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Vascular > AV PTA Portfolio > Flashcards

AV PTA Portfolio Flashcards

1
Q

Percutaneous

A

through the skin

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2
Q

Transluminal

A

through the lumen (vessel)

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3
Q

Angioplasty

A

reopens narrowed blood vessels and restores

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4
Q

Intimal Hyperplasia is a response to what?

A

injury to the blood vessel

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5
Q

What is the result of intimal hyperplasia?

A

formation of a neo-intima over the site of injury

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6
Q

What accelerates intimal hyperplasia?

A

the presence of prosthetic material in the blood vessel

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7
Q

Intimal hyperplasia may result from:

A

endovascular intervention, or turbulent flow

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8
Q

Re-stenosis occuring 3-12 months after an angioplasty is typically due to:

A

Intimal hyperplasia

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9
Q

Early thrombosis of a fistula is most often due to ________, while late thrombosis tends to be due to _________.

A

an inflow problem, an outflow stenosis

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10
Q

Failed PTA in hemodialysis includes:

A
  • 30% residual stenosis
  • “flow limiting” dissection
  • abrupt closure
  • vessel rupture
  • additional thrombus
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11
Q

If you have resistant stenosis:

A

use a high pressure balloon

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12
Q

elastic stenosis definition

A

balloon can efface waist, but lesion returns

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13
Q

What is reccomended for elastic stenosis?

A
  • prolonged high pressure PTA
  • 5 minutes, 2 cycles
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14
Q

Proper PTA techniques

A
  • same diameter as vessel
  • only dilate diseased segments
  • slow inflation
  • prolonged dialation
  • stenosis < 30%
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15
Q

Balloon material design

A
  • puncture resistance
  • trackability
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16
Q

catheter design

A
  • inflate/ deflate time
  • trackability
  • pushability
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17
Q

tip design

A
  • trackability
  • crossability
  • pushability
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18
Q

the diameter of a non compliant balloon will:

A

stay consistent regardless of pressures

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19
Q

the diameter of a semi-compliant balloon will:

A

grow beyond labeled diameter

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20
Q

What is barotrauma?

A

physical tissue damage caused by a pressure difference between an unvented space inside the body.

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21
Q

What percentage of the balloon should focus on its pressure on the lesion?

A

100%

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22
Q

ultra non-compliant composite balloons

A
  • only 1% of growth from nominal to RBP
  • reduced chance of over expansion
  • the maximum dilation force is concentrated at the lesion site
  • Dorado, Conquest/40, Atlas/ Gold Balloon Catheters
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23
Q

Conquest Overview

A

first ultra non-compliant fiber balloon

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24
Q

Atlas overview

A

ultra non-compliant, large diameter, fiber balloon

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25
Q

Dorado overview

A

first and only fiber balloon offered in longer lengths

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26
Q

atlas gold overview

A

next generation, large diameter, fiber balloon

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27
Q

Conquest 40 overview

A

first and only fiber balloon up to 40 ATM

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28
Q

Presto 40 ATM Inflation device

A
  • pressures up to 40 ATM
  • larger 30cc barrels allows for rapid and easy deflation
  • ergonomic handle
  • fills up to 24 x 40 mm Atlas Gold
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29
Q

Conquest Balloon Catheter

A
  • ultra non-compliant
  • RBP up to 30 ATMs
  • wide range of sizes
  • 5- 12 mm diameters
  • 2- 8 cm lengths
  • 50, 75, & 120 cm catheter shafts
  • co-axial shaft
30
Q

conquest 40 balloon catheter

A
  • ultra non- compliant
  • RBP up to 40 ATMs
  • tampered tip compared to conquest
  • 4-12 mm diameters
  • 2-10 cm lengths
  • shaft size optimized for inflation/ deflation
    -stent indication
  • co-axial shaft design
31
Q

conquest 40 is reccomended for use in:

A
  • Percutaneous transluminal angioplasty in the femoral, iliac, and renal arteries and for the treatment of obstructive lesions of native or synthetic arteriovenous dialysis fistua
  • post dialation of stents and stent grafts
32
Q

The conquest 40 is not for use in the:

A

coronary arteries

33
Q

Dr. Vesely Case study

A
  • angioplasty baloon inflation pressures during treatment of hemodialysis graft-related stenosis
  • 34% of grafts and veins
34
Q

Dr. Trerotola case study

A
  • prospective study on balloon inflation pressures and other technical aspects of hemodialysis access angioplasty
  • 20% of fistula
35
Q

Dr. Rajan case study

A
  • ultra high pressure vs. high pressure angiolasty treatment of venous anastomotic stenosis in hemodialysis grafts: is there a difference in patency?
  • 13% of grafts
36
Q

Dorado balloon catheter

A
  • proprietary composite balloon technology on a hybrid catheter
  • multiple indications; post-stent dialation claim
  • ultra non-compliant
  • puncture resistant
  • checker flex points
37
Q

what is the CHECKER balloon process?

