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PN-3078-0001 Rev. C 01/13

English

INSTRUCTIONS FOR USE

AngioSculpt® Percutaneous Transluminal Coronary Angioplasty (PTCA)

Scoring Balloon Catheter

Rapid Exchange (RX) Delivery System

NOTE: These instructions apply to all balloon diameters and

lengths.
STERILE: Sterilized with ethylene oxide gas. Do not use if the package

is open or damaged.
CONTENTS: One (1) AngioSculpt® Scoring Balloon Catheter.
STORAGE: Store in a dry, dark, cool place.

DEVICE DESCRIPTION

The AngioSculpt catheter comprises a standard balloon catheter that

incorporates a nitinol component. The proximal end of the catheter is

a common PTCA catheter design comprising a hypotube connected

to a plastic hub. The hub-hypotube contact area is supported by a

relatively soft strain relief to avoid kinking. The hub is used to inflate

the balloon and can be connected to a standard inflation device. The

distal part of the catheter consists of a conventional nylon balloon and

a laser-cut nitinol scoring element having three or more spiral struts

that wrap around the balloon. The struts create focal concentrations

of dilating force, which minimizes balloon slippage and assists in

the luminal expansion of stenotic coronary arteries. The catheter is

compatible with standard 0.014” coronary guide wires and 6F guiding

catheters. The catheter length is approximately 137 cm and is offered in

diameters of 2.0 – 3.5 mm in 0.5 mm increments. The working length of

the scoring element ranges from 6 to 20 mm. The catheter is supplied

sterile and is intended for a single use. Figure 1 below depicts the

AngioSculpt catheter.

Figure 1: AngioSculpt Catheter

II. INDICATIONS

The AngioSculpt Scoring Balloon Catheter is indicated for the

treatment of a hemodynamically significant coronary artery stenosis,

including in-stent restenosis, for the purpose of improving myocardial

perfusion.

III. CONTRAINDICATIONS

The AngioSculpt catheter should not be used for the following:
• Coronary artery lesions unsuitable for treatment by percutaneous

revascularization.

• Coronary artery spasm in the absence of a significant stenosis.

IV. WARNINGS

• This device is intended for single (one) use only. Do not resterilize

and/or reuse, as this can potentially result in compromised device

performance and increased risk of inappropriate resterilization and

cross contamination.

• To reduce the potential for vessel damage, the inflated diameter

of the balloon should approximate the diameter of the vessel just

proximal and distal to the stenosis.

• PTCA in patients who are not acceptable candidates for coronary

artery bypass graft surgery requires careful consideration, including

possible hemodynamic support during PTCA, as treatment of this

patient population carries special risk.

• When the catheter is exposed to the vascular system, it should be

manipulated while under high quality fluoroscopic observation. Do

not advance or retract the catheter unless the balloon is fully deflated

under vacuum. If resistance is met during manipulation, determine

the cause of the resistance before proceeding.

• Balloon pressure should not exceed the rated burst pressure (RBP).

[The RBP is based on results of in-vitro testing. At least 99.9% of the

balloons (with 95% confidence) will not burst at or below their RBP.

Use of a pressure monitoring device is recommended to prevent

over-pressurization.]

• PTCA with the AngioSculpt device should only be performed at

hospitals where emergency coronary artery bypass graft surgery can

be quickly performed on site (or at a nearby facility) in the event of a

potentially injurious or life-threatening complication.

• Use only the recommended balloon inflation medium. Never use air

or any gaseous medium to inflate the balloon.

• Proceed cautiously when using the AngioSculpt catheter in a freshly

deployed bare metal or drug eluting stent. The AngioSculpt catheter

has not been tested for post-dilation of stents or lesions distal to

freshly deployed stents in clinical studies. Bench testing has shown

no additional risk when inserting or withdrawing the AngioSculpt

catheter through stents (no interference with stent struts, no

retention of or damage to AngioSculpt catheter).

• Use the catheter prior to the “Use Before” (expiration) date specified

on the package.

