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T echnical I ssues

Provisionnal T stenting With the Frontier stent. T echnical I ssues. GUIDANT. Martial Hamon Caen, France. (7 French compatible device; stent length of main branch 18 mm). Diago. Wiring 2 vessels. LAD. Case. After Kissing Balloon dilation. Placement of The Frontier stent.

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T echnical I ssues

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  1. Provisionnal T stenting With the Frontier stent Technical Issues GUIDANT Martial Hamon Caen, France (7 French compatible device; stent length of main branch 18 mm)

  2. Diago. Wiring 2 vessels LAD Case After Kissing Balloon dilation Placement of The Frontier stent Procedure

  3. Frontier implantation Provisionnal T stenting Direct stenting of side branch Simutaneous kissing procedure Final Result Case Procedure

  4. Provisionnal T stenting With the Frontier stent Case Procedure Before After

  5. Guidant MUTI-LINK FRONTIER™ Coronary Bifurcation Stent System • 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 Stent Description

  6. 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). Technical Issues • 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.

  7. 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. Technical Issues

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