OptimalStentDeployment

支架的最優(yōu)化釋放

吉林大學(xué)第二醫(yī)院劉斌后期支架血栓形成—考慮的因素抗血小板治療停止延遲的內(nèi)皮化后期貼壁不全多聚物過敏/炎癥后期支架血栓形成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的病例完全閉塞暴露的支架44歲的男性因急性心梗住院,為最初的DES支架植入31個(gè)月后由LIA結(jié)果判斷后期支架血栓形成EurHeartJ.21Oct2005.ThePOSTITTrialStentingandPost-Dilatation造影沒有預(yù)示亞理想的貼壁,包括:-病變長(zhǎng)度-狹窄百分率-參照血管直徑-支架的類型

71%的病人沒有到達(dá)理想的支架貼壁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應(yīng)該后擴(kuò)*MSA：最小支架面積*MLD：最小管腔直徑*兩者為衡量支架是否充分貼壁的指標(biāo)1/3InflationpressureanddilatationforcePressurexDiameter2xWallThicknessF=1mm3mm1.5mm0.5mmX10DilatationForceJailedwiresforside-branchprotectionBaselineSide-Branchprotectionsidebranchesareselectivelywired12391/05Cypher3.0x33mmIfSBsremainopenwithoutprotectionitmeansthatthestentisnotfullyexpanded!!支架的最優(yōu)釋放保證病人的遠(yuǎn)期預(yù)后FIRESTARisdesignedtoprovide“CrossabilitywithAccuracy〞

優(yōu)異的通過性能精確預(yù)擴(kuò)張性能FIRESTAR?RxPTCABalloon

?LowestProfile

最小的通過外徑優(yōu)異的通過性能FIRESTAR?

具有最小通過外徑,專為復(fù)雜病變?cè)O(shè)計(jì)8atmNominalPressure14atmRatedBurstPressure?sizesatover17atm可提供精確擴(kuò)張,減少對(duì)病變邊緣的損傷,減少再狹窄精確擴(kuò)張性能精確預(yù)擴(kuò)張的意義在復(fù)雜病變中減少對(duì)病變邊緣健康血管的損傷,確保遠(yuǎn)期療效CordisDuraStarTM

非順應(yīng)性球囊

DURASTARisdesignedtoprovide“AccuracywithCrossability〞耐高壓精確擴(kuò)張性能優(yōu)異的通過性能耐高壓精確擴(kuò)張性能NP、RBP、1/4size壓力均是高壓球囊中最大的，是業(yè)內(nèi)最值得信賴的高壓球囊DURASTAR具有最平的順應(yīng)性曲線

1、順應(yīng)性外徑最小2、縱向伸長(zhǎng)最小化3、“狗骨頭〞更小25°：更精確擴(kuò)張和縱向伸長(zhǎng)最小化16°：提高通過支架和病變的能力耐高壓精確擴(kuò)張性能精準(zhǔn)擴(kuò)張，不會(huì)損傷支架外的正常血管縱向伸長(zhǎng)最小化保證精確擴(kuò)張DURASTAR?動(dòng)物模型X光下球囊縱向伸長(zhǎng)比較DURASTAR?球囊的縱向伸長(zhǎng)更小.保證球囊擴(kuò)張時(shí)保持在支架內(nèi)區(qū)域,不損傷邊緣正常血管*QuantumMaverickandNCRAPTOR?3.0x20mmballooninflatedto