A

a proprietar manufacturing process that creates a pattern of flex points on the tightly wrapped balloon

38
Q

Impacts of the CHECKER balloon process:

A
  • improved trackability
  • reduced crossing profile
  • reduced balloon guard removal resistance
39
Q

Dorado Balloon catheter range of sizes

A
  • 3-10 mm diameter
  • 2-20 cm length balloons
  • 40, 80, 120, 135 catheter lengths
  • 30/70 “contrast to saline”
40
Q

Dorado catheter features

A
  • low profile
  • high rated burst pressure and burst range
  • range of sizes
41
Q

Vaccess Balloon Catheter quick notes

A
  • OBLs or outpatient lab facilities only
  • low cost high pressure balloon
42
Q

Vaccess Balloon Catheter features

A
  • non- compliant hemodialysis access balloon catheter with fixed hub
  • coaxial shaft and short tip design
  • designed for access centers
43
Q

Vaccess balloon Catheter sizes

A
  • 4-12 mm diameters
  • 2- 8 cm balloon lengths
  • 50 and 80 cm catheter lengths
44
Q

Atlas Balloon catheter

A
  • ultra non-compliant
  • very low profile
  • co-axial shaft
  • designed for low- and- high pressure use
  • largest working range (12 ATMs)
45
Q

Atlas balloon catheter sizes

A
  • 12- 26 mm diameters
  • 2, 4, 6 cm lengths
  • 75 & 120 cm catheter lengths
46
Q

The biggest difference between the atlas and the atlas gold are the:

A

shorter shoulders on the atlas gold

47
Q

Atlas gold balloon catheter

A
  • short shoulders
  • reduced tapered tip
  • improved trackability
  • designed for low- and high- pressure use
  • largest working range (12 ATMs)
48
Q

Ultraverse 035 catheter design

A
  • OTW
  • semi-compliant
  • dual lumen
  • GeoAlign Marker system
  • Checker flex points
49
Q

key sales messages- ultraverse 035

A
  • 3-12 mm diameters
  • 20- 300* mm lengths
  • up to 8 x 80* through a 5Fr. sheath
  • 75 & 130 cm catheter lengths
50
Q

What is the GeoAlign marker system?

A

non- radiopaque markings on the catheter shaft

51
Q

GeoAlign marker system features

A
  • 1 cm increments
  • every 10 cm is labeled with distance from distal balloon tip
  • thicker bands denote the mid-way point (5 cm) between labeled distances
52
Q

GeoAlign Messaging

A
  • designed to facilitate repeatable catheter alignment at the lesion
  • designed to increase procedure efficiency by minimizing fluoroscopy exposure by 27% average in pre-clinical study
53
Q

Boston Scientific .035 PTA Competition

A
  • Mustang
  • Gladiator
54
Q

Boston Scientific Mustang

A
  • high pressure, non- compliant, low-profile, excellent trackability
  • up to 24 ATM (7- 9 mm ranging 20-18 ATM)
  • NyBax balloon material
  • 5fr sheath up to 7mm x 200 mm, 6 fr sheath 8-10 x 80 mm, 12 mm 7F
  • dual lumen
  • mediglide coating
55
Q

Boston Scientific Gladiator

A
  • high pressure, non-compliant, low profile, excellent trackability
  • same features as mustang
  • low cost alternatives for access centers
56
Q

Boston Scientific Mustang profile trade-offs

A

fiber-based balloons are designed to avoid circumferential ruptures but require more material-often increasing profile

57
Q

Calcified lesions: Dorado IFU

A

no calcium of graft precaution

58
Q

Calcified lesions: Conquest IFU

A

no calcium or graft precaution

59
Q

Calcified lesions: Mustang IFU

A

use with caution for procedures involving calcified lesions or synthetic vascular grafts due to the abrasive nature of these inflation sites

60
Q

Boston Scientific Gladiator size offerings

A
  • diameters: 3-10, 12 mm
  • balloon lengths: 20, 30, 40, 60, 80, 100, 120, 150, 180, 200 mm
  • catheter lengths: 40, 75, 135 cm
  • sheath size: 5, 6, 7F
61
Q

Boston Scientific Gladiator pressure offerings

A
  • nominal: 3-12 ATM
  • RBP: 14-24 ATM
62
Q

Boston’s Athletis balloon

A
  • Vectran braided balloon design enables optimized deliverability and ultra high pressures up to 40 ATM
  • the unique, non-compliant balloon design enables it to open to the stated diameter even in highly resistent lesions
63
Q

Boston’s Athletis balloon trackability

A
  • lower profile tip by 24% to conquest 40
  • both have RBP of 40
  • conquest 40 takes 16% more force to track to to stenosis
  • more non- compliant
64
Q

Ultra non-compliant balloons have a growth factor of _____% or less

A

1

65
Q

What PTA Balloon is our Large Diameter PTA balloon? (Select all that applys)

A
  • Atlas
  • Atlas Gold
66
Q

Conquest 40 offers a rated Burst up to how many ATM’s?

A

40

67
Q

The GeoAlign® Marker System offers a _____ % reduction in fluoroscopy time.

A

27

68
Q

What are two major improvements that were made to Conquest® 40 as compared to the original Conquest? (Select all that apply)

A
  • tampered tip
  • higher ATM ratings
69
Q

Which PTA balloon offers an ultra non-compliant balloon with Checker Flex Points, 3-10 mm and 40, 80, 120, 135 catheter lengths?

A

Dorado

70
Q

What are some key benefits to the Presto 40 inflation? (Select all that apply)

A
  • Pressure rating up to 40 atm
  • Larger 30cc barrell
  • Ergonomic handle
  • Fills up to 24x40 Atlas Gold Catheter
71
Q

Succesfful PTA treatment is characterized by (Select all that apply)

A
  • No significant residual stenosis (>30%)
  • The waist of the balloon is effaced
  • Thrill is restored in the access site
  • Patient is able to resume dialysis

Vascular (24 decks)

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