常用支架的特点

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,再狭窄的讨论,动脉硬化,(,斑块,)vs.,再狭窄,A,C,支架横截面病理结果,金属裸支架内狭窄,雷帕霉素涂层支架,内膜光滑，无再狭窄,1,2,3,女性，,71,岁，成功雷帕霉素洗脱支架植入术后,16,个月,死于脑卒中,图,1,DES,表面内皮化,80%,箭头所指为支架远端（侧面）未被内皮覆盖,图,2,DES,表面内皮细胞呈点状不愈合,图,3,内皮细胞间连接不良,箭头所指为血小板聚集,Eventually,the sun will set,DES will only delay the inevitable,late clinical results will fail to show long-term benefits because things must heal,.Thats the way nature works.“,Dr.Renu,Virmani,迟发性血栓,DES,安全吗？,DES in Diseased Human Coronary Artery,16 Months After SES Implantation,Guagliumi,et al.Circulation 2003;107:1340-1,LATE THROMBOSIS,62 yr old lady presenting with acute chest pain 1 yr 2 months following DES in LCX.Aspirin and,plavix,was stopped 2 days prior to knee surgery,Potential mechanisms:Late stent thrombosis,malapostion,late,restenosis,Chronic persistent inflammation,Hypersensitivity,Toxicity,?Infection,Tissue breakdown,Microabscesses,Weakening of walls,Thrombogenic,milieu,Intimal,Proliferation,Late,Malaposition,Late,Stent Thrombosis,Late,传统的,Polymer,的剥离,支架打开时因,polymer,粘连,拉拽,polymer,形成,网状剥离,Polymer,从支架上被扯下来,裸露出金属表面,TCT 2004,传统的,Polymer,的损伤,TCT 2004,EXCEL,可降解涂层药物支架,支架名称,EXCEL,TM,设计,波纹状结构,6,或,9,个环,材料,316,不锈钢,支架壁厚度,0.0047”,支架结构,技术数据,综合性能,金属动脉比,17.5%,弹性回缩,3%,单元直径,0.060,镶嵌式标记,推送力强,追踪性强,顺应性好,支撑力好,不挡侧枝,支架外径,0.040”,透视性,清晰,易于进入边支,EXCEL DES,平台,:,S-,stent,较小的外径,高柔软性,支撑力较好,外表面平滑,示踪性和血管顺应性好,均一性扩张,波环、开环结合的短臂设计，血管覆盖,较好,易于进入边支和穿越近端支架,EXCEL,支架球囊,命名压,6,atm,爆裂压,16,atm,Tip,prolife,0.019,Tip Length 1.52.0mm,Crossing,prolife,0.0390.046,介于半顺应与非顺应性之间的耐高压球囊,