Q. Why might it be important for physicians to consider Vessel Prep prior to DCB?
A. Intuitively if the expectation is to allow a pharmacologically active agent at the time of its delivery, then I think that intuitively it makes sense to me that modifying the disease burden to then allow the drug to be optimally pharmacologically, biologically active is the appropriate strategy. There are some ongoing data, ongoing trials right now which will address that a little bit further but in the meantime I think that as we embark on that strategy it does make intuitive sense to me to prepare the vessel optimally to then use this very sophisticated product.
Q. How do you plan to combine atherectomy and DCB into your practice? In what type of lesions would debulking prior to DCB be ideal?
A. I think that the greater the disease burden, that is the more significant the stenosis is, you know CTO is obviously at the extreme, I think that’s one and then also if it’s very heavily calcified. I think that those are probably the two subsets where some degree of vessel preparation, debulking, atherectomy, prior to using drug-eluting balloon, is probably the optimal strategy.
Q. Why is the Jetstream System a good choice for Vessel Prep prior to DCB?
A. I think the unique features of the Jetstream are in its design features. First of all it comes in a variety of sizes; all of those incorporate the rotational component and aspiration, so independent of whether the device has blade expansion or not, all of them incorporate the rotational aspect and simultaneous aspiration which is I think fundamentally important. But also all of them incorporate the same basic properties of the ability to debulk tissue of varying complexity and varying morphology, whether it’s soft plaque, eccentric plaque, fibrous, calcified, thrombus burden, it’ll treat all of those effectively. It’s very dependent on the appropriate technique but if the device is selected appropriately in the appropriate patient and if the operators adhere to proper technique I think the device is highly effective for all lesion morphologies with drug-eluting balloon, with plain old balloon angioplasty, or ultimately with stenting.