C–Closed web Choose from various lengths, diameters, variable tapering and flaring, and an array of proximal and distal designs to create a stent graft to your exact specifications. AXB2222W30XH AXF2424W30XH AXF2626W30XH AXF2828W29XH AXF3030W28XH AXF3232W28XH AXF3434W28XH AXF3636W26XH Proximal Diameter (mm) 22 24 26 28 30 32 34 36 Proximal Diameter (mm) 10 12 12 14 14 16 16 18 18 18 18 18 18 18 18 18 18 18 20 20 22 22 Distal Diameter (mm) 10 8 12 10 14 12 16 12 12 14 14 16 16 18 18 20 22 24 16 20 18 22 Indications The Talent® Abdominal Stent Graft is indicated for the endovascular treatment of abdominal aortic aneurysms with or without iliac involvement having: • Iliac/femoral access vessel morphology that is compatible with vascular access techniques, devices, and/or accessories; • A proximal aortic neck length of ≥ 10 mm; • Proximal aortic neck angulation ≤ 60°; • Distal iliac artery fixation length of ≥ 15 mm; • An aortic neck diameter of 18–32 mm and iliac artery diameters of 8–22 mm; and • Vessel morphology suitable for endovascular repair. Contraindications The Talent Abdominal Stent Graft is contraindicated in: • Patients who have a condition that threatens to infect the graft. • Patients with sensitivities or allergies to the device materials. Warnings and Precautions • The long-term performance of endovascular grafts has not yet been established. All patients should be advised that endovascular treatment requires lifelong, regular follow-up to assess their health and the performance of their endovascular graft. Patients with specific clinical findings (e.g., endoleaks, enlarging aneurysms or changes in the structure or position of the endovascular graft) should receive enhanced follow-up. Specific follow-up guidelines are described in the Instructions for Use. • The Talent Abdominal Stent Graft System should only be used by physicians and teams trained in vascular interventional techniques, including training in the use of the device. Specific training expectations are described in the Instructions for Use. • Always have a vascular surgery team available during implantation or reintervention procedures in the event that conversion to open surgical repair is necessary. • The Talent Abdominal Stent Graft System is not recommended in patients unable to undergo or who will not be compliant with the necessary preoperative and postoperative imaging and implantation studies as described in the Instructions for Use. • After endovascular graft placement, patients should be regularly monitored for perigraft flow, aneurysm growth or changes in the structure or position of the endovascular graft. • Inappropriate patient selection may contribute to poor device performance. • Exercise care in handling and delivery technique to aid in the prevention of vessel rupture. • Patients experiencing reduced blood flow through the graft limb and/or leaks may be required to undergo secondary interventions or surgical procedures. • Intervention or conversion to standard open surgical repair following initial endovascular repair should be considered for patients experiencing enlarging aneurysms and/or endoleak. An increase in aneurysm size and/or persistent endoleak may lead to aneurysm rupture. • Prior to the procedure, pre-operative planning for access and placement should be performed. See Instructions for Use. • Renal complications may occur: - From an excess use of contrast agents. - As a result of emboli or a misplaced stent graft. The radiopaque marker along the edge of the stent graft should be aligned immediately below the lower-most renal arterial origin. Graft Covered Length (mm) 81 75 81 75 80 75 80 140 80 140 75 140 80 140 80 80 80 80 74 79 74 79 Stent Graft Total Length (mm) 95 90 95 90 95 90 95 155 95 155 90 155 95 155 95 95 95 95 90 95 90 95 Catheter Diameter (F) 18 18 18 18 18 18 18 20 18 20 18 20 18 20 18 18 20 20 18 18 20 20 WITH THE XCELERANT® HYDRO DELIVERY SYSTEM • Studies indicate that the danger of microembolization increases with increased duration of the procedure. • Inadequate seal zone may result in increased risk of leakage into the aneurysm or migration of the stent graft. Other possible causes of migration are deployment of the proximal spring into a thrombus-filled or severely angled vessel wall. • The safety and effectiveness of the Talent Abdominal Stent Graft System has not been evaluated in some patient populations. Please refer to the product Instructions for Use for details. MRI Safety and Compatibility Non-clinical testing has demonstrated that the Talent Abdominal Stent Graft is MR Conditional. It can be scanned safely in both 1.5T & 3.0T MR systems under certain conditions as described in the product Instructions for Use. For additional information regarding MRI please refer to the product Instructions for Use. Adverse Events Potential adverse events include (not arranged in any particular order): Amputation; Anesthetic complications and subsequent attendant problems (e.g., aspiration); Aneurysm enlargement; Aneurysm rupture and death; Aortic damage (including perforation, dissection, bleeding, rupture and death); Arterial or venous thrombosis and/or pseudoaneurysm; Arteriovenous fistula; Bleeding, hematoma or coagulopathy; Bowel complications (e.g., ileus, transient