TREAT SMARTER. ACHIEVE MORE. When Treating Thrombus

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1 TREAT SMARTER. ACHIEVE MORE. When Treating Thrombus

2 Treat Smarter When you want fast, safe, predictable results EKOS Ultrasound Accelerated Thrombolysis Unlocks The Clot Without Ultrasonic Energy With Ultrasonic Energy With Ultrasonic Energy And Thrombolytic When clot forms, plasminogen receptor sites are embedded deep within the fibrin. The EKOS device micro-transducers transmit high frequency, low power sound waves. For the clot to be dissolved, lytic agents must access the receptor sites. The unique EKOS ultrasound waveform causes fibrin strands to thin, exposing plasminogen receptors. The Infusion Catheter delivers thrombolytic, while non-cavitational pressure waves created by ultrasound force drug deep into the clot. Tightly wound fibrin strands inhibit the drug from penetrating, limiting access to receptor sites on the interior of the clot. This limits the amount of lytic that escapes downstream (see model below). This makes thrombus more permeable and allows lytic to penetrate deeper. Drug Dispersion Across Simulated Valve in Simulated Clot In vitro model of venous valve without ultrasound with ultrasound

3 Achieve More When treating thrombus EKOS ultrasonic devices are designed to gently accelerate the penetration of thrombolytic agents into thrombus, providing high levels of lysis performance and safety in a fraction of the time required by standard catheter-directed thrombolysis. Unlike other pharmacomechanical technologies available on the market, the EkoSonic Endovascular System does not cause hemolysis or vessel and valve damage. No hemolysis 1 No bradycardia/heart block No renal failure risk Clinically proven technology offers superior thrombus clearance 2 Increased drug uptake 3 Up to 70% deeper thrombus penetration 48% greater drug absorption within 1 hour 84% greater drug absorption within 2 hours No mechanical disruption 4 resulting in distal embolization No vessel or valve damage 1 5.4F LARGE VESSEL Highly efficient system provides reliable performance Fast and simple placement Optimal and uniform distribution reduces lytic dose 50-70% 2 Reduces physician lab time 5 Easy to navigate Ultrasonic waves encompass entire vessel 1 Soltani, A., et al. Absence of biological damage from prolonged exposure to intravascular ultrasound: A swine model. Ultrasonics 46 (2007) Parikh, S., et al. Ultrasound-Accelerated Thrombolysis for the Treatment of Deep Vein Thrombosis: Initial Clinical Experience. Journal of Vascular and Interventional Radiology, Volume 19, Issue 4, April 2008, pp Francis, CW., et al. Ultrasound Accelerates Transport of Recombinant Tissue Plasminogen Activator into Clots. Ultrasound in Medicine and Biology 21.3 (1995): Braaten, JV., et al. Ultrasound Reversibly Disaggregates Fibrin Fibers. Throm Haemost 1997; 78: Compared to mechanical devices which must be operated solely in the lab.

4 EKOS It Anywhere in the Periphery EKOS It Arteries Veins Through IVC Filters1 Behind Valves2 Grafts3,4 1. Patel et al. J Vasc Interv Radiol 2012;23(3):S Parikh et al. J Vasc Interv Radiol 2008;19(4): Stambo and Gabriel. Radiography 2011;17(1): Motarjeme. J Endovasc Ther 2007;14:

5 Treat Thrombus of Any Size and Volume

6 The EkoSonic Endovascular System Cross Section of the Infusion Catheter Cart and universal power supply (UPS) currently unavailable outside the United States Drug Delivery Lumens Therapy Optimization Sensor Central Coolant Lumen Ultrasonic Core in Central Lumen EkoSonic Endovascular Device 5.4 F Infusion Catheter Ultrasonic Core Tranducers The EkoSonic Endovascular device consists of a sophisticated Ultrasonic Core within an Infusion Catheter. Flexibility of devices provides easy navigation through vascular anatomy without damaging vessel walls. Radiopaque marker bands at the distal and proximal ends of the treatment zone enhance catheter visibility and placement. Continuous monitoring by the Infusion Catheter facilitates optimization of the ultrasonic energy, enabling the system to adjust settings as lysis progresses. Multiple treatment zone options enable a precise match to the length of the clot, optimizing delivery of thrombolytic agents. The EkoSonic Control Unit Intuitive controls make setup and operation simple. The highly visual iconic layout provides ability to monitor operating status and alarms at a glance even from a distance. Treatment time and total average power is graphically displayed, aiding in communication with both patient and physician. Thermal Coupler

7 EKOS Corporation N Creek Pkwy S Bothell, WA Customer Service Fax 24 Hour USA Technical Service (888 EKOS HELP) 24 Hour International Technical Service select option 2

8 Superior Technology Outstanding Partnership EKOS provides unparalleled support to its customers Live 24 x 7 x 365 Technical Support Help Line Online Learning Center Practice Development Programs Made in the USA When you want fast, safe, predictable results EKOS It EKOS Corporation N Creek Pkwy S Bothell WA T (toll free in USA) T F US FDA Cleared Indications: The EkoSonic Endovascular System is intended for controlled and selective infusion of physician-specified fluids, including thrombolytics, into the peripheral vasculature. The EkoSonic System is cleared for the infusion of solutions into the pulmonary arteries. Contraindications Not designed for peripheral vasculature dilation purposes. This system is contraindicated when, in the medical judgment of the physician, such procedure may compromise the patient s condition. See device instructions for use for complete prescribing information. EKOS and EkoSonic are registered trademarks of EKOS Corporation, a BTG International group company. EKOS It and Treat Smarter, Achieve More are trademarks of EKOS Corporation, a BTG International group company. BTG and the BTG roundel logo are registered trademarks of BTG International Ltd EKOS Corporation US-EKO