FeaturingBifurcation

Trans-Radial Approach T

echn

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ssue

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Martial HamonCaen, France

Provisionnal T stentingWith the Frontier stent

Main Branch Balloon

2.5mm 3.0mm 3.5mm 4.0mm

Side Branch Balloon

2.0mm 2.5mm

(7 French compatible device; stent length of main branch 18 mm)

GUIDANT

FeaturingBifurcation

Trans-Radial Approach

Case

Procedure

LAD

Diago.

Wiring2 vessels

After KissingBalloon dilation Placement of

The Frontier stent

FeaturingBifurcation

Trans-Radial ApproachFrontier implantation Provisionnal T stenting

Final Result

Case

Procedure

Direct stenting of side branchSimutaneous kissing procedure

FeaturingBifurcation

Trans-Radial Approach

Case

ProcedureBefore After

Provisionnal T stentingWith the Frontier stent

FeaturingBifurcation

Trans-Radial Approach

• Designed for preserving side branch access

• Integrated-tip design allows single tip delivery, avoiding wire wrap

• Stent deploys with simultaneous “kissing balloon inflation”

• Wire position is maintained in both branches throughout the procedure

Guidant MUTI-LINK FRONTIER™ Coronary Bifurcation Stent System

Stent

Description

FeaturingBifurcation

Trans-Radial Approach

Lesion selection and preparation• Lesion type: to be avoided• calcified vessels• Tortuous vessels• very small vessels.

• Preparation of lesion• Pre-dilate the lesion(s)• Keep 2 wires in place after pre-dilatation, to facilitate your exchange wire

placement through the OTW lumen (buddy wire technique).

Tec

hnica

l Iss

ues

• Materials• ≥ 7 French guiding catheter recommended• Long guide wire for side branch access (extra-support preferred)• The nominal diameter is the distal diameter of the device. The proximal

diameter is 0.6 to 0.8 mm larger.

FeaturingBifurcation

Trans-Radial Approach

• Manipulation

• Do not torque the system. It is NOT designed to respond to torque• Remove the mandrel when the integrated tip is near the carina• Once mandrel is removed, do not push the system forward without a second

guide wire in the OTW lumen emerging distally.• Use the middle balloon marker for good placement of the Frontier stent at the

carina.• Observe the relative position of the two guide wires, as parallel wires with

clear divergence at the carina indicate optimal positioning prior to deployment.

• Do not pull back un-deployed Frontier system through guiding catheter. If needed, pull back entire system with the guiding catheter as a single unit.

• Post-dilate with kissing balloons if result is not optimal following Frontier deployment.

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hnica

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