DES Polymers

Hypersensitivity to Polymers May be Responsible For Delayed Healing and Late Stent Thrombosis*

¹Nebeker et al., J Amer Coll Cardiol, 47:1, 2006.

Polymer Biocompatibility Impact

llustration based on Beckmann JA et al., JAMA, ;287(19):2570–2581, 2002 and Roesen P, Ferber P, Tschoepe D.
Macrovascular disease in diabetes: current status, Exp Clin Endocrinol Diabetes, 109(supp 12):S474–S486, 2001.
¹Image: Tongi et al., Int J Cardiol, 120:212, 2007.
^2,3Image: Joner et al., J. Am. Coll. Cardiol, 48:193–202, 2006.
⁴Image: Awata et al., ACC.08

PC Polymers

PC Polymer Is Highly Biomimetic to Resemble the Red Blood Cell Membrane For High Biocompatibility and Minimal Inflammation

• 90% of phospholipids in the outer membrane of a red blood cell contain the PC (phosphorylcholine) headgroup
• PC polymer mimics the chemical structure of the phospholipid headgroup

Reduced Inflammatory Response With Endeavor Stent—Low Inflammation Scores Indicate Greater Biocompatibility^†

^†R. Virmani

Endeavor and Its PC Polymer Demonstrate Low Inflammatory Scores

*Data on file at Medtronic CardioVascular.
†Data from Abbott XIENCE US Physician presentation SE2924433D.
‡Inflammation scores developed by Dr. Renu Virmani; CVPath Institute Inc.; Schwartz RS et al., Circulation. 2004;110:2498-2505.
Preclinical results may not be indicative of clinical results.

Inflammation Scores: Comparison at 30 Days In Porcine Model

Preclinical data on file at Medtronic, Inc.
Preclinical results may not be indicative of clinical results.

PC Polymer Demonstrates Low Inflammatory Scores—Comparison of Inflammation Scores

• Healing and the polymer: PC polymer is biomimetic and biocompatible for minimal inflammation.

*Data on file at Medtronic CardioVascular.
†Data from Abbott XIENCE US Physician presentation SE2924433D.
‡Inflammation scores developed by Dr. Renu Virmani; CVPath Institute Inc.; Schwartz RS et al., Circulation. 2004;110:2498-2505.
Preclinical results may not be indicative of clinical results.

Human OCT Study: 100% of Endeavor Stent Struts Covered by 6 Months¹—Stent Struts Are Apposed to Vessel Wall With Uniform Stent Coverage

24,076 Endeavor Struts Were Uniformly Covered¹

¹Guagliumi et al., ESC 2008.
OCT:Optical coherence tomography.

Functional Endothelial Healing

Vessels implanted with Endeavor DES exhibit functional healing.

Marker of Healthy Endothelial Cell Function

• Normal, healthy endothelial cells produce nitric oxide (NO)
• The eNOS protein, the enzyme that catalyses NO synthesis, is a marker of healthy endothelial cell function
• Vessels implanted with Endeavor show high eNOS levels, suggesting good NO production and a functional endothelium

Scores compared with Driver bare metal stent control. Preclinical data on file at Medtronic, Inc.

Positive Acetylcholine (ACH) Challenge Response

ACH exposure in a normal, healthy artery causes vasodilation; ACH exposure in a setting of atherosclerosis or endothelial dysfunction causes vasoconstriction.

In preclinical testing, vessels implanted with Endeavor show vasodilation, indicating functional endothelium.

Haraguchi et al. TCT 2006.
Preclinical results may not be indicative of clinical performance.