V. PRECAUTIONS
• Prior to angioplasty, the catheter should be examined to verify

functionality, device integrity and to ensure that its size and length

are suitable for the specific procedure for which it is to be used.

• Only physicians trained in the performance of percutaneous

transluminal coronary angioplasty should use the catheter system.

• During and after the procedure, appropriate antiplatelet,

anticoagulant and coronary vasodilator therapy consistent with

institutional practice for coronary stent procedures should be

provided to the patient.

• Do not rotate the catheter shaft in excess of 180 degrees when the

tip is constrained.

• Do not rotate the catheter luer hub in excess of five (5) turns during

use.

• Do not advance or retract the AngioSculpt catheter over the floppy

portion of the guide wire.

• Catheter manipulation, including advancement and retraction,

should be performed by grasping the hypotube shaft.

• If unusual resistance is felt when the catheter is being manipulated

or if it is suspected that the guide wire has become kinked, carefully

remove the entire catheter system (AngioSculpt catheter and

steerable guide wire) as a unit.

• If fluoroscopic guidance indicates that the AngioSculpt catheter has

advanced beyond the end of the guide wire, withdraw the catheter

and reload the wire before advancing again.

Содержание AngioSculpt RX

Страница 1: ...sse retningslinjer er beregnet til brug i lande uden for USA Retningslinjer til brug i USA findes i PN 3172 0001 eller p vores website p www angioscore com products ifu aspx Dessa anvisningar r avsedd...

Страница 2: ...v C 01 13 GB English 3 F Fran ais 6 D Deutsch 9 I Italiano 12 E Espa ol 15 NL Nederlands 18 P Portugu s 22 GR 26 DK Dansk 29 S Svenska 32 FIN Suomi 36 N Norsk 39 PL Polski 42 H Magyar 46 CZ esk 49 TR...

Страница 3: ...of this patient population carries special risk When the catheter is exposed to the vascular system it should be manipulated while under high quality fluoroscopic observation Do not advance or retrac...

Страница 4: ...ASA clopidogrel There was no attempt to alter standard practice for these study patients other than using the investigational device Coronary angiography in the views best demonstrating the target les...

Страница 5: ...iding catheter 6F Hemostatic valve Contrast medium diluted 1 1 with normal saline Sterile heparinized normal saline 10cc and 20cc syringes for flushing and balloon prep Inflation device indeflator 0 0...

Страница 6: ...aire sans st nose significative IV MISES EN GARDE Ce dispositif est pr vu pour un usage unique Ne pas le rest riliser ni le r utiliser au risque d alt rer le bon fonctionnement du dispositif et d augm...

Страница 7: ...emble des interventions et en l absence de MACE survenus l h pital M thodes Les patients ont t trait s de mani re classique et conform ment aux pratiques de l tablissement relatives aux interventions...

Страница 8: ...la r ussite du d ploiement du cath ter AngioSculpt Aucune situation de dysfonctionnement du dispositif ou de retenue de l un de ses composants ni d embolie n a t rencontr e Chaque dispositif a t soign...

Страница 9: ...ufweitungsdruck st rker auf den Bereich der St tzen so dass das Rutschverhalten des Ballons minimiert und die luminale Aufweitung stenotischer Koronararterien erleichtert wird Der Katheter ist mit sta...

Страница 10: ...n Bei der Studienpopulation handelte es sich um erwachsene Patienten bei denen eine klinisch indizierte perkutane Koronarintervention vorgesehen war Nach der Erteilung ihrer Einverst ndniserkl rung un...

Страница 11: ...heter behandelten entfernt lag Dieser Patient erforderte keine chirurgische Intervention und erlitt keine weiteren schwerwiegenden klinischen Komplikationen im Verlauf der Nachsorge Der AngioSculpt Ka...

Страница 12: ...entleert ist Der Katheter darf zum Herausziehen nur am Hypotube Schaft gefasst werden 16 Alle Komponenten inspizieren um sicherzustellen dass das Produkt intakt ist Die Einrichtungsvorschriften f r di...

