Prairie Cardiovascular Consultants CTO Equipment Tony J. DeMartini, MD Prairie Cardiovascular Consultants Springfield, IL, USA

Disclosures As a faculty member for this program, I disclose the following relationships with industry: Speakers Bureau for Abbott Vascular, Boston Scientific and Bridgepoint Medical

Sheaths Guides Support Catheters Wires Crossing Catheters Guide Support Systems Snares

Sheaths 45cm 8 French long sheaths for femoral access Arrow sheaths preferred for additional support

Guides XB or EBU guides in the left system Avoid side hole guides to prevent “false sense of security” regarding impaired flow XBRCA or AL guides in the right system Use side hole guides to prevent aortic dissection with injections especially with proximal and/or ostial disease

Support Catheters Balloon Catheters Non-Balloon Catheters Crossboss

Non-Balloon Catheters Distal Proximal O.D. I.D. O.D I.D FineCross MG 1.8Fr（0.60mm） 0.018'' （0.45mm) 2.6Fr（0.87mm） 0.021'' （0.55mm) Excelsior (BSC) 2.0Fr（0.67mm） 0.019''（0.48mm) 0.019'' （0.48mm) Transit (Cordis) 2.3Fr（0.76mm） （0.50mm) 2.8Fr（0.95mm） FINECROSS MG Excelsior Transit 7 7 7

Wires Fielder XT Fielder FC Confienza Pro 12 Pilot 200

Fielder XT Soft jacketed wire with 0.009” diameter tip and 0.014 shaft with 1.2 gram tip deflection Used for antegrade probing and “knuckle” technique 30 second wire antegrade Generally “knuckles” at transition point

Fielder FC Soft jacketed wire with 0.014” diameter tip with 1.6 gram tip deflection Used for retrograde wiring of septal and epicardial channels Provides excellent tactile feedback and response Will often advance through collaterals with minimal operator interaction Collaterals will push the wire back out if not monitored closely

Confienza Pro 12 Stiff wire with 0.009” diameter tip and 0.014” shaft with 12.4 gram tip deflection Hydrophilic Used for wire escalation in antegrade approach and for reentry either antegrade or retrograde Dangerous wire that should be exchanged after the intended task is complete

Pilot 200 Hydrophilic wire with 0.014” tip and shaft Has 4.1 gram tip deflection Used for “knuckle” technique in both antegrade and retrograde approach Provides more force than Fielder XT when doing “knuckle” technique Also provides controllable wire for probing

Crossing/Reentry Catheters Crossboss/Stingray Tornus Corsair

Crossboss/Stingray Crossboss Highly torqueable coil wired shaft Atraumatic tip rarely exits vessel True lumen or adventitial CTO crossing

Crossboss/Stingray Stingray balloon Flat balloon that is self orienting 3 ports [(lumenal (green), adventitial (red) and end hole (blue)]

Tornus Braided stainless steel catheter Tapered threaded tip Available in 2.1 and 2.6 mm Counterclockwise rotation to advance

Corsair ①0.86mm　(2.6Fr) ②0.82mm　(2.5Fr) ③0.86mm　(2.6Fr) Marker coil Polyurethane resin + Tungsten powder Tungsten braiding Available in 130 and 150mm lengths. Recommend only carrying 150mm device. 31

Guide Support Guideliner

Snares Ensnare Usually 27mm or 30mm snares Wire brought retrograde into aorta and snare used to bring wire into antegrade system and then externalize

Thank you