Medtronic CardioVascular Interventional Pipeline

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Medtronic CardioVascular Interventional Pipeline
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DISCLOSURES
Professor Martin T Rothman VP Medical Affairs,
Coronary Peripheral Santa Rosa,
California Professor of Interventional
Cardiology, Barts and the London NHS Trust

• Never prepared so long in advance of talk
• Never had to have slides approved
• Never spoken as a company employee before

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NEXT GENERATION STENT PLATFORM

• Development target
• New platform manufacturing technology for
  enhanced deliverability and conformability
• Particularly for tortuous, long and small vessels
• Potential future platform for new BMS and future
  generation DES
• Potential utilization of new alloys
• Innovation concept helical design
• Continuous sinusoidal interlocked pattern
• Thin rounded struts
• Early prototype results
• Improved flexibility vs. modular technology
• Lower crossing profile
• Improved deliverability in tortuous vessels

In animal studies
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DRUG FILLED STENT CONCEPT

• Development target
• No abluminal polymer essentially a BMS surface
• Addressing issues of
• Polymer biocompatibility
• Inflammation upon polymer degradation
• Surface coating durability
• Innovation concept
• Drug filled stent concept (DFS)
• Early prototype results
• Hole dimension allow for
• Controlled
• Prolonged
• Tailored elution profiles

Drug fills hollow structure Exits through holes
Drug elution controlled by
organic
diffusion physics
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POLYMERLESS NANOTECHNOLOGY

• Development targets
• Rapid healthy endothelialization
• Significant inhibition of restenosis / cell
• proliferation without the use of a polymer
• Innovation concept
• Porous surface - for non-polymeric
  
• drug release
• Pro-healing surface
• Challenges
• Ability to fine tune elution and obtain desired
• efficacy

Nanoporous surface modification adherence and
growth of cultured human endothelial cells as
compared to bare metal (4-days)
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Demonstrated in in vitro studies
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BIOABSORBABLE POLYMER SURFACES

• Development Targets
• Coating and drug elution
• characteristics to ensure efficacy
• Biocompatibility during biodegradation
• Rapid enough degradation to reduce anti-
• platelet therapy
• Innovation concept
• Bioabsorbable polymer
• Challenges
• Degrading without any significant inflammatory
  response over a reasonable time to ensure good
  biocompatibility and safety

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TRANSCATHETER
AORTIC VALVE TECHNOLOGY
ENGAGER TM
COREVALVE

• Porcine Pericardium Valve
• Self expanding multi-level Nitinol frame
• Partially repositionable
• 18Fr Delivery System

• Bovine Pericardium Valve
• Self expanding Nitinol frame
• Self positioning technology
• Trans-apical
• Patented Venturi design optimizes hemodynamics

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TRANSCATHETER
AORTIC VALVE TECHNOLOGY
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RESISTANT HYPERTENSION CATHETER BASED
TECHNOLOGIES

• Catheter-based procedure using standard
  interventional techniques
• RF energy delivered through the renal artery wall
  to denervate the renal nerves
• Pilot study suggests significant and sustained
  reductions in blood pressure in patients with
  resistant hypertension

Hyperactivity of the renal sympathetic nerves
plays a key role in hypertension
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ERECTILE DYSFUNCTION CATHETER BASED TECHNOLOGIES

• Erectile dysfunction (ED) - largely a vascular
  disease
• Significant portion of ED caused by inadequate
  blood flow
• 75 of men with CAD have ED
• ED shown to predate CAD by 3 years
• Despite drug therapy - ED still a significant
  unmet medical need
• Many patients dont optimally respond to current
  drugs (PDE5i)
• Medtronic pioneering interventional ED approach -
  co-operation with interventional cardiologists
  and urologists stenting of pelvic arteries
• - ZEN (feasibility) study - 50 patients/10 USA
  centers
• - Results expected by 2011
• - Study will add insight into proper patient
  selection

ZEN (Zotarolimus-Eluting Peripheral Stent System
for the Treatment of Erectile Dysfunction in
Males with Sub-Optimal Response to PDE5
Inhibitors)
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Not bad for 9 days in new job
Medtronic CardioVascular Interventional Pipeline