Medtronic cardiovascular interventional pipeline
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Medtronic CardioVascular Interventional Pipeline. 1. 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

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Medtronic CardioVascular Interventional Pipeline

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Medtronic cardiovascular interventional pipeline

Medtronic CardioVascular Interventional Pipeline

1


Disclosures

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


Next generation stent platform

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

7


Medtronic cardiovascular interventional pipeline

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

8


Polymerless nanotechnology

POLYMERLESS NANOTECHNOLOGY

NSM

Bare metal

  • 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)*

9

*Demonstrated in in vitro studies


Bioabsorbable polymer surfaces

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

10


Medtronic cardiovascular interventional pipeline

TRANSCATHETER AORTIC VALVE TECHNOLOGY

COREVALVE®

ENGAGER TM

  • 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

12


Medtronic cardiovascular interventional pipeline

TRANSCATHETER AORTIC VALVE TECHNOLOGY


Resistant hypertension catheter based technologies

RESISTANT HYPERTENSION CATHETER BASED TECHNOLOGIES

Change in

Blood Pressure

(mmHg)

89% Responder Rate

Repeated measures ANOVA: P<0.001 for SBP & DBP

P<0.00001 vs. baseline for each SBP & DBP

  • 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


Erectile dysfunction catheter based technologies

ERECTILE DYSFUNCTIONCATHETER 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 don’t 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)


Not bad for 9 days in new job

Not bad for 9 days in new job…

Medtronic CardioVascular Interventional Pipeline


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