波士顿科学弓上介入产品介绍纪强课件

1 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 波士顿科学脑血管缺血疾病解决方案 产产品专员专员 纪纪强 Call2014.8.13 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 波士顿科学脑血管缺血整体解决方案 颈动脉 颅外血管介入 椎动脉锁骨下动脉 导丝 Zipwire PT2 导管 Imager / Mach 球囊 Sterling MR / USSV 支架 Carotid Wallstent 保护伞 Filterwire EZ 导丝 Zipwire Thruway / V18 导管 Imager / Mach 球囊 Sterling MR / USSV 支架 Express SD 导丝 Zipwire Amplatz/ V18 导管 Imager / Mach 球囊 Mustang/ Sterling MR 支架 Express LD 3 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 议程 波士顿科学颈动脉狭窄解决方案 波士顿科学锁骨下动脉狭窄解决方案 波士顿科学椎动脉狭窄解决方案 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 波士顿科学颈动脉狭窄解决方案 5 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Carotid Wallstent闭环支架 Filterwire EZ保护伞 Sterling Monorail球囊 闭环支架相关临床研究 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Carotid Wallstent 7 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 临床有效性 闭环设计 高输送性 可回收 显影性 血管适应性 Carotid Wallstent要点 8 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 支架输送系统 Monorail 导管设计，0.014“导 丝输送系统； 5F (6 19(1):23-30. 44 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 闭环单元设计优势 径向支撑力 当使用闭环设计支架时，术后低血压的发生率更低! J Vasc Interv Radiol.2008 Jan;19(1):23-30. Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 支架单元设计如何影响临床结果? 46 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 闭环与开环支架设计的腔内影像 47 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 闭环单元设计优势 -更光滑平整的内腔 当使用闭环设计支架时，血栓保护装置挂在支架上的发生率更低 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 支架网孔面积积如何影响临临床结结果? 49 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 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 50 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 闭环单元设计优势 支架网孔面积 Does Free Cell Area Influence the Outcome in Carotid Artery Stenting? Bosiers et al. Eur J Vasc Endovasc Surg 2007;33:135-141. 51 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 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? Bosiers et al. Eur J Vasc Endovasc Surg 2007;33:135-141. Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 波士顿科学锁骨下动脉狭窄解决方案 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute.53 锁骨下动脉 椎动脉 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute.54 Tandem Architecture Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute.55 MicroMacro Tandem Architecture Stent Design Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute.56 Tandem Architecture 支架设计 MICRO单元 n柔顺性 n输送性更佳 n顺应性 n释放更容易 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute.57 Tandem Architecture Stent Design MACRO单元 n 杰出的径向支撑力 n 出色的显影性 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute.5 8 n 卓越的管腔覆盖能力 n 一致的径向支撑力 两者将结合可提供： Tandem Architecture Stent Design Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute.60 支架直径5-10 mm 支架长度5-8mm: 17, 27, 37, 57 mm 9-10mm: 25, 37, 57 mm 推送杆长度75 17:633641 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. Express LD 典型病例 1. 头臂干动脉开口狭窄 2. 右侧颈总动脉开口合并左侧锁骨下动脉开口狭窄 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. p性别：男 p年龄：52岁 p诊断：头臂干动脉开口重度狭窄 1.Express LD头臂干动脉开口重度狭窄 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. 1.Express LD头臂干动脉开口重度狭窄 BSC Express LD 10mm*37mm 球扩释放 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. 术后造影 1.Express LD头臂干动脉开口重度狭窄 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. p性别：男 p年龄：65岁 p诊断： 右侧颈总动脉开口狭窄 左侧锁骨下动脉狭窄 2.Express LD右侧颈总动脉开口合并左侧锁骨下动脉狭窄 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. II型弓双导丝技术+加硬泥鳅加强支撑 2.Express LD左侧颈总动脉开口合并左侧锁骨下动脉狭窄 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. BSC Express LD 8mm*37mm 术后即刻造影 2.Express LD左侧颈总动脉开口合并左侧锁骨下动脉狭窄 77 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 波士顿科学椎动脉狭窄解决方案 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. 临床适应症血管 标称支架尺寸直径 (mm) x 长度 (mm) q4.0 x 15, 19 q5.0 x 15, 19 q6.0 x 14, 18 q7.0 x 15, 19 金属材质316L不锈钢 结构设计专利的Tandem ArchitectureTM支架设计在支架的近端具有额外连接点 输送导管由Maverick球囊平台发展而来的UltraSoft SVTM SDS球囊扩张导管 套管设计轻质， 单片设计 导丝尺寸.014“或.018“ 推荐血管鞘外径5FR (1.9 mm): 4.0 6.0 mm 6FR (2.2 mm): 7.0 mm 推荐导引导管内径6FR (.060“/1.52 mm) 4.0 mm 6FR (.064“/1.63 mm) 5.0 mm 6FR (.067“/1.70 mm) 6.0 mm 7FR (.078“/1.98 mm) 7.0 mm 球囊材质DynalLEAP 支架张开的压力8 ATM/811 kPa 标称压力10 ATM/1013 kPa 额定破裂压14 ATM/1419 kPa Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. 4mm 7mm 6mm 5mm 15, 19mm 15, 19mm 14, 18mm 15, 19mm DiameterDiameter 直径直径 LengthLength 长度长度 4mm 7mm 6mm 5mm 5/6F 6/7F 5/6F 5/6F DiameterDiameter 直径直径 Sheath/GuideSheath/Guide 血管鞘血管鞘/ /导管导管 Express Vascular SD Stent System Product Specifications 产品技术参数 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. Customized Tandem Architecture Stent Design 专利的Tandem Architecture 支架设计 Increased lumen support at proximal end of stent 在支架的近端提供额外的管腔支撑 Superb radial strength 卓越的径向作用力 Low recoil 低回缩 DESIGN 设计 Increased lumen support at proximal end of stent 增加了支架近端的管腔支撑 Leading Edge Flexibility with Proximal End Support 在提供近端支撑的同时具有杰出的柔顺性 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. Low profile, 6F (.067”) guide catheter compatible through 6.0mm stent diameter 低外形轮廓，直径6.0mm的支架可通过6F (.067“)导引导管 Outstanding trackability over a .014” or .018” guide wire 可使用 .014“或 .018“导丝，具有出色的跟踪性 DELIVERABILITY 输送性 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. Customized balloon lengths for each stent size 每种尺寸的支架均有相应的长度的球囊 Stent is precisely set between swaged marker bands using laser alignment technology 支架被精确的预置在激光校准的放射性标记之间 Minimal stent shortening: 6% or less 最小的支架短缩：6%或更少 PRECISION 准确性 Balloon Balloon OverhangOverhang 球囊超出部分球囊超出部分 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. Express SD Stent Features and BenefitsExpress SD Stent Features and Benefits Express SD Express SD 支架支架 特性和利益特性和利益 特性利益 支架近端有额外的连接点 Macro/micro单元在支架的近端 1/3处由连接点连接在一起出色的管腔覆盖和支撑，尤其适用于开口处病变 Tandem Architecture 支架设计 最小的支架短缩准确的支架放置和完美的病变覆盖 Micro单元杰出的柔顺性和卓越的输送性 Macro单元在直接全长均有一致的径向作用力 优异的管腔支撑 不透X 射线 极佳的可视性 Confidential information of Boston Scientific Corporation. Do not copy or distribute.Confidential information of Boston Scientific Corporation. Do not copy or distribute. USSV delivery system Features and USSV delivery system Features and BenefitsBenefits U