ischemia, infarction, necrosis); Cardiac complications and subsequent attendant problems (e.g., arrhythmia, myocardial infarction, congestive heart failure, hypotension, hypertension); Claudication (e.g., buttock, lower limb); Death; Edema; Embolization (micro and macro) with transient or permanent ischemia or infarction; Endoleak; Fever and localized inflammation; Genitourinary complications and subsequent attendant problems (e.g., ischemia, erosion, fistula, incontinence, hematuria, infection); Hepatic failure; Impotence; Infection of the aneurysm, device access site, including abscess formation, transient fever and pain; Lymphatic complications and subsequent attendant problems (e.g., lymph fistula); Neurologic local or systemic complications and subsequent attendant problems (e.g., confusion, stroke, transient ischemic attack, paraplegia, paraparesis, paralysis); Occlusion of device or native vessel; Pulmonary/ respiratory complications and subsequent attendant problems (e.g., pneumonia, respiratory failure, prolonged intubation); Renal complications and subsequent attendant problems (e.g., artery occlusion, contrast toxicity, insufficiency, failure); Surgical conversion to open repair; Vascular access site complications (including infection, pain, hematoma, pseudoaneurysm, arteriovenous fistula, dissection); Vascular spasm or vascular trauma (e.g., iliofemoral vessel dissection, bleeding, rupture, death); Vessel damage; Wound complications and subsequent attendant problems (e.g., dehiscence, infection, hematoma, seroma, cellulitis); Stent graft complications: improper component placement, incomplete component deployment, component migration, suture break, occlusion, infection, stent fracture, graft twisting and/or kinking, insertion and removal difficulties, graft material wear, dilatation, erosion, puncture, and perigraft flow. Please reference product Instructions for Use for more information regarding indications, warnings, precautions, contraindications and adverse events. CAUTION: Federal (USA) law restricts this device to sale by or on the order of a physician. Notes and References: 1. Difficult access is defined as tortuous iliac anatomies. Bench testing data on file. 2. Crossing profile similar to or lower than closest competitors. 3. Competitive devices were tested with Cook Introducer sheaths, 18F with the Gore Excluder, and 20F with the Cook Zenith. Test units were all 28 mm bifurcated stent grafts. 4. Talent® Abdominal Stent Graft System Instructions For Use. 5. Gore Excluder® AAA Endoprosthesis Instructions for Use. 6. Zenith® AAA Endovascular Graft Instructions For Use. 7. Talent on all delivery systems. www.medtronic.com www.talentstentgraft.com Medtronic Vascular 3576 Unocal Place Santa Rosa, CA 95403 USA Tel: 707.525.0111 Talent® Abdominal Stent Graft CardioVascular LifeLine Customer Support Tel: 877.526.7890 Tel: 763.526.7890 Product Services Tel: 888.283.7868 Fax: 800.838.3103 For distribution in the USA only. © 2008 Medtronic, Inc. All rights reserved. Printed in the USA. Trademarks are property of their respective owners. UC200902101aEN 11/09 Talent® Abdominal Stent Graft Expanding the Indications for EVAR Treat More Patients Designed to Deliver Short Necks Excellent Patient Outcomes Low Profile • The Talent Abdominal Stent Graft is the only FDA-approved device for proximal aortic neck length as short as 10 mm Over 12 Years of Worldwide Experience7 • Xcelerant Hydro Delivery System facilitates stent graft treatment in patients with difficult access1 • More than 45,000 patients implanted worldwide • System does not require a sheath, unlike Gore and Cook systems • Over 150 peer-reviewed articles • Never withdrawn from any market for reasons related to safety and effectiveness A Comparison of Delivery System Profiles2,3 Talent Xcelerant Hydro Delivery System4 Gore Excluder System5 Artery Diameter: 7.3 mm Artery Diameter: 7.3 mm Angled Necks • Designed with approximately 15 mm suprarenal stent length for conformability to angulated anatomy Sheath Diameter: 24F Inner Diameter: (18F) Inner Diameter: (20F) Sheath Required Sheath Required Inner Diameter: N/A Sheath Not Required Artery Diameter: 8 mm Sheath Diameter: 22F Delivery System Diameter: 22F • Approved for aortic neck angulation up to 60 degrees Cook Zenith System6 Excellent Clinical Results US PMA Pivotal Clinical Data at 12 Months 98% Hydrophilic Coating Large Necks 0 • Designed to aid navigation through tight and tortuous iliacs • Approved to treat up to 32 mm diameter necks • Available in stent graft sizes from 22-36 mm Wide Range of Sizes • Most extensive offering of main bodies and extensions on the market – over 1,150 combinations Pre-Operative Angiogram • Tapered and flared iliac limb sizes from 8 to 24 mm • Full spectrum of sizes available up to 36 mm, including 34 mm for complete spectrum of choice Easy and Accurate Three-Step Deployment A Comparison of Aortic Neck Device Diameters 1 2 Medtronic Talent Cook Zenith® Gore Excluder® 22 24 26 28 30 Size (mm) 32 34 36 Post-Operative Angiogram 3 Freedom from aneurysm-related mortality No reported ruptures or conversions 96.5% Freedom from secondary endovascular procedures 100% Stent graft patency 0.8% Migration
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