Страница 13: ...della struttura sanitaria di appartenenza relative alle procedure di impianto di stent coronarici Non far ruotare lo stelo del catetere pi di 180 gradi quando la punta vincolata Non far ruotare il ra...

Страница 14: ...osa e inibitori della glicoproteina 2b 3a a discrezione del ricercatore Tutti i pazienti erano disponibili e si sono sottoposti a follow up clinico a 14 28 giorni dal trattamento mediante catetere Ang...

Страница 15: ...10 15 secondi fino a ottenere il gonfiaggio completo del dispositivo A sua discrezione il medico pu effettuare il gonfiaggio fino a raggiungere una pressione massima pari o inferiore alla pressione no...

Страница 16: ...lpt Utilice el cat ter antes de que transcurra la fecha Use Before caducidad especificada en el envase V PRECAUCIONES Antes del procedimiento de angioplastia debe examinar el cat ter para verificar su...

Страница 17: ...fartos de miocardio revascularizaciones coronarias o intervenciones coronarias percut nea posteriores al alta clase de angina y una valoraci n electrocardiogr fica en el consultorio Resultados Una vez...

Страница 18: ...te radiogr fico deje el conjunto bajo vac o durante 30 segundos 9 Interrumpa cuidadosamente el vac o de la jeringa de 20 cc y retire sta del orificio de inflado del bal n 10 Acople el dispositivo de i...

Страница 19: ...er mag uitsluitend worden opgevoerd of teruggetrokken wanneer de ballon onder vacu m volledig is geleegd Indien er tijdens het manipuleren weerstand wordt ondervonden moet de oorzaak van de weerstand...

Страница 20: ...aand De primaire prestatiedoelstelling betrof het verkrijgen van geslaagde percutane revascularisatie gedefinieerd als een vermindering in de stenose van de diameter van de te behandelen laesie 50 na...

Страница 21: ...bevestigen Uit de resultaten van de intravasculaire echo blijken de scoring van de plaque en lumenexpansie na behandeling met de AngioSculpt katheter Er waren geen perforaties of andere tekenen van o...

Страница 22: ...n alle interventies 19 Verwijder alle katheters en behandel de arteri le punctieplaats overeenkomstig het ziekenhuisprotocol 20 Blijf pati nten behandelen met ASA clopidogrel riclopidine en GP2b 3a bl...

Страница 23: ...corpo do hipotubo Caso seja sentida uma resist ncia n o habitual durante a manipula o do cateter ou se suspeitar que o fio guia est vincado retire a totalidade do sistema do cateter cateter AngioSculp...

Страница 24: ...ram aos crit rios de inclus o no estudo A idade e sexo dos doentes que participaram no estudo reflectiu a distribui o t pica em doentes n o seleccionados orientados para interven o coron ria percut ne...

Страница 25: ...e insufla o do cateter de bal o 8 Aspire retire o ar existente no l men do cateter de bal o utilizando uma seringa da 20 cc com 2 3 cc de contraste radiogr fico e deixe ficar em v cuo durante 30 segun...

Страница 26: ...ngioSculpt 0 014 6 F 137 cm 2 0 3 5 mm 0 5 mm 6 20 mm 1 AngioSculpt 1 AngioSculpt II AngioSculpt III AngioSculpt IV PTCA PTCA RBP RBP in vitro 99 9 95 RBP PTCA AngioSculpt AngioSculpt AngioSculpt Angi...

Страница 27: ...age 27 of 68 PN 3078 0001 Rev C 01 13 VI 1 1 CABG VII AngioSculpt 45 AngioSculpt 2 0 4 0 mm 30 mm 60 60 AngioSculpt Q Q TLR 50 24 CPK I CPK 4 12 24 AngioSculpt 14 28 CABG PCI 45 63 10 7 69 AngioSculpt...

