Coronary stent synergy drug eluting stent

Drug-eluting stent technology has shown encouraging efficacy compared to bare metal stents, significantly reducing restenosis and revascularization procedures. Still, there remains a concern for being able to treat ever-increasing complex lesions, ensuring proper healing, and managing dual antiplatelet therapy (DAPT).

1. Coronary stent-SYNERGY Everolimus -Eluting Platinum Chromium Coronary Stent System

2. What is SYNERGY Stent Composed of metal stent, bioabsorbable polymer coating and drug coating Metal stent made of Platinum Chromium Alloy, consisting of platinum, chromium, iron, nickel, and molybdenum The drug is released from the stent to reduce restenosis, treat complex lesions to ensure proper healing and manage dual antiplatelet therapy (DAPT)

3. Polymer Coating The polymer coating is positioned on the outside of the stent (side in contact with the coronary artery wall) The polymer carries and protects the drug before and during the procedure Once the stent is implanted, it helps control drug release into the coronary arterial wall Absorbed by the body in approximately 4 months

4. Drug coating The SYNERGY Stent is coated with Everolimus and polymer Designed for consistent and controlled release of the drug from the stent surface into the artery walls Both the amount and release rate of drug have been selected for healing and minimizing restenosis Reducing the need for additional treatment in the stented area The Everolimus drug is completely eluted with drug is completed eluted with optimal kinetics at 3 months

5. Why SYN ERGY? Optimal and early healing Minimal polymer exposure Treating complex lesions Exceptional deliverability, enhanced visibility and navigating tight lesions Exceptional overexpansion while maintaining mechanical properties

6. 1. Optimal and early healing Ultra-thin 74-µm struts show more rapid healing compared to thicker stent strut designs in clinical cases and in preclinical research¹˒² The Synchrony Bioabsorbable Polymer promote rapid endothelialization Lower inflammation rates 1. Presented by J. M. de la Torre, MD at EuroPCR 2014. 2. Presentation by Kazuyuki Yahagi, MD; Michael Joner , MD; Renu Virmani , MD at TCT 2014.

7. Lower inflammation rate In a preclinical model, SYNERGY BP Stent demonstrated: Significantly reduced Early inflammation versus Bare Metal Stents (BMS) Significantly reduced Late inflammation versus Permanent Polymer (PP) Stents

8. Optimal healing SYNERGY BP Stent has shown full stent strut coverage as early as 30-days in humans and showed 0% stent thrombosis in all these OCT analysis³ 3. Adapted from presentation by Ida Riise Balleby , MD at ACC 2016.

9. Optimal healing SYNERGY BP Stent showed numerically lowest ST rates compared to other DES despite being used in patients with more complex disease SYNERGY™ Stent Safety: ST rates in real-world SCAAR registry SYNERGY BP Stent showed numerically lowest ST rates compared to other new-generation DES despite use in more complex patients with AMI ST rates in SCAAR AMI Subset Definite Stent Thrombosis SYNERGY Stent demonstrated the lowest ST rates in patients with ACS ST rates in real-world SCAAR registry ACS Subset

10. 2. Minimal polymer exposure Polymer is gone shortly after the drug is completely eluted at 3 months

11. 2. Minimal polymer exposure Not all bioabsorbable polymer stent are created equal

12. 3. Treating complex lesions Indicated for improving coronary luminal diameter in patients with symptomatic ischemic heart disease, including patients with acute myocardial infarction and patients with concomitant diabetes mellitus due to discrete de novo native coronary artery lesions Acute coronary syndrome Unstable angina Renal failure Coronary bifurcation lesions Coronary multi-vessel disease Coronary saphenous vein graft lesions Coronary artery ostial lesions Unprotected left main coronary artery lesions Coronary artery total occlusion lesions In-stent restenosis in coronary artery lesions

13. 4. Exceptional deliverability, enhanced visibility, navigating tight lesions Laser-cut hypotube provides exceptional deliverability by improving pushability and trackability PtCr alloy provides excellent visibility for accurate stent placement and assessing malaposed struts

14. 5. Exceptional overexpansion while maintaining mechanical properties Wide range of labeled post-dilation limits

15. 5. Exceptional overexpansion while maintaining mechanical properties The SYNERGY large vessel model becomes stronger as it is expanded to its over-expansion limit

16. 5. Exceptional overexpansion while maintaining mechanical properties Robust design for bifurcation stenting The 2-connector design throughout the body maximizes side cell expansion capabilities and provides flexibility for bifurcation stenting Fewer connectors minimize chance of having a connector obstructing the side branch, providing better side branch access