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1、Optimal Stent Deployment 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,Predictors of DES Thrombosis & Restenosis,使用 DES支架的LaST的病例,完全闭塞,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,Eur Heart J. 21 Oct 2005.,The POSTIT Trial,Stenting and Post-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
2、% 的病人没有达到理想的支架贴壁（n=256),Lesion Length,% Stenosis,Average RVD,% Patients Meeting IVUS Criteria for Sub-Optimal Stent Deployment,12mm,12mm,70%,70%,3mm,3mm, Brodie, et al. Final Results From The POSTIT Trial. Catheterization and Cardiovascular Interventions 2003; 59: 184-192, Table 3,Copyright 2004 by
3、Boston Scientific Corporation or its affiliates. All rights reserved. Information for the use only in countries with applicable health authority product registrations.,POSTIT研究:,29， IVUS 36%， 12atm MSA/MLD：p0.001,* 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,1/3,Inflation pressure and dilatation for
4、ce,1mm,3mm,1.5mm,0.5mm,Jailed wires for side-branch protection,Baseline,Side-Branch protection,side branches are selectively wired,12391/05,If SBs remain open without protection it means that the stent is not fully expanded !,支架的最优释放保证病人的远期预后,FIRE STAR is designed to provide “Crossability with Accur
5、acy” 优异的通过性能 精确预扩张性能,FIRE STAR Rx PTCA Balloon, Lowest Profile 最小的通过外径,优异的通过性能,FIRE STAR 具有最小通过外径,专为复杂病变设计,8 atm Nominal Pressure 14 atm Rated Burst Pressure sizes at over 17 atm,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,Cordis Dura StarTM 非顺应性球囊,DURA STAR is designed to p
6、rovide “Accuracy with Crossability” 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、1/4 size 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,DURA STAR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,DURA STAR,动物模型X光下球囊纵向伸长比较,DURA STAR 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,* Quantum Maverick and NC RAPTOR 3.0x20 mm balloon inflated to RBP in a porcine carotid artery.,.,Product,Dura Star: 6F指引导管球囊对吻的兼容性,球囊对吻时，Dura Star需要的推送力最小,即推送最容易,药物支架时代需要最优的支架释放,精确安全的预扩 精确安全的后扩,谢 谢！,