Страница 28: ...15 67 6 14 DS 75 27 12 91 17 46 8 15 38 68 17 19 3 81 3 75 MLD mm 0 75 0 35 2 49 0 43 1 83 0 59 2 91 0 47 RVD DS MLD p 0 001 AngioSculpt AngioSculpt IVUS AngioSculpt 3 3 AngioSculpt n 30 ISR AngioScul...

Страница 29: ...nballon og et laserslebet ridseelement af nitinol med tre eller flere spiralstivere viklet omkring ballonen Stiverne danner fokale koncentrationer af dilatationskraft hvilket minimerer ballonglidning...

Страница 30: ...m 5 omgange under brug AngioSculpt kateteret m ikke f res frem eller tr kkes bagud over den bl de del af guidewiren Manipulering af kateteret inklusive fremf ring og tilbagetr kning skal udf res ved a...

Страница 31: ...ige medikamenter inklusive Aspirin Clopidogrel intraven s heparin og glycoprotein 2b 3a h mmere Alle patienter var disponible og deltog i en klinisk opf lgning 14 28 dage efter behandling med AngioScu...

Страница 32: ...middel inden den f res ind i kroppen gentag om n dvendigt anvisningen i trin 9 11 12 F r AngioSculpt produktet frem over koronarguidewiren til m ll sionen kan fordilatere med et ballonkateter med en d...

Страница 33: ...eller annan gas f r aldrig anv ndas f r att fylla ballongen Iakttag stor f rsiktighet n r AngioSculpt katetern anv nds i en nyligen insatt stent av bar metall eller en l kemedelsavgivande stent Angio...

Страница 34: ...kemedel tillf rdes efter interventionen enligt institutionens protokoll f r perkutana koronara interventioner involverande stentar EKG registrerades omedelbart efter ingreppet och efter 24 timmar elle...

Страница 35: ...tentar 2 Utf r koronarangiografi i den projektion som b st demonstrerar lesionen som ska tg rdas innan katetern anv nds 3 L gg in nskad koronar 0 014 tums ledare ver och f rbi lesionen 4 Anv nd steril...

Страница 36: ...puolilla jotta verisuonen vaurioitumisriski pienenisi PTCA toimenpiteen tekeminen sellaisille potilaille jotka eiv t ole hyv ksytt vi ehdokkaita sepelvaltimon ohitussiirreleikkaukseen edellytt huolell...

Страница 37: ...sena Menetelm t Potilaita hoidettiin tavanomaisella tavalla ja hoitolaitoksen sepelvaltimon perkutaanisia interventioita koskevan k yt nn n mukaisesti esimerkiksi antikoagulantteja esim hepariinia ja...

Страница 38: ...ensis isen kaikukuvauksen katetrilla tai AngioSculpt katetrilla Ahtaumaa t ytyi siksi esilaajentaa pienipalloisella katetrilla 1 5 2 0 mm mink j lkeen AngioSculpt katetria k ytettiin onnistuneesti V l...

Страница 39: ...Arbeidslengden p sk ringselementet varierer fra 6 til 20 mm Kateteret leveres sterilt og er beregnet til engangsbruk Figur 1 nedenfor illustrerer AngioSculpt kateteret Figur 1 AngioSculpt kateter II I...

Страница 40: ...kateter Synlig blodpropp med angiografi p m llesjonsstedet M l Det prim re sikkerhetsm let var p vise forekomst og alvorsgrad av anordningsrelaterte komplikasjoner MACE d d Q b lge ikke Q b lge MI TLR...

Страница 41: ...er I fire lesjoner var stenosen s alvorlig at den innledningsvis ikke kunne krysses av IVUS kateteret eller AngioSculpt kateteret og ble derfor dilatert p forh nd med et lite ballongkateter 1 5 2 0 mm...

Страница 42: ...erzenie zw onych t tnic wie cowych Cewnik jest kompatybilny z prowadnikami wie cowymi o rednicy 0 36 mm 0 014 cala i z cewnikami prowadnikowymi o rednicy 6F Cewnik ma oko o 137 cm d ugo ci Dost pne s...

