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IVUS image interpretation for PAD intervention

Dr Michael Lichtenberg and Dr Konstantinos Stavroulakis discuss the basics of IVUS image interpretation for PAD intervention. Using case based examples, they demonstrate the added value of IVUS to assess the architecture and pathology of diseased arteries and how this additional information may influence treatment strategy and improve patient outcomes

Dr Lichtenberg and Dr Stavroulakis discuss the IVUS technical characteristics and the rationale for using IVUS to complement angiography in PAD intervention

Using case based examples, Dr Stavroulakis discusses the four pillars of IVUS, a framework that demonstrates the added value IVUS brings to angiography

Dr Stavroulakis demonstrates the use of IVUS to understand calcium geometry and morphology and how this may influence treatment strategy.

Dr Lichtenberg demonstrates the ability of IVUS to reveal the depth, circumference and free lumen area resulting from dissection and how this may impact treatment strategy.

Dr Stavroulakis discusses how angiography can often underestimate severity of PAD, and how IVUS can accurately measure and quantify percent stenosis and plaque burden.

Dr Lichtenberg demonstrates the sensitivity of IVUS to detect and differentiate between chronic and acute thrombus, and how this information informs treatment strategy.

IVUS in Endovascular Procedures

A Practical overview highlighting the value of IVUS in venous, aortic and PAD procedures.

Discover the value of IVUS in Endovascular Procedures

Angiography alone is

not enough

Angiography provides information on luminal characteristics of peripheral arteries, but severely underestimates the extent of atherosclerosis in patients with PAD, even in “normal appearing” vessels.¹

Visualize the best path forward with IVUS eyes

Philips IVUS provides the visualization needed to gain deeper insights into the lesion and choose the best procedural path forward.

Lumen

Eccentric fibrotic plaque with deep calcium nodule

Accoustic shadowing

Expand to see critical lesion characteristics

Vessel size

Guides device sizing to ensure precise wall apposition, drug delivery, and placement

Vessel diameter

Lumen diameter

Plaque burden

Plaque morphology

Understand plaque type and severity to help guide proper device selection

Soft

Fibrous

Calcific

Thrombus

CTO

Plaque geometry

Visualize plaque burden location for precise treatment

Concentric

Eccentric

Guidewire position

Confirm true lumen or sub-intimal guidewire location

True lumen

Sub-intimal

Take the IVUS Challenge

Play now

Treat optimally with versatility

The Philips portfolio of therapeutic devices offers the versatility needed to treat the majority of PAD cases, including complex lesions.

Imaging

See Clearly. Evaluate vascular morphology in blood vessels

Turbo-Elite and Turbo-Power laser atherectomy

PV014Rx

Designed for the evaluation of PAD lesions, the Visions PV.014 Rx digital IVUS is 55% stiffer than Eagle Eye Platinum Coronary IVUS¹², and features a 20mm field of view in a 5F compatible catheter.

PV018

The Visions PV.018 digital IVUS features a 24mm field of view in a 6F compatible catheter to evaluate vessel architecture and pathology and may aid in the

determination of treatment algorithms and lead to improved endovascular outcomes¹³

PV035

The Visions PV .035 digital IVUS catheter with 60mm imaging diameter evaluates vascular morphology in blood vessels and provides cross-sectional imaging of these vessels.

Crossing

Cross your toughest lesions

Quick-Cross catheter

The support you need to handle any lesion

Pioneer Plus catheter

The Pioneer Plus IVUS-guided re-entry catheter is designed to identify true lumen with speed for the most challenging CTOs. With the unique offering of IVUS and a dual-wire system in one device, the Pioneer Plus catheter provides clinicians with IVUS-guided clarity to true lumen re-entry for their patients.

