DES在复杂病变中的循证医学使用指南精选.pptVIP

date DES在复杂病变中的循证医学使用指南 Dedicated Trials with CYPHER? Stent in Specific Patient/Lesion Types PRISON-II200 pts with CTO crossed by wire randomized to BX Velocity vs. Cypher PRISON-II200 pts with CTO crossed by wire randomized to BX Velocity vs. Cypher PRISON II: 36-month Clinical Follow-Up PRISON II: Stent Thrombosis in Target Vessel at 36 Month Follow-Up Nordic Bifurcation RCT413 pts at 28 centers in 5 countries with true bifurcation received Cypher in main vessels and randomized to PTCA vs. Cypher (crush”, “culotte”, “Y” or other techniques) of side branch with final kiss. Clinical FU at 6 months. Nordic Bifurcation Study (n=413)Major Endpoints (clinically driven) Ostial and Shaft LM Stenting with DES  MAIN COMPARE LM Registry Death or Q-wave MI (adjusted) MAIN COMPARE LM Registry Repeat Revascularization (adjusted) Drug-eluting Stents in AMI (RCTs) Drug-eluting Stents in AMI (RCTs)Mortality Drug-eluting Stents in AMI (RCTs)Reinfarction Drug-eluting Stents in AMI (RCTs)Stent thrombosis Drug-eluting Stents in AMI (RCTs)Target lesion revascularization Cordis三代DES设计特点 DES设计的基本要素 Cordis三代DES设计特点 Cypher Select Plus的CYPH2ONIC亲水涂层技术 涂层在SDS 的远端体部之外 具体位置在从与导丝交换点到近球囊封点之间的大约9英寸距离(25厘米长) 摩擦阻力 光滑性测试 光滑性测试 亲水涂层使得Cypher Select Plus 的外杆光滑程度比CYPHER?高94% 三维心脏模型推送实验结果 持久性测试 Plus 的亲水涂层技术 总结 特别为(CYPH2ONIC) CYPHER Select +研制的光滑外涂层 使SDS在摩擦区域的摩擦阻力减少了90%以上,使得推送力更加顺滑的从近端传向远端,而且涂层保持良好的持久性 减少摩擦即意味着省力和易推送 相对于Cypher Select来说,在推送性方面释放了可以更多可以提高的潜能 CYPHER? 支架在不同病变和病人亚组中表现的循证医学 P=0.023 P=0.006 P0.001 P0.001 IIb CRF DES Evidence-based MedicineGuidelines Summary2008 Acute myocardial infarction (due to safety concerns) 支架 平台设计 ） 药物聚合物 输送系统 ） CYPH2ONIC 亲水涂层-使得推送力能顺滑的 从支架近端推送杆传递到末梢头端 ? Cordis Corporation 2006. Confidential. For Internal Use Only - Not For Distribution. CYPHER Select+为什么选择改进推送系统？ 输送性的因素影响是那些？ 支架外形 支架材质 头端长度 支架的顺应性 还有么？？ 我们发现：支架推送系统和血管壁之间的摩擦阻力、支架推送系统同导管壁之间的摩擦阻力影响着支架的推送性能 这就意味着——支架输送系统的顺滑程度对输送性有很大的影响 CYPHER Select 增强了输送系统的特性: CYPH2ONIC 亲水涂层 – 减