Страница 43: ...a Zgon Zawa mi nia sercowego ostry zawa mi nia sercowego Ca kowite zamkni cie wiat a poszerzanej t tnicy wie cowej Rozwarstwienie perforacja rozerwanie lub uszkodzenie t tnicy wie cowej Tamponada work...

Страница 44: ...ia aortalno wie cowego CABG przezsk rnej interwencji wie cowej PCI stopie nasilenia objaw w dusznicy oraz ocen elektrokardiograficzn Wyniki Po uzyskaniu wiadomej zgody zakwalifikowano 45 kolejnych pac...

Страница 45: ...ikatnie wsuwaj c dystalny koniec cewnika do wn trza zako czenia strzykawki o obj to ci 10 ml i wstrzykuj roztw r soli fizjologicznej do czasu gdy w proksymalnym odcinku kana u prowadnika pojawi si kro...

Страница 46: ...el a lehets ges hemodinamikai t mogat s biztos t s t is bele rtve mivel ezen betegpopul ci kezel se speci lis kock zattal j r A kat tert az rrendszeren bel l j min s g r ntgen tvil g t s mellett aj nl...

Страница 47: ...elv ltoz s tm r j nek sz k lete 50 lesz az sszes intervenci elv gz se ut n s a k rh zban nem alakult ki MACE M dszerek A betegek kezel se standard m don s a percutan coronaria intervenci kra vonatkoz...

Страница 48: ...m lis luminalis ter let p 0 001 az AngioSculpt el tti llapottal sszehasonl tva Az AngioSculpt kat tert mind a 46 elv ltoz s eset n sikeresen felhelyezt k N gy elv ltoz sn l a sz k let olyan nagym rt k...

Страница 49: ...etru sest vaj c z trubice hypotube p ipojen k plastov mu st Oblast spojen trubice hypotube a st je opat ena relativn m kk m prvkem pro uvoln n nap t aby nedoch zelo k zalamov n st se pou v k pln n bal...

Страница 50: ...du akutn pln uz v r l en koron rn tepny Disekce perforace ruptura nebo poran n koron rn tepny Tampon da perikardu Neobnoven pr toku slab pr tok v l en c v Neodkladn bypass koron rn ch tepen CABG Neodk...

Страница 51: ...nci Pacienti byli l eni standardn mi peropera n mi l ky v etn aspirinu clopidogrelu intraven zn ho heparinu a inhibitor glykoproteinu 2b 3a podle rozhodnut zkou ej c ho V ichni pacienti byli k dispozi...

Страница 52: ...do bal nkov ho lumenu katetru vnikly bublinky vzduchu 11 Aspirujte pomoc plnic ho za zen a aretujte ve stavu podtlaku POZN MKA P ed zaveden m katetru do t la pacienta mus b t z bal nku odstran n ve ke...

Страница 53: ...an n Balonu i irmek i in asla hava veya herhangi bir gazl madde kullanmay n AngioSculpt kateterini yeni yerle tirilmi bir plak metal veya ila sal n ml stent i inde kullan rken dikkatli ilerleyin The A...

Страница 54: ...ekildi CPK ve e er CPK anormal olarak y ksekse Troponin I i lemden sonra 4 ve 12 saatte ve 24 saatte taburcu olma ncesinde hangisi nce geldiyse l ld AngioSculpt kateteri ile tedavi edilen hastalar i i...

Страница 55: ...cuna dikkatle yerle tirip proksimal k lavuz tel l meninden damlalar k ncaya kadar salin enjekte ederek k lavuz tel l meninden s v ge irin 7 Kateter balon i irme portuna i inde 2 3 ml radyografik kontr...

Страница 56: ...pt I AngioSculpt 0 014 6 F 137 2 0 2 5 3 0 3 5 6 20 AngioSculpt 1 1 AngioSculpt II AngioSculpt III AngioSculpt IV RBP in vitro 99 9 95 AngioSculpt AngioSculpt AngioSculpt AngioSculpt AngioSculpt Use B...

