1152_Alan Lumsden_KEYNOTE_VERSION 02

IVUS and Robotics for Femoral and Popliteal Disease.
Alan B Lumsden, FACS, FRCS Ed Hons.
Walter W Fondren III Chair
Medical Director
Methodist DeBakey Heart and Vascular Center
Houston, Texas.
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Conflicts
• Alan Lumsden, MD
For the 12 months preceding this CME activity, I disclose the following types of financial
relationships:
Honoraria received from: Boston Scientific Corp., WL Gore, Medtronic, Hansen
Medical
Consulted for: Abbott Vascular, Boston Scientific Corp., WL Gore, VNUS Medical,
Maquet, Siemens, Medtronic, Hansen Medical
Held stock in:
Hatch Medical, Northpoint Domain, Embrella
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Robotic System
Remote Wire Manipulator (RWM)
Remote Catheter Manipulator (RCM)
Physician Workstation
Main Display
3D Controller
Touch Screen
Workstation
Controller
Foot Pedal
Magellan™ Robotic System
Magellan™ Robotic Catheters
Combining IVUS and Robotics:
center line navigation, re entry, increased size
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Evidence-Based Approach
Continuum of Evidence
Pre-Clinical, In
Vivo Feasibility &
Safety
J Endovasc
Therapy, 2011
Pre-Clinical
First-in-Man
J Vascular
Surgery, 2013
Carotid Stenting
Potential Benefits
J Cardiovascular
Surgery, Dec 2012
First-in-Man
fEVAR Case Report
(first fEVAR case)
J Vascular
Interventional
Radiology, 2013
Specific Procedural
Applications
ROVER Registry
Prospective data collection
at Magellan clinical sites
Comprehensive
Registry
FDA Approval:
Initial Worldwide Clinical Use: Types of Cases
fTEVAR
Uterine Fibroid
Embolization
Upper
Extremity/
Thoracic
Aorto Femoral
Visceral
fEVAR
EVAR/
Endoleak
Aorto Femoral 34% EVAR/Endoleak 21% fEVAR 10% Visceral 17% Upper Extremity/Thoracic 12% fTEVAR 3% Uterine Fibroid EmbolizaEon 3%
ROVER Registry Data
Results from:
Houston Methodist Hospital & Miami Cardiac & Vascular Institute
Magellan™ Case:
Crossing of Right SFA Occlusion
• Crossing of long (>15cm), heavily calcified Right SFA occlusion.
• Occlusion crossed after <5 min navigation at remote workstation.
Restored Flow AGer Balloon InflaEon
Stability & pushability of robotic catheters enables crossing of lesion in presence of significant
calcification; and subsequent balloon inflation through Magellan Guide.
Images Courtesy Houston Methodist Hospital
CTO
Minimal dXRT
Steering within occlusion
Crossing between vessels.
PQ bypass
Targeting reentry balloon.
EFAB: Endovascular Femoral Artery Bypass
Exploiting Naturally occurring Spaces
Controlled Entry and re-entry
Steering within an occlusion
Augmentation of function of devices
Conclusion.
• IVUS:
–cross sectional imaging
–can be combined with other catheters
• Robotics :
–stability
–pushability
–minimizes dXRT to operator
–predictable
IVUS and Robotics for Femoral and Popliteal Disease.
Alan B Lumsden, FACS, FRCS Ed Hons.
Walter W Fondren III Chair
Medical Director
Methodist DeBakey Heart and Vascular Center
Houston, Texas.
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