Vessel prep

Prepare multiple lesion morphologies, locations and characteristics

Phoenix atherectomy system

Front-cutting mechanical atherectomy for treating mixed morphologies with low risk of embolization³

Turbo-Elite and Turbo-Power laser atherectomy

Clinically proven ablation in all lesion types above and below the knee; indicated for ISR²

AngioSculpt scoring balloon

Reduces risk of flow limiting dissections including in calcified lesions⁴

Definitive treatment

Treat lesions without leaving metal behind

Stellarex drug-coated balloon

Low-dose DCB reporting durable treatment effect in common to complex patients, including high rate of severely calcified lesions.^5,6

No mortality signal in pooled ILLUMENATE RCT analysis and larger data set through 3 years⁷.

Intravascular Systems

Multi-modality approach with diverse capabilities for precise and accurate guidance every time

Core M2

Vascular System easy-to-use, small footprint, digital IVUS imaging system, designed for peripheral vascular procedures and operable directly from the sterile field

Intrasight

The IntraSightapplications platform is where imaging, physiology, and software all come together to clearly identify coronary and peripheral artery disease, and allow for more optimized treatment plans.

MERGING OUR STRENGTHS

Intact Vascular is excited to now be a part of Philips. As one team, we look forward to continuing to expand our image-guided therapy devices portfolio.

Learn more

Phoenix 2.2mm deflected atherectomy catheter

The Phoenix 2.2 mm auto-deflected catheter offers the latest innovation of front cutting mechanical atherectomy tools⁹ in the Phoenix atherectomy family. The newest Phoenix can create lumen 82% greater in size than the previous generation¹⁰ and is available in a 6F profile for use both above and below the knee.*

Learn more

Introducing Phoenix new, more efficient cutter head design**

Greater cutting efficacy, due to new cutter head design with 5 degree relief angle¹⁰

Treat safely and effectively

with low-dose Philips Stellarex drug-coated balloon

Now available in 150 and 200mm!

Learn more

Full view treatment planning

The integration of visualization and interventional technologies allows physicians to see the complete picture and create a more informed and individualized procedural approach.

Explore treatment plan example

Treatment plan example 1

Treatment plan example 2

Treatment plan example 1

Lumen

Eccentric fibrotic plaque with deep calcium nodule

Acoustic shadowing

Treatment plan example 2

Lumen with fresh thrombus

Micro-calcification

Calcified plaque with acoustic shadowing

See clearly

Vessel size: 5.5 mm diameter

Plaque morphology: Fibrotic plaque with intimal and medial calcium

Plaque geometry: Eccentric lesion

Guidewire position: True lumen

Vessel size: 6 mm diameter

Plaque morphology: Mixed, thrombic plaque with medial calcium

Plaque geometry: Eccentric lesion

Guidewire position: True lumen

Treat optimally

Quick-Cross catheter: Confidently cross challenging morphologies

Phoenix deflecting atherectomy: Front facing to cut, capture and clear mixed morphologies, including calcium; deflecting capabilities for larger luminal gain

AngioSculpt scoring balloon: Score calcium to reduce dissection⁴

Stellarex DCB: Designed for performance in calcium

Quick-Cross catheter: Confidently cross challenging morphologies

Turbo-Power laser atherectomy: Forward facing directional debulking to clear thrombus; rotation for improved deliverability in calcified lesions

AngioSculpt scoring balloon: Safely dilate residual stenosis⁴

Stellarex DCB: Designed for performance in calcium

Let's Talk

Fill out the form below to get started.

How can we help you?

Contact information

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Country

First name*

First name (phonetic)

Last name*

Last name (phonetic)

Salutation

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Email address*

Business phone

Company*

Job title

Industry

Function

Specialty

Department

State or Province

City

Address

Zip or Postal Code

By specifying your reason for contact we will be able to provide you with a better service.

We work with partners and distributors who may contact you about this Philips product on our behalf.

Follow up information

Preferred method of contact

Best time to call

Estimated time of purchase

Comments

What is cross border data transfer?

I agree on cross-border transfer of personal information.

CEE specific legal checkbox

I would like to receive marketing related electronic communications about Philips products, services, events and promotions that may be relevant to me based on my user preferences and behaviour.

