闭环支架优势讲义课件

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,*,Boston Scientific Confidential-For Internal Use Only.Do Not Copy,Display or Distribute Externally,Confidential information of Boston Scientific Corporation.Do not copy or distribute.,1,Boston Scientific Confidential-For Internal Use Only.Do Not Copy,Display or Distribute Externally,Confidential information of Boston Scientific Corporation.Do not copy or distribute.,Confidential information of Boston Scientific Corporation.Do not copy or distribute.,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,*,Boston Scientific Confidential-For Internal Use Only.Do Not Copy,Display or Distribute Externally,Confidential information of Boston Scientific Corporation.Do not copy or distribute.,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,*,*,Boston Scientific Confidential-For Internal Use Only.Do Not Copy,Display or Distribute Externally,Confidential information of Boston Scientific Corporation.Do not copy or distribute.,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,*,*,Boston Scientific Confidential-For Internal Use Only.Do Not Copy,Display or Distribute Externally,Confidential information of Boston Scientific Corporation.Do not copy or distribute.,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,*,*,Boston Scientific Confidential-For Internal Use Only.Do Not Copy,Display or Distribute Externally,Confidential information of Boston Scientific Corporation.Do not copy or distribute.,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,*,闭环支架优势,闭环支架优势,不同支架设计,开环设计,闭环设计,Carotid Wallstent,TM,Precise,TM,Acculink,TM,不同支架设计 开环设计 闭环设计 Carotid Walls,闭环单元设计,闭环单元设计,闭环单元设计的三大要素,Radial Force,Scaffolding,Cell Design,主要目的：通过临床数据的支持整合闭环设计的三大组成以将,Carotid Wallstent,区分于其他颈动脉支架,Stent,Lumen,径向支撑力,支架网孔面积,单元结构设计,闭环单元设计的三大要素Radial ForceScaffol,支架网孔面积如何影响临床结果,?,支架网孔面积如何影响临床结果?,CAS,的目的,CAS,的目的是预防卒中的再次发生,卒中是第三大死因，且是致残的首要因素,.,*Data on file at BSC.,CAS的目的CAS的目的是预防卒中的再次发生卒中是第三大死,6,颈动脉支架的植入,防止斑块的脱落是首要目的！,斑块覆盖是最重要的！,颈动脉支架的植入防止斑块的脱落是首要目的！,支架网孔面积,不同的支架不同,CWS,的网孔面积只有,Acculink,的,1/10,支架网孔面积 不同的支架不同CWS的网孔面积只有Accul,闭环单元设计优势,Benefit#1,支架网孔面积,闭环单元设计优势Benefit#1 支架网孔面积,Does Carotid Stent Design Influence Outcomes?,R.M.Bersin,Catheterization and Cardiovascular Interventions 2008;72:863866,目前为止，已经完成,3,项有关颈动脉支架设计与临床结果的回顾性、非随机研究。,Does Free Cell Area Influence the Outcome in Carotid Artery Stenting?,Bosiers et al.,A,retrospective analysis of 30 day outcomes of a carotid artery stenting multicenter database consisting of 3179 consecutive patients,SPACE,a,retrospective,randomized trial of carotid artery stenting versus endarterectomy in standard surgical risk patients with symptomatic carotid artery stenoses,Schillinger M,Gschwendtner M,Reimers B,et al.Does carotid stent cell design matter?A retrospective,nonrandomized review of a carotid artery stenting multicenter database consisting of 1,684 consecutive patients,Does Carotid Stent Design Influence Outcomes?,Bersin.Catheterization and Cardiovascular Interventions 2008;72:863866.,.,Does Carotid Stent Design Infl,Does Free Cell Area Influence the Outcome in Carotid Artery Stenting?,Bosiers et al.Eur J Vasc Endovasc Surg 2007;33:135-141.,目的,:,明确颈动脉支架设计，尤其是支架网孔面积，对于颈动脉支架术后,30,天卒中、死亡或,TIA,的影响。,30,天结果的回顾性分析,TIA,，死亡,大和小卒中,(,非心肌梗死,),共,3179,接受颈动脉支架手术的患者,4,个中心,Bosiers,Deloose-Belgium,Peeters,Verbis-Belgium,Setacci,Donato et al.-Italy,Cremonesi,Castriota-Italy,Does Free Cell Area Influence the Outcome in Carotid Artery Stenting?,Bosiers et al.Eur J Vasc Endovasc Surg 2007;33:135-141.,Does Free Cell Area Influence,闭环支架优势讲义课件,第,30,天事件：闭环,vs.,开环支架设计,TIA,死亡,大和小卒中,Does Free Cell Area Influence the Outcome in Carotid Artery Stenting?,Bosiers et al.Eur J Vasc Endovasc Surg 2007;33:135-141.,对于症状性患者，术后第,30,天的主要事件发生率差异显著,开环支架设计,(7.0%),VS,闭环支架设计,(2.2%)(p0.0001),Does Free Cell Area Influence the Outcome in Carotid Artery Stenting?,Bosiers et al.Eur J Vasc Endovasc Surg 2007;33:135-141.,N=3179,P=0.005,N=1317,P0.0001,N=1862,P=1.0,第30天事件：闭环 vs.开环支架设计TIA,死亡,13,Does Free Cell Area Influence the Outcome in Carotid Artery Stenting?,Bosiers et al.Eur J Vasc Endovasc Surg 2007;33:135-141,.,术后,=(TIA,卒中,死亡,),直到术后,30,天发生,闭环,vs.,开环支架设计,Does Free Cell Area Influence the Outcome in Carotid Artery Stenting?,Bosiers et al.Eur J Vasc Endovasc Surg 2007;33:135-141.,对于症状性患者，手术,30,天以后的主要事件发生率差异显著,开环支架设计,(6.3%),VS,闭环支架设计,(1.3%)(p0.0001),N=3179,P0.0001,N=1317,P0.0001,N=1862,P=1.0,Does Free Cell Area Influence,14,患者评估,由独立神经病学医师进行神经学上的,局限性,回顾性的研究,非随机设计可能导致在选择时会因特定病变类型有所偏向,注册数据受制于自我审计,技术复杂性没有评估，结果没有经过风险校正,有必要进行前瞻性的随机研究来比较不同支架网孔面积以得到最终结论,Does Free Cell Area Influence the Outcome in Carotid Artery Stenting?,Bosiers et al.Eur J Vasc Endovasc Surg 2007;33:135-141.,Does Free Cell Area Influence the Outcome in Carotid Artery Stenting?,Bosiers et al.Eur J Vasc Endovasc Surg 2007;33:135-141.,患者评估Does Free Cell Area Influe,总结,四个中心的,30,天结果回顾性分析,N=3179 CAS patients,对于症状性患者，术后第,30,天的主要事件发生率差异显著，开环支架设计,(7.0%)VS,闭环支架设计,(2.2%)(p0.0001),对于症状性患者，手术,30,天以后的主要事件发生率差异显著，开环支架设计,(6.3%)VS,闭环支架设计,(1.3%)(p0.0001),Does Free Cell Area Influence the Outcome in Carotid Artery Stenting?