导引导丝的设计

1、Guide Wire Design导引导丝的设计 Guide Wire Function 导丝的功能 Guide Wire Selection Goals 选择导丝时要达到的目标 Guide Wire Performance Characteristics 导丝的性能 Guide Wire Components & Design 导丝的结构和设计Guide Wire Function导丝的功能 Facilitate access to diseased vessels and the delivery of interventional equipment 协助介入器械输送至病变部位 Trac

2、k through the vessel 在血管中走行 Access and cross lesions 到达并通过病变 Support & deliver interventional devices 支撑并输送介入器械 Steer into and protect side branches 进入并保护分支血管Guide Wire Selection Goals 选择导丝时要达到的目标 Traverse the coronary anatomy safely, independently and without damaging the vessel 安全通过冠脉血管，对血管不造成损伤 A

3、ppropriate match for clinical setting 满足不同的临床需求Workhorse/front-line use 主力/一线导丝Navigate tortuous anatomy 通过迂曲血管Provide extra support 提供更强支撑力Crossing highly stenosed lesions 通过高度狭窄的病变Guide Wire Performance Characteristics导丝的性能Flexibility 柔软度Support 支撑力Steering 操控性Lubricity 顺滑度Tracking 跟踪性Torque respo

4、nse 扭矩传递Visibility 可视性Tactile Feedback 触觉反馈Crossability 通过能力Performance性能Design设计 What will affect Guide Wire Performance Characteristics? 导丝的性能由何决定？ Guide Wire Components & Design导丝的结构和设计 Core Diameter 核芯直径 Core Taper 核芯椎体 Core Material 核芯材料 Tip Style 头端类型 Coils and Covers 弹簧圈和聚合物护套 Coating 涂层Core

5、Diameter 核芯直径 Diameter affects flexibility, support and torque 核芯直径影响导丝的柔软度、支撑力和扭矩传递Smaller Diameter = More Flexibility直径越小 = 更柔软Larger Diameter = More Support & Torque直径越大 = 支撑力更强 & 扭矩传递更好Core Taper 核芯椎体 Tracking 跟踪性Ability of wire body to follow tip around bends 导丝体部随着头端的弯曲而弯曲的能力 Degree of support

6、 支撑力的大小Core Taper 核芯椎体Longer taper 较长椎体Shorter taper较短椎体Parabolic grind流线型核芯锥体PORABOLIC GRINDGradual transitions, provide less prolapse and improves ability to follow itself into acute bends较长且过渡平缓的核芯椎体，减少导丝头端脱垂的可能性，提高导丝的跟踪性Core Taper 核芯椎体Abrupt transitions or shorter taper may result in difficulty

7、accessing acute angles突然变细或较短的椎体，导丝头端容易脱垂，难以通过成角的部位prolapseCore Taper 核芯椎体Core Material 核芯材料Affects flexibility, support, steering and tracking 核芯材料影响导丝的柔软度、支撑力、操控性和跟踪性Stainless Steel 不锈钢Nitinol 镍钛合金High Tensile Strength Stainless Steel 高强度不锈钢Stainless steel 不锈钢不锈钢 Original core material technology

8、最初应用于导丝的材料 Good support, push force and torque 提供良好的支撑力、推送力和扭矩传递 Less flexible than newer core materials 与新型材料相比柔软度欠佳Core Material 核芯材料Nitinol 镍钛合金镍钛合金 Super-elastic alloy designed for kink resistance 超弹性合金，抗打折能力强 Excellent flexibility and steering 柔软度高、操控性好 Durable nature may facilitate treatment o

9、f multiple lesions and/or tortuous vessels 性质耐用，可治疗多个病变和/或迂曲血管病变Core Material 核芯材料Core Material 核芯材料 Nitinol 镍钛合金 Nitinol 镍钛合金镍钛合金 Super-elastic alloy designed for kink resistance 超弹性合金，抗打折能力强High Tensile Strength Stainless Steel 高强高强度不锈钢度不锈钢 Durasteel More durable than regular stainless steel 比常规不锈

10、钢更耐用 Retains shape 形状保持能力强 Good flexibility 良好的柔软度 Excellent steering and tracking 出色的操控性和跟踪性Core Material 核芯材料Tip Style 头端类型 Affects steering 影响操控性 Design options 头端设计类型Core-to-tipShaping ribbonCore-to-tipShaping ribbonTip Style 头端类型 - Core-to-Tip Precise steering and tip control 可实现对导丝头端的精细操作 Grea

11、ter tactile feedback 良好的触觉反馈 Stiffness for crossing resistant lesions 提供适当头端硬度以通过高阻力病变 Tip Style 头端类型 - Shaping Ribbon Flexible 柔软 Softer tip 头端硬度较小 Allows shape retention 头端塑形保持较好Coils 弹簧圈护套 Affect support, steering, tracking and visibility 影响导丝的支撑力、操控性、跟踪性和可视性 Impact dimension of wire 影响导丝的直径 Affe

12、ct tactile feedback 影响导丝的触觉反馈Outer Coils 外部弹簧圈Tip Coils Only 仅有头端弹簧圈Intermediate Coils 中段弹簧圈护套 Provide device trackability 改善器械输送性 Contribute to diameter 维持导丝的通体直径一致 Tip Coils 头端弹簧圈护套 Distal 2-3 cm of wire 导丝远端 2-3 cm的部位 Radiopaque 可视性 Stretched for tip shaping and softness 可以伸展，利于头端塑形及其柔软度Polymer 聚

13、合物护套 Polymer or plastic 聚合物或塑料 Provide lubricity 改善顺滑性 Smooth tracking through tortuosity 跟踪性好，更容易通过迂曲的血管Polymer Cover 聚合物护套Combinations 护套的组合 Tip coils plus 头端弹簧圈加上:Intermediate coils 中段弹簧圈Bare core 裸核芯Plastic cover 塑料护套Polymer 聚合物护套 Polymer over tip coils 弹簧圈外覆有聚合物护套Radiopacity 可视性Affected by coil

14、s and covers 受弹簧圈和聚合物护套影响Tip Coils头端弹簧圈护套头端弹簧圈护套Coatings 涂层 Affect lubricity and tracking 影响导丝的顺滑性和跟踪性 Facilitate smooth movement 使器械在导丝上面的移动更顺滑 Distal 30-35 cm 导丝远段30-35 cm Types 类型Hydrophilic 亲水涂层Hydrophobic 疏水涂层Coatings 涂层 Hydrophilic 亲水涂层Attracts water 吸引水分子Applied over polymer and stainless ste

15、el, including tip coils 涂在聚合物护套、不锈钢核芯和头端弹簧圈护套外Thin, non-slippery solid when dry 干燥状态下为一薄层、不光滑物质Becomes gel when wet 润湿时呈光滑的凝胶状Reduces friction 降低摩擦阻力Increases trackability 提高跟踪性Coatings 涂层 Hydrophobic 疏水涂层Repels water 排斥水分子Silicone on working area of wire, excluding tip 涂在导丝工作区域（头端除外）的硅树脂No actuatio

16、n required 无需激活Reduces friction 降低摩擦阻力Increases trackability 提高跟踪性Guide Wire Covers and Coatings导丝的护套和涂层No Coating 无涂层Hydrophobic Coating 疏水涂层Hydrophilic Coating 亲水涂层Polymer Cover With Hydrophilic Coating 聚合物护套加亲水涂层Lubricity 光滑性Tactile Feedback (related coils) 触觉反馈Summary 总结 Variation in guide wire compone