支架的最优化释放

OptimalStentDeployment

支架的最优化释放

吉林大学第二医院刘斌后期支架血栓形成—考虑的因素抗血小板治疗停止延迟的内皮化后期贴壁不全多聚物过敏/炎症后期支架血栓形成Predictorsof

DESThrombosis&RestenosisDESThrombosisDESRestenosisUnderexpansionFujiietal.JAmColl

Cardiol2005;45:995-8)Okabeetal.,AmJCardiol.2007;100:615-20Sonodaetal.JAmColl

Cardiol2004;43:1959-63Hongetal.EurHeartJ2006;27:1305-10TAXUSIV,V,VImeta-analysisFujiietal.Circulation2004;109:1085-1088Edgeproblems(geographicmiss,secondarylesions,largeplaqueburden,etc)Fujiietal.JAmColl

Cardiol2005;45:995-8)Okabeetal.,AmJCardiol.2007;100:615-20Sakuraietal.AmJCardiol2005;96:1251-3Liuetal,AmJCardiol,inpressCostaetal,AmJCardiol,2008;101:1704-11

使用DES支架的LaST的病例完全闭塞暴露的支架44岁的男性因急性心梗住院,为最初的DES支架植入31个月后由LIA结果判断后期支架血栓形成EurHeartJ.21Oct2005.ThePOSTITTrialStentingandPost-Dilatation造影没有预示亚理想的贴壁,包括:-病变长度-狭窄百分率-参照血管直径-支架的类型

71%的病人没有到达理想的支架贴壁¹〔n=256)LesionLength%StenosisAverageRVD%PatientsMeetingIVUSCriteriaforSub-OptimalStentDeployment>12mm<12mm<70%>70%>3mm<3mm¹Brodie,etal.FinalResultsFromThePOSTITTrial.CatheterizationandCardiovascularInterventions

2003;59:184-192,Table3Copyright©2004byBostonScientificCorporationoritsaffiliates.Allrightsreserved.Informationfortheuseonlyincountrieswithapplicablehealthauthorityproductregistrations.POSTIT研究:

29％，IVUS36%，

>12atmMSA/MLD：p<0.001应该后扩*MSA：最小支架面积*MLD：最小管腔直径*两者为衡量支架是否充分贴壁的指标1/3InflationpressureanddilatationforcePressurexDiameter2xWallThicknessF=1mm3mm1.5mm0.5mmX10DilatationForceJailedwiresforside-branchprotectionBaselineSide-Branchprotectionsidebranchesareselectivelywired12391/05Cypher3.0x33mmIfSBsremainopenwithoutprotectionitmeansthatthestentisnotfullyexpanded!!支架的最优释放保证病人的远期预后FIRESTARisdesignedtoprovide“CrossabilitywithAccuracy〞

优异的通过性能精确预扩张性能FIRESTAR™RxPTCABalloon

•LowestProfile

最小的通过外径优异的通过性能FIRESTAR™

具有最小通过外径,专为复杂病变设计8atmNominalPressure14atmRatedBurstPressure¼sizesatover17atm可提供精确扩张,减少对病变边缘的损伤,减少再狭窄精确扩张性能精确预扩张的意义在复杂病变中减少对病变边缘健康血管的损伤,确保远期疗效CordisDuraStarTM

非顺应性球囊

DURASTARisdesignedtoprovide“AccuracywithCrossability〞耐高压精确扩张性能优异的通过性能耐高压精确扩张性能NP、RBP、1/4size压力均是高压球囊中最大的，是业内最值得信赖的高压球囊DURASTAR具有最平的顺应性曲线

1、顺应性外径最小2、纵向伸长最小化3、“狗骨头〞更小25°：更精确扩张和纵向伸长最小化16°：提高通过支架和病变的能力耐高压精确扩张性能精准扩张，不会损伤支架外的正常血管纵向伸长最小化保证精确扩张DURASTAR™动物模型X光下球囊纵向伸长比较DURASTAR™球囊的纵向伸长更小.保证球囊扩张时保持在支架内区域,不损伤边缘正常血管*QuantumMaverickandNCRAPTOR™3.0x20mmballooninflatedto