Страница 57: ...Page 57 of 68 PN 3078 0001 Rev C 01 13 VI 1 1 VII AngioSculpt 45 AngioSculpt 2 0 4 0 30 60 60 AngioSculpt Q 50 24 4 12 24 I AngioSculpt 14 28 45 63 10 7 69 AngioSculpt 2b 3 14 28 AngioSculpt...

Страница 58: ...lpt n 36 mm 2 87 0 41 mm 15 67 6 14 75 27 12 91 17 46 8 15 38 68 17 19 3 81 3 75 mm 0 75 0 35 2 49 0 43 1 83 0 59 2 91 0 47 p 0 001 AngioSculpt AngioSculpt AngioSculpt 3 3 AngioSculpt n 30 AngioSculpt...

Страница 59: ...11 12 AngioSculpt 2 0 2 5 13 AngioSculpt 2 2 10 15 14 2 15 AngioSculpt 16 AngioScore Inc 17 18 2 19 20 2b 3 AngioSculpt PTCA RX ETO 1 AngioSculpt I AngioSculpt PTCA 0 014 6F 137 cm 2 0 3 5 mm 0 5 mm 6...

Страница 60: ...C 01 13 RBP RBP in vitro 99 9 95 RBP AngioSculpt PTCA AngioSculpt AngioSculpt AngioSculpt AngioSculpt UseBefore V 180 5 AngioSculpt AngioSculpt AngioSculpt X VI 1 1 CABG CVA X VII AngioSculpt 45 Angi...

Страница 61: ...ngioSculpt 2 AngioSculpt Q MACE AngioSculpt 46 46 50 AngioSculpt 2 2 AS n 46 AS n 10 AS n 36 n 36 RVD mm 2 87 0 41 mm 15 67 6 14 DS 75 27 12 91 17 46 8 15 38 68 17 19 3 81 3 75 MLD mm 0 75 0 35 2 49 0...

Страница 62: ...6 10cc 7 20 cc X 2 3 cc 8 X 2 3 cc 20 cc 30 9 20 cc 10 X 50 50 11 9 11 12 AngioSculpt 2 0 2 5 mm 13 AngioSculpt 2 10 15 2 RBP 14 AngioSculpt 2 15 AngioSculpt 16 AngioScore Inc EC 17 18 2 19 20 GP2b 3...

Страница 63: ...I AngioSculpt ISR III AngioSculpt IV PTCA PTCA RBP RBP RBP 99 9 95 AngioSculpt PTCA AngioSculpt AngioSculpt AngioSculpt AngioSculpt V 180 5 AngioSculpt AngioSculpt AngioSculpt VI 1 1 CABG CVA VII sing...

Страница 64: ...oSculpt MACE Q wave non Q wave 1 AngioSculpt non Q wave MI AngioSculpt MACE AngioSculpt 46 46 50 AngioSculpt 2 2 AS n 46 AS n 10 AS n 36 n 36 RVD mm 2 87 0 41 N A N A N A mm 15 67 6 14 N A N A N A DS...

Страница 65: ...III ANGIOSCULPT 6F 1 1 10cc 20cc 0 014 IX AngioSculpt 1 ASA GP2b 3a 2 3 0 014 4 1 0 x RVD AngioSculpt 5 6 10cc 7 2 3cc 20cc 8 2 3cc 20cc 30 9 20cc 10 50 50 11 9 11 12 AngioSculpt 2 0 2 5mm 13 AngioScu...

Страница 66: ...Page 66 of 68 PN 3078 0001 Rev C 01 13 This page is intentionally blank...

Страница 67: ...vice Intended for Single Use Only Do Not Reuse Dispositif exclusivement destin un usage unique Ne pas r utiliser Dieses Produkt ist nur zur einmaligen Verwendung vorgesehen Nicht wiederverwenden Dispo...

Страница 68: ...D I m nimo del cat ter gu a Minimale binnendiameter geleidekatheter DI M nimo do Cateter guia Guidekateter mindste indvendige diameter Minsta innerdiameter styrkateter Ohjainkatetrin v himm issis l p...

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