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foreign [Music] take a few minutes here to talk about using the TAC device by Phillips in critical limb ischemia cases in particular my disclosures so the goal is to talk about the the time and the need to have a focal tool that helps you with dissection repair specific to pad interventions so before having this device in our armamentarium most tibial dissections which are sort of inevitable especially in Long ctOS of typical interventions were using coronary balloon expandable bare metal stents now that being what we had at the time it seemed like it works fine the data seems to be pretty well but in fact well talk about at the end here thats not the right tool for this type of application so having a dedicated scaffold that is meant for dissection repair really has changed the game but lets take a look at what happens before we had it this is just a briefcase a patient with a TMA that was not healing as you can see in the middle picture you can see in the initial angiograms there