波科外周Guidewires-中文(导丝).ppt

Peripheral Guide Wires: 外周介入导丝： Standard, Hydrophilic & Specialty 标准，亲水性 & 特殊,This document is intended for internal educational purposes only and shall not be distributed outside of Boston Scientific.,PI Guide Wires Overview,Purposes of a guide wire: 导丝的作用： Gain access into vessels 到达目标血管 Deliver devices 输送手术器械 Cross lesions 穿越病变部位 Used in vascular and non-vascular procedures 可用于血管和非血管介入手术 Used in all diagnostic and therapeutic procedures 可用于所有的诊断和治疗介入手术 The Backbone of every procedure 每例介入手术均需使用,PI Guide Wires General Features & Intended Benefits,PI Guide Wires General Components 外周介入导丝的一般结构,Core Wire: Usually Stainless Steel or Nitinol 导丝轴芯：通常为不锈钢和镍钛诺合金,Distal Tip: Working end of wire; comes in multiple shapes: straight, angled, shapeable, J 远端头端：导丝的工作端；有多种形状：直型，成角型，可塑性，J型,Lubricious Coating: PTFE, Silicone, or Hydrophilic 光滑涂层：PTFE，硅，或亲水性,Distal Tip 远端,Safety Ribbon 安全带,Core wire 轴芯,Coil wire 螺旋金属丝,Proximal End 近端,Floppy/Light Support (POBA): Starter Guide Wire 松软型/轻度支撑（POBA）：StarterTM 导丝 Most flexible; least rail support 最佳的柔韧性；最小的支撑力 Less likely to cause vessel damage 最小的血管损伤 Moderate Support (Stent): Magic Torque Guide Wire 中度支撑（支架）： Magic Torque 导丝 Rail support between Floppy & Extra Support 介于松软型 & 超硬导丝之间 Added support for stent delivery 为放置支架提供额外的支撑 Extra Support (Stent): Amplatz Guide Wire 额外支撑（支架）： Amplatz 导丝 Long rail support region, but soft tip 杆身支撑力更强，柔软的头端 Designed for first generation stent delivery 设计用于放置第一代的支架,PI Guide Wires Core Wire Flexibility & Support 轴芯 柔韧性 & 支撑力,Diameters most commonly used in interventions: 在介入手术中最常使用的导丝直径： .014” - Coronary and small vessel balloons - 冠状动脉和小血管球囊 .018” - Renal and small vessel balloons - 肾动脉和小血管球囊 .035” - Balloons and catheters, “workhorse” - 球囊和导管，“使用最普遍” .038” - Large devices requiring extra support (rarely used) - 需要额外支撑的较大器械（很少使用） Other less common diameters are .032” and .025” 其他较少使用的直径： .032” 和 .025” Trend towards smaller diameters (.014”) 趋向于小直径导丝（.014”） Common guide wire lengths: 通常的导丝长度： 75cm, 150cm, 180cm, 260cm, 300cm,PI Guide Wires Sizing Diameters & Lengths 尺寸 直径 & 长度,PI Guide Wires Distal Tip Configurations 远端头端的类型,Tip Configurations: 头端类型： Straight, angled, J-Tip 直型，成角型， J型 Non-hydrophilic, hydrophilic 非亲水性，亲水性 Standard, floppy, stiff 标准型，松软型，硬型 Tip taper 渐细的锥形头端,PI Guide Wires Types for Gaining Initial Access,Bentson Guide Wire Straight, floppy, atraumatic tip J-Tip Guide Wire Atraumatic - use when worried about the potential for vessel perforation. 无创伤 用于避免血管壁穿孔 Starter Guide Wire Standard workhorse ZIPwire Guide Wire Not indicated as a starter wire, but often used by physicians.,PI Guide Wires BSC Products,The three classifications of wires sold by Boston Scientific are: Standard Guide Wires 标准导丝 Starter Guide Wire (includes Bentson, Newton, & Rosen shapes) Hydrophilic Guide Wires 亲水性导丝 ZIPwire Guide Wire (.18”, .025”, .035”, .038“) Specialty Guide Wires 特殊导丝 V-18 Control Wire Guide Wire (.018“) Platinum PLUS Guide Wire (.014”, .018“, .025”) Thruway Guide Wire (.014“ & .018“) Magic Torque Guide Wire (.035“) Amplatz Super Stiff Guide Wire (.035“ & .038”) Meier Guide Wire (.035“),PI Guide Wires BSC Product Positioning,Starter Guide Wires,The information included in this section is considered proprietary to Lake Region Manufacturing, Inc. Any copying, sharing and/or distributing is prohibited.,Starter Guide Wire Product Positioning,A family of ultra-smooth, PTFE guide wires.,Workhorse guide wire for routine procedures.,Starter Guide Wire Indications,INTENDED USE: Starter guide wires are designed for percutaneous vessel entry using the Seldinger technique to facilitate subsequent introduction(s) of an intravascular device.,Starter Guide Wire Product Specs,*Most are finger straightenable,Bentson, Newton, and Rosen are industry standard wire types sold by other companies as well. Available with or without heparin coating. Straight and J-tips available with fixed or moveable core (not available in all sizes).,Starter Guide Wire Features & Intended Benefits,Starter Guide Wire Areas of Clinical Use,Gaining access for routine procedures,Starter Guide Wire Key Competitors,The following competitors also sell Bentson, Newton and Rosen wires, as well as other PTFE-coated competiting workhorse wires: Cook market leader in standard guide wires Angiodynamics Cordis St. