innovative, micro catheters - unknown - setting a new standard

7/31/2019 Innovative, Micro Catheters - Unknown - Setting a New Standard

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C O N T R O L

A N D D E L I V E R

m i c r o c a t h e t e r s

A FAMILY OF INNOVATIVE

CEREBROVASCULAR MICROCATHETERS

COURIER Enzo

COURIER


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Setting a New Standard

With its unique combination of deflectability and stability, COURIER Enzo sets a new standard

for microcatheters.

Dial-In Stability

Enzos active tip deflection allows better control of the desired stability to reduce kickbackduring embolization. This can help in challenging cases with acute turns and small or densely

packed aneurysms in which catheter access is tenuous.

Pack. REDIRECT. Pack.

The ability to deflect Enzos tip during the procedure can facilitate the redirection

of embolics, allowing more control over the positioning and packing of coils,

especially in large or multilobular aneurysms. This could eliminate the need toremove, reshape, and reposition the cathetersaving valuable procedure time.

The Enzo tip remained stable inside an

acutely angled 4 mm supraclinoid ICA

aneurysm throughout the procedure.

The Enzo tip was redirected to coil the upper and lower lobes progressively in a complex upper basilar aneurysm.

Upper lobe coiled Lower lobe coiledPre-coiling

Pre-coiling Post-coiling


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90 cm Shaft Marker:Allows for

expedited microcatheter insertion

into a guiding catheter for reduced

fluoroscopic use.

Two Radiopaque Markers: Platinum

radiopaque markers, 3 cm apart, enhance

fluoroscopic visibility of the catheter tip.

Flexible and Stable Distal Shaft

Segment: Micrus proprietary

design and fabrication techniques

result in superior tip shaperetention and stability* to reduce

kickback.

Proximal Shaft: Multiple slender

stainless-steel ribbons crisscross

to form a dense proximal braided

section, providing better catheter

pushability and control.*

Shaft Construction: Multilayer

shaft construction creates smooth

transition zonesfrom a soft, low-

profile distal segment with enhanced

resistance to ovalization to a

supportive proximal end.

1.8 F Distal OD:

Helps navigate through

stent cells.

COURIER helped treat a giant 3 cm

pericallosal artery aneurysm. It held a

J-curve shape and was stable through

a high degree of tortuosity.

Exceptional Trackability.

Preferred Outcomes.

COURIER Microcatheters feature the most pushable proximal shaft*, a flexible distal

segment, and a patented hydrophilic coating that ensure excellent trackability to help

you get thereand provide excellent stability within the lesion to help you stay there.


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Visionary Innovation. Unmatched Performance.

COURIER Enzo brings a whole new level of functionality to neurovascular microcatheters. The secret lies

in the unique actively deflectable tip that allows in vivocontrol of the tip shape via Enzos ergonomic hub.

COURIER Enzos tip can be deflected up to 90 degrees (from straight) in opposing directions. This permits

a greater level of control over catheter and embolic placement.

Ergonomic Deflection Knob:

Allows in vivocontrol of Enzos tip,

deflectable up to 90 degrees (from

straight) in opposing directions.

In this 4 mm posterior communicating artery aneurysm

case, notice how sharply Enzo deflected into the large

neck. It managed to steadily hold this tenuous access

point throughout the treatment. Later, Enzo aided coiling,

deflecting away from the dome.

The Revolutionary

COURIER Enzo Microcatheter


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*Data on file, Micrus Endovascular Corporation.

COURIER shape retention provides

better shape stability inside the lesion.

Additional Shape Loss Over 3 Hours

30

0

Shape

Retention

(Degrees)

Time (Hours)

0.5 1 1.5 2 2.5 3

60

45

90

75

Product A Product CProduct BCOURIER 170

Product A Product BCOURIER 170

90

45

0

Product C

89

81

7064

InitialShape

(Degrees)

All microcatheters were shaped to 90 degrees. Starting shape

is shown after mandrel was removed.

Increasing Initial Shape Loss

25

19

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COURIER Straight and

Preshaped Microcatheters

Shape It. Get There. Stay There.

The unique design of COURIER Microcatheters delivers the ideal balance of form and function. The result is a rich set of

features and an optimal blend of access and support that are particularly suited for distal accessbecause getting there

is only half the challenge.

Endurance Technology Beyond Just Shape Retention

COURIER features our exclusive Endurance Technology, integrating all layers of the microcatheter into a well-balanced

laminate. The result is amazing shapability and retention of the tip shape during even the most complex, lengthy procedures.

Shapability

COURIERs superior shapability* allows you to match the anatomy one to one, reducing the need to overshape.

Shape RetentionCOURIER retained over 90% of its initial tip shape after 3 hours of simulated use*.


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Avenue des Baumettes 7

1020 Renens

Switzerland

T +41.21.631.3434

F +41.21.631.3444

821 Fox Lane

San Jose, CA 95131

United States

T 408.433.1400

F 408.433.1401

1st Floor, Unit 4

Stansted Courtyard

Takeley

Bishops Stortford

Essex

CM22 6PU

United Kingdom

T +44.800.612.6363

F +44.800.612.8484

CAUTION: Federal (U.S.A.) law restricts this device to sale by or on the order of a physician.

MICRUS, COURIER, and the M logo are registered trademarks of Micrus Endovascular Corporation. Enzo and Endurance Technology are trademarks of Micrus Endovascular Corporation.

Other product names or marks are the property of their respective owners.

2007 Micrus Endovascular Corporation. All rights reserved. P/N 50885-01 REV A

170170

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CATALOG NUMBER DESCRIPTION PROXIMAL/DISTAL ID TOTAL/ PROXIMAL OD/

USABLE LENGTH LOW-PROFILE DISTAL OD

MST170000-00 Straight .0170 / .0170 156 cm / 150 cm 2.3 F ( .76 mm) / 1.8 F ( .59 mm)

MPS170045-00 45 .0170 / .0170 156 cm / 150 cm 2.3 F ( .76 mm) / 1.8 F ( .59 mm)

MPS170090-00 90 .0170 / .0170 156 cm / 150 cm 2.3 F (.76 mm) / 1.8 F (.59 mm)

Compatible with embolics including Micrus 10, 14, and 18 System Microcoils*

Compatible with embolics including Micrus 14 and 18 System Microcoils*

170170

190

Minimum guiding catheter ID:

COURIER 170 Microcatheters: .035 / .889 mm

COURIER 190 Microcatheters: .042 / 1.067 mm

COURIER Enzo Microcatheters: .050 / 1.27 mm

Hydrophilic coated length (distal to proximal): 100 cm

Recommended guidewire diameter: .014

* Please refer to the appropriate Instructions for Use for compatibility information.

CATALOG NUMBER DESCRIPTION PROXIMAL/DISTAL ID TOTAL / PROXIMAL OD/


MSH170000-00 Deflectable .0170 / .0170 160 cm / 150 cm 3.0 F (1.0 mm) / 2.9 F (.97 mm)



MSH190000-00 Deflectable .0190 / .0190 160 cm / 150 cm 3.1 F (1.03 mm) / 3.0 F (1.0 mm)



MST190000-00 Straight .0190 / .0190 156 cm / 150 cm 2.4 F (.79 mm) / 1.9 F (.63 mm)

MPS190045-00 45 .0190 / .0190 156 cm / 150 cm 2.4 F (.79 mm) / 1.9 F (.63 mm)

MPS190090-00 90 .0190 / .0190 156 cm / 150 cm 2.4 F (.79 mm) / 1.9 F (.63 mm)

Compatible with embolics including Micrus 10, 14, and 18 System Microcoils*

Compatible with embolics including Micrus 14 and 18 System Microcoils*


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Courier EnzoTM Increases

Packing Density

The Courier Enzo deflectable tip microcatheter can distribute coils within

an aneurysm to achieve improved packing density. 3 INRs evaluated its

performance in an in-vitro study under angiography. 10 silicone aneurysms,

each 10mm in diameter, were coiled using Courier Enzo and a conventional

competitive microcatheter (Product A). The end point was when the micro-

catheter was kicked out of the aneurysm.

Enzo showed a statistically significant 9% increase in packing density as

compared to Product A. Micrus Cerecyte Microcoils were used in both

arms. Enzo consistently demonstrated higher packing density.

* Study performed at Stanford University Medical Center. Data on file,

Micrus Endovascular Corporation

* Presidio, Helipaq, Ultipaq and Cashmere Microcoils were

used during the study

Courier Enzo allows better control of the microcatheter tip.

This helps direct the coils and find empty spaces within

the interstices of the coil mass, especially during the final

stages of coiling.*

Better stability provides

higher packing density

Redirecting Enzos tip

resists catheter kickback

The Courier Enzo is designed to deflect. It provides

stability by resisting being kicked out of the lesion.

This can provide consistently higher packing density.

* Please refer to IFU for proper handling instructions.

ENZO Product A

3O%

O%

1O%

4O%

5O%

2O%39.1%

0.9%

29.6%

7.4%

Packing density with Enzo and Product A


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Packing Density Can Affect

Re-treatment Rates

P/N 51040 02 R A

www.micruscorp.com

CAUTION:Federal (U.S.A.) law restricts this device to sale by or on the order of a physician.

MICRUS, the M logo, Courier and Cerecyte are registered trademarks of Micrus Endovascular Corporation.

Enzo is a registered trademark of Micrus Endovascular Corporation.

2008 Mi E d l C i All i h d

There is a significant correlation

between embolized volume and

stability of embolized aneurysms.

Embolized volume is a more objective

index than is subjectively angiographic

percentage occlusion.2

The CARAT study reported that the

degree of aneurysm occlusion after

the initial treatment is a strong predictor

of the risk of subsequent rupture in

patients presenting with subarachnoid

hemorrhage, which justifies attempts

to completely occlude aneurysms.1

Non-procedural re-rupture from the index aneurysm by degree of occlusion*

Coiling

* Based on Kaplan-Meier analysis and the log-rank test with censoring at time of rupture,

retreatment, or loss to follow-up.

Overall

Degree of Occlusion

Complete (100%)

Small residual neck

(91%-99%)

Residual neck

(70%-90%)

Partial (

innovative, micro catheters - unknown - setting a new standard

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