Final CEE consent

1. Kashyap VS. Pavkov ML, Bishop PD, et al. Angiography underestimates peripheral atherosclerosis: lumenography revisited. J Endovasc Ther. 2008;15(1): 117-125.

2. Dippel et al. Randomized controlled study of excimer laser atherectomy for treatment of femoropopliteal in-stent restenosis: initial results from the EXCITE ISR trial (EXCImer Laser Randomized Controlled Study for Treatment of FemoropopliTEal In-Stent Restenosis). JACC Cardiovasc Interv. 2015 Jan;8(1 Pt A):92-101

3. Davis, Thomas et al., Safety and effectiveness of the Phoenix Atherectomy System in lower extremity arteries: Early and midterm outcomes from the prospective multicenter EASE study. Vascular. September 27, 2017, DOI: 10.1177/1708538117712383.

4. Kiesz RS, Scheinert D, Peeters PJ, et al. Results from the international registry of the AngioSculpt Scoring Balloon Catheter. J Am Coll Cardiol. 2008;51:10(suppl B);75.

5. Brodmann M, Sustainable Antirestenosis Effect With a Low-Dose Drug-Coated Balloon The ILLUMENATE European Randomized Clinical Trial 2-Year Results, J Am Coll Cardiol Intv 2018;11:2357–64. Dec 2018

6. Mathews J. NCVH, 2019. Stellarex in the Treatment of the SFA and Popliteal: Late-Breaking 3-Year Data. May 29, 2109 New Orleans, LA.

7. Gray et al. Mortality Assessment of Paclitaxel-Coated Balloons Patient-Level Meta-Analysis of the ILLUMENATE Clinical Program at 3 Years. Circulation. 2019;140:1145–1155. DOI: 10.1161/CIRCULATIONAHA.119.040518

8. Bard Lutonix Instructions for Use, BAW1387400r3

9. Based on bench tests. Data on file at Philips.

10. Compared to previous generation cutter head Phoenix atherectomy system catheters. Bench test data on file at Philips.

Performance in bench tests is not indicative of the behavior in clinical practice.
11. Gagne PG, TaharaRW, FastabendCP,etal. Venography versus intravascular ultrasound for diagnosing and treating iliofemoral vein obstruction. J VascSurg:Venousand LymDis 2017;5:678-87.

12. N=15 Data on File at Volcano Corporation. Windchill Report #209-0205.08

13. PliagasG, Saab F, StavroulakisK, et al. Intravascular Ultrasound Imaging Versus Digital Subtraction Angiography in Patients with Peripheral Vascular Disease. J Invasive Cardiol. 2020 Mar;32(3):99-103

Refer to product labeling for complete indications, contraindications, and warnings.

Caution: federal law restricts this device to sale by or on the order of physician

Some or all products manufactured by Spectranetics, a Philips company. Approved for external distribution. D050123-00 042019

*Minimum vessel size 3.0mm, see IFU.

**Available on Phoenix 1.8, 2.2mm tracking and 2.2mm deflected catheters.

***Data from independent CEC (clinical events committee) adjudication of all events resulting in death across all studies.

See clearly.

Treat optimally.

Contact information

IVUS image interpretation for PAD intervention

IVUS in Endovascular Procedures

Angiography alone is

not enough

Visualize the best path forward with IVUS eyes

Expand to see critical lesion characteristics

Vessel size

Plaque morphology

Plaque geometry

Guidewire position

Take the IVUS Challenge

Treat optimally with versatility

Imaging

Crossing

Vessel prep

Definitive treatment

Intravascular Systems

MERGING OUR STRENGTHS

Phoenix 2.2mm deflected atherectomy catheter

Introducing Phoenix new, more efficient cutter head design**​

Treat safely and effectively

Now available in 150 and 200mm!

Full view treatment planning

See clearly

Treat optimally

Let's Talk

Fill out the form below to get started.

Contact information

Introducing Phoenix new, more efficient cutter head design**