支架XiencePRIME

2011 Abbott. All rights reserved. AP2934329 Rev. D.,Information contained herein intended for healthcare professionals from geographies outside the U.S. and Japan only.,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,DES,的设计,药物,作用机制,治疗窗,载药量,稳定性,支架和输送系统,（支架平台）,支架壁厚度,结构性支撑,顺应性,球囊头端,跟踪性,聚合物,生物相容性,机械完整性,聚合物厚度,药物释放曲线,支架平台：发展史,MULTI-LINK,市场占有率,第一,1997,MULTI-LINK TRISTAR,市场占有率,第一,1999,MULTI-LINK TETRA,市场占有率,第一,2000,MULTI-LINK PENTA,市场占有率,第一,2001,MULTI-LINK ZETA,市场占有率,第一,2002,MULTI-LINK VISION,市场占有率,第一,2003,MULTI-LINK 8,1,最新,2009,MULTI-LINKDUET,市场占有率,第一,1998,环和环为平行的正弦波形，由规律分布的,Link,相连, 3-3-3,连接,弯曲连接, 3-3-3,连接,弯曲连接, 3-3-3,连接,弯曲连接,钴铬合金, 3-3-3,连接,弯曲连接,钴铬合金, 3-3-3,连接, 3-2-3,连接, 3-2-3,连接, 3-3-3,连接,1. MULTI-LINK 8 is the bare metal platform for XIENCE PRIME.,支架平台对再狭窄的影响,支架壁厚度与再狭窄,支架壁厚度与内皮化,R. Virmani, TCT 2008,DES,支架壁厚度,XIENCE PRIME,支架梁厚度,:,81 m,合金,:,钴铬合金,聚合物厚度,:,7.8 m,ENDEAVORRESOLUTE,91 m,合金,:,钴镍合金,聚合物厚度,:,6.2 m,PROMUSELEMENT,81 m,合金,:,铁铂合金,聚合物厚度,:,7.8 m,CYPHER,140 m,合金,:,聚合物厚度,:,12.6 m,316L,不锈钢,3.0 mm diameter stents, 500 x magnification. Photos taken by and data on Abbott Vascular.,支架梁厚度,:,支架梁厚度,:,支架梁厚度,:,聚合物,DES,聚合物的作用,涂层完整性,药物释放曲线,生物相容性,时间延长及在钙化病变中均保持完整,药物释放的可调整性及可重复性,组织和血液的相容性,DES,涂层技术需要满足三个基本的设计要求,涂层完整性,: CYPHER Select,涂层完整性,: TAXUS Libert,涂层完整性,: Endeavor,涂层完整性,: Resolute vs Xience,Xience:,涂层牢固粘附于金属支架上，但不粘球囊；具有出色的弹性，延展性,= 600-750%,涂层完整性与血栓的关系,血栓,vs,涂层完整性,Flap-,制作成有管腔内悬垂物及末端环缺陷,Gouge-,故意在涂层表面制造划痕及粗糙表面,结论,-,涂层完整性在血栓形成过程中有很大的影响,DES:,药物释放,最佳药物释放时间：,120,天完全释放,生物相容性,:,抗血栓,生物相容性,:,内皮化,生物相容性,:,炎症反应低,临床前研究结果,Source,：,Virmarni R,，,Reduction of inflammation and plaque burden by an everolimus-Eluting stents in an atherosclerotic rabbit double injury model, PCR, 2010,术后,28,天，更少的炎症，更好的内皮化,Xience,Resolute,DAPT,中断后的晚期支架血栓发生率（,30,天,-1,年）,次级研究终点：,确定的,/,可能的支架血栓,药物,EES vs PES: SPIRIT IV,EES vs SES:,LESSON1,Xience,P,RIME,vs,Xience V,X,ience,PRIME,设计目标,Data on Abbott Vascular.,4.00,3.50,3.00,2.75,1,2.50,2.25,38,33,28,23,18,15,12,8,4.00,3.50,3.00,2.75,1,2.50,2.25,38,33,28,23,18,15,12,8,XIENCE PRIME,Stent Length (mm),Stent Diameter (mm),XIENCE PRIME,SV,XIENCE PRIME XIENCE,PRIME LL,传承,Xience,研究的优效性结果,以更出色的第八代,MULTI-LINK,支架为平台,规格齐全，最长,38mm,，且,38mm,支架的输送性与,18mm,支架相似,XIENCE PRIME,MULTI-LINK,系列支架在设计上的持续创新,XIENCE V,药物,/,剂量,依维莫司,88,1,g,依维莫司,88,1,g,聚合物,氟化,聚合物,氟化,聚合物,钴铬,合金,钴铬,合金,支架,材料,支架,设计,MULTI-LINK,VISION,MULTI-LINK,8,输送,系统,XIENCE PRIME,输送系统,ML VISION,输送系统,RBP: 16 atm,球囊椎体,长度,: 3-5 mm,RBP: 18 atm,球囊椎体,长度,: 1-2 mm,球囊,采用一致的设计,1. Dosing information for 3.0 x 18 mm stent.,Data on Abbott Vascular.,XIENCE PRIME,FDA,和,SFDA,认可唯一可沿用,Xience V,临床数据的,DES,XIENCE PRIME,支架设计,改进的,MULTI-LINK,设计，提高了输送性,体部环,XIENCE V,XIENCE PRIME,增加了孔的长度,=,提高支架的柔软度和支架压握于球囊上的牢固度,XIENCE V,XIENCE PRIME,增加了弯曲连接的高度，以提高输送性,Tests performed by and data on Abbott Vascular.,Images on Abbott Vascular,支架设计,输送系统,XIENCE PRIME,XIENCE V,海波管,ID/OD,XIENCE PRIME,海波管外径较,Xience V,大,13%,以获得更好的触觉反馈,更大导管腔,输送系统,XIENCE PRIME,不锈钢连接提供更好的推送力及更大的抗扭曲能力,输送系统,最小支架外球囊降低可能的支架边缘损伤,3.0 mm x 18 mm,XIENCE PRIME,，,XIENCE, V , CYPHER Select, and Endeavor. 3.0 mm x 20 mm TAXUS Libert,安全,.,第一,.,持续一致的低支架血栓发生率,一项又一项的研究,32,