1 / 19

A GLIMPSE INTO THE FUTURE

A GLIMPSE INTO THE FUTURE. DR. CARMEN WALBERT MD MEDICAL DIRECTOR CARDIOVASCULAR MEDTRONIC EUROPE. DISCLOSURES. DR. CARMEN WALBERT MD MEDICAL DIRECTOR CARDIOVASCULAR MEDTRONIC EUROPE. A GLIMPSE INTO …. MEDTRONIC’s cardio-vascular portfolio

wilmet
Download Presentation

A GLIMPSE INTO THE FUTURE

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A GLIMPSE INTO THE FUTURE DR. CARMEN WALBERT MD MEDICAL DIRECTOR CARDIOVASCULAR MEDTRONIC EUROPE

  2. DISCLOSURES DR. CARMEN WALBERT MD MEDICAL DIRECTOR CARDIOVASCULAR MEDTRONIC EUROPE

  3. A GLIMPSE INTO … • MEDTRONIC’s cardio-vascular portfolio • Drug filled stent concept • Drug eluting balloon • Resistant hypertension and renal sympathetic radiofrequency ablation • Erectile dysfunction and stenting of pudendal artery • Leadless pacemakers

  4. FUTURE “As for the future, your task is not to foresee it, but to enable it.” (Antoine de Saint-Exupery)

  5. MEDTRONIC PORTFOLIO OF FUTURE INTERVENTIONAL THERAPIES

  6. CONTINUOUS SINUSOID TECHNOLOGY PLATFORM ENABLING TECHNOLOGY Wire form allows multitude of new options BARE METAL STENTS DRUG-FILLED STENT DRUG-ELUTING STENTS • Integrity • 1st generation • ~91μm Resolute Integrity Core Wire (S10) Platforms for next generation DES New Alloys

  7. IN.PACT:Medtronic-Invatec DEB balloon line Freepac: Proprietary hydrophilic drug coating formulation Drug: Paclitaxel (3g /mm2 balloon surface) Paclitaxel + Hydrophilic Spacer: Urea (100% natural component) IN.PACT DRUG ELUTING BALLOON DEB: short term elution for long term effect Freepac  • Separates Paclitaxel molecules • Balances hydrophilic and lipophilic properties • Facilitates Paclitaxel elution into the vessel wall

  8. 3 HYPERTENSION - MAJOR GLOBAL PUBLIC HEALTH CONCERN • Around 30 – 40% of the adult population in the developed world, suffer from hypertension. 1 • Hypertension estimated to cause 4.5% of current global disease burden.2 • Hypertension – number one risk factor for premature death worldwide 1 • Globally the estimated annual healthcare expenditure directly related to hypertension is approximately 500 billion $. 3 1. Mathers C. et al., WHO 2009 2. 2003 WHO/ISH statement on management of hypertension 3. Lawes C.M. et al., Lancet 2008; 371: 1513 - 1518 The statistics speak volumes, but physicians do not treat populations. They treat patients. The human cost is high.

  9. THE HUMAN COST OF UNCONTROLLED HYPERTENSION (I) • Attributable to arterial hypertension • 54 % of strokes • 47% of ischemic heart disease Lawes et al., Lancet 2008; 371:1513 - 1518

  10. THE HUMAN COST OF UNCONTROLLED HYPERTENSION (II) Among stroke patients: J Rendon et al., J Hypertens 2008; 26 (suppl.4) 1-14

  11. RESISTANT ARTERIAL HYPERTENSION • Resistant hypertension = when a therapeutic plan that has included attention to lifestyle measures and the prescription of at least three drugs (including a diuretic) in adequate doses has failed to lower systolic and diastolic blood pressure to goal.1 • The % of patients achieving adequate blood pressure control to guideline target values remains low. • In the region of 30% even among those who are diagnosed and treated. 2 1. 2007 Guidelines for the management of arterial hypertension,European Heart Journal (2007) 28, 1462–1536 2. Kearney PM et al., Worldwide prevalence of hypertension: a systematic review. J Hypertens 2004; 22:11-19

  12. RESULTS SYMPLICITY HTN 1 * RESISTANT HYPERTENSION CATHETER BASED TECHNOLOGIES • Concept Description • Catheter-based procedure using standard interventional techniques • RF energy delivered through the renal artery wall to denervate the renal nerves Hyperactivity of the renal sympathetic nerves plays a key role in hypertension * Trial performed with SYMPLICITY CATHETER SYSTEM A device developed by Ardian Krum, Henry. “Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study, Lancet, doi:10.1016/S0140-6736(09)60566-3. April 2009; updated @ PCR 10 (May 2010)

  13. The trasaction is subject to customary closing conditions, including U.S. and foreign regulatory clearances RESULTS SYMPLICITY HTN 2 * RESISTANT HYPERTENSION CATHETER BASED TECHNOLOGIES • Concept Description • Catheter-based procedure using standard interventional techniques • RF energy delivered through the renal artery wall to denervate the renal nerves Hyperactivity of the renal sympathetic nerves plays a key role in hypertension * Trial performed with SYMPLICITY CATHETER SYSTEM A device developed by Ardian Symplicity HTN-2 Investigators, Lancet Published online November 17, 2010 DOI:10.1016/S0140-6736(10)62039-9

  14. A PATIENT WITH RESISTANT HYPERTENSION

  15. ERECTILE DYSFUNCTIONLARGELY A VASCULAR DISEASE • Erectile dysfunction Largely a vascular disease • Significant portion of ED caused by inadequate blood flow • 75% of men with CAD have ED 1 • ED shown to predate CAD by ~3 years 1 1. JH Rogers TCT 2010

  16. ERECTILE DYSFUNCTIONCATHETER BASED TECHNOLOGIES • Despite drug therapy - ED still a significant unmet medical need • Many patients don’t optimally respond to current drugs (PDE5i) • Medtronic-sponsored PANPI study showed correlation between poor PDE5i response and disease in internal pudendal artery • FIM (ZEN trial) - initiated in the USA • Safety and feasibility study for stenting treatment of refractory ED • Close collaboration with urologists and IC • Planning to enroll 50 patients / 20 sites • If successful, larger pivotal trial to follow ZEN (Zotarolimus-Eluting Peripheral Stent System for the Treatment of Erectile Dysfunction in Males with Sub-Optimal Response to PDE5 Inhibitors) 1. O’Connell et al., based on the Massachusetts Male Aging Study on Impotence. Exp Gerontol. 2004 Jul;39(7):975-84

  17. DIME Diameter = 17,91 mm Thickness = 1,35 mm PACEMAKERS THROUGH THE YEARS 5800 5858 First External Pacemaker First Implantable Pacemaker Pediatric Asynchronous PG 1958 1970 1960 Synergist™ Elite™ Kappa® Adapta™ Activitrax® First LeadlessPacemaker 2015 est 1986 1989 1991 1998 2006

  18. PERCUTANEOUS LEADLESSMICRO-PACEMAKER Steerable Sheath/Catheter Miniaturized, leadless VVI/R pacer with basic therapy and diagnostic set • KEY POTENTIAL BENEFITS • Less-invasive, easier to use, more cost effective • Less implanted hardware ("invisible") • Faster, simpler procedure • (totally percutaneous, no surgery) • Fewer complications (no lead or device pocket) • Shorter hospital stay • Easier follow-up • MRI safe

  19. THANK YOU ‘ These days people seek knowledge, not wisdom. Knowledge is of the past, wisdom is of the future.(Vernon Cooper)

More Related