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EXALT™ Model D physicians.

Steady performance across all ERCP complexity grades1-7

EXALT™ Model D cases demonstrated flexibility, maneuverability and control

EXALT Model D was the first marketed single-use duodenoscope for endoscopic retrograde cholangiopancreatography (ERCP) procedures and was found to be usable across varying degrees of ERCP complexity grades in 1,100 patients from seven trials.1-7 Explore the case studies and watch the footage below to see how EXALT Model D offered consistent flexibility, maneuverability, stability and control in a wide variety of ERCP procedure cases.

EXALT Model D case studies

Dr. Simien Case Study.

Overcoming duodenal obstruction in a challenging ERCP procedure using EXALT Model D Single-Use Duodenoscope*

Dr. Melvin Simien shared how he used EXALT Model D to overcome difficult scope advancement caused by extrinsic duodenal compression from a pancreatic mass. After 20 minutes of unsuccessful attempts with a reusable scope, he switched to the EXALT Model D scope, which enabled navigation to the duodenum and successful metal stent placement for biliary drainage.

Dr. Simien is a paid consultant of Boston Scientific. 

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Dr. Singla Case Study.

ERCP with plastic stent placement using EXALT Model D Single-Use Duodenoscope*

Dr. Sumit Singla shared his strategy for placing a plastic stent with EXALT Model D after an unsuccessful attempt with a reusable scope. Using EXALT Model D offered maneuverability that allowed him to efficiently visualize the ampulla and gain access for a successful plastic stent placement.

Dr. Singla is a paid consultant of Boston Scientific.

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Dr. Shah Case Study.

Ampullectomy with EXALT Model D Single-Use Duodenoscope*

Dr. Bhavesh Shah explained how ERCP with endoscopic ampullectomy was performed using EXALT Model D in a 78-year-old patient with a polypoid lesion at the ampulla, which pathology diagnosed as tubular adenoma.

Dr. Shah is a paid consultant of Boston Scientific.

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Dr. Vareedayah Cast Study.

Bilateral Epic™ metal stent placement using EXALT Model D Single-Use Duodenoscope*

Dr. Ashley Vareedayah shared a case of bilateral metal stent placement with Epic using EXALT Model D in a patient with a history of a high-grade neuroendocrine tumor with numerous liver lesions and associated hilar strictures.

Dr. Vareedayah is a paid consultant of Boston Scientific.

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Case video library

Dr. Matthew Eves shared how ERCP can help to perform biliary drainage for a patient with a Klatskin’s tumor using a single-use duodenoscope.

Dr. Eves is a paid consultant of Boston Scientific.

Dr. Mandeep Bhamra shared the case of a patient with unresectable pancreatic adenocarcinoma invading the duodenum. Since the patient was undergoing chemotherapy and a risk of cross-contamination from a reusable scope was a concern, Dr. Bhamra opted to use EXALT Model D.

Dr. Bhamra is a paid consultant of Boston Scientific.

Dr. Jeremy Barber used EXALT Model D in a patient with a history of unresectable pancreatic cancer presenting with cholangitis secondary to an obstructed biliary stent.

Dr. Barber is a paid consultant of Boston Scientific.

Dr. Quin Liu used EXALT Model D to perform an ERCP with stent exchange for a patient with a history of liver transplant and resulting ischemic strictures. Dr. Liu selected EXALT Model D due to the patient’s history of antibiotic-resistant bacteremia.

Dr. Liu is a paid consultant of Boston Scientific.

Dr. Shyam Varadarajulu presented a biliary stent placement case for hilar stricture using EXALT Model D.

Dr. Varadarajulu is a paid consultant of Boston Scientific.

Dr. Adarsh Thaker shared case footage of two ERCP procedures demonstrating the control and maneuverability of EXALT Model D. The first case showed scope passage into the duodenum of a patient in the prone position. The second case demonstrated how EXALT Model D maneuvers in difficult or angulated strictures.

Dr. Thaker is a paid consultant of Boston Scientific.

Dr. Shyam Varadarajulu used EXALT Model D to cannulate the dorsal pancreatic duct and placed a stent to treat a 63-year-old patient with recurrent acute pancreatitis.

Dr. Varadarajulu is a paid consultant of Boston Scientific.

Dr. Shyam Varadarajulu used EXALT Model D and SpyGlass™ DS II Direct Visualization System during an ERCP procedure on a 48-year-old patient to diagnose cholangiocarcinoma in a biliary stricture.

Dr. Varadarajulu is a paid consultant of Boston Scientific.

Dr. Adarsh Thaker presented case footage demonstrating scope passage into the duodenum of a patient in the prone position. EXALT Model D was used on a second patient with multi-focal biliary obstruction.

Dr. Thaker is a paid consultant of Boston Scientific.

Dr. Shyam Varadarajulu presented case footage using EXALT Model D for a biliary stent replacement in an 85-year-old patient with cholangiocarcinoma and obstructive jaundice.

Dr. Varadarajulu is a paid consultant of Boston Scientific.

Case study library

Dr. Eric Frizzell shared the case of an ERCP procedure using EXALT Model D with SpyGlass™ DS II Direct Visualization System in an 86-year-old patient with a history of extended spectrum beta-lactamases Escherichia coli cholangitis due to a retained common bile duct stent.

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Dr. Frizzell is a paid consultant of Boston Scientific.

Dr. Richard Seidel demonstrated use of EXALT Model D for complicated procedures in immunocompromised patients.

Read case study

Dr. Seidel is a paid consultant of Boston Scientific.

Dr. Prasun Shah shared a case using EXALT Model D in a COVID-19-positive patient who was treated for metastatic pancreatic cancer.

Read case study

Dr. Shah is a paid consultant of Boston Scientific.

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Let’s discuss how to make EXALT Model D an essential part of your ERCP toolkit.

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*Results from case studies are not necessarily predictive of results in other cases. Results in other cases may vary.

1. Bruno MJ, Beyna T, Carr-Locke D, et al. Global prospective case series of ERCPs using a single-use duodenoscope. Endoscopy. 2023;55:1103–1114. Sponsored in part by Boston Scientific.

 

2. Muthusamy VR, Bruno MJ, Kozarek RA, et al. Clinical evaluation of a single-use duodenoscope for endoscopic retrograde cholangiopancreatography. Clin Gastroenterol Hepatol. 2020;18:2108–2117.e3.

Sponsored in part by Boston Scientific.

3. Bang JY, Hawes R, Varadarajulu S. Equivalent performance of single-use and reusable duodenoscopes in a randomised trial. Gut. 2021;70:838–844.

4. Napoléon B, Gonzel JM, Grandval P, et al. Evaluation of the performances of a single-use duodenoscope: prospective multi-center national study. Dig Endosc. 2022;34:215–221.

5. Slivka A, Ross AS, Sejpal DV, et al. Single-use duodenoscope for ERCP performed by endoscopists with a range of experience in procedures of variable complexity. Gastrointest Endosc. 2021;94:1046–1055.

 

6. Shahid HM, Bareket R, Tyberg A, et al. Comparing the safety and efficacy of two commercially available single-use duodenoscopes. J Clin Gastroenterol. 2023;57:798–803.

7. Persyn D, Van Malenstein H, Vanderschuren E, et al. Performance and applicability of a first generation single-use duodenoscope: a single-center cohort study. Ann Gastroenterol. 2022;35:368–375.

Sponsored in part by Boston Scientific.

Caution: U.S. Federal law restricts this device to sale by or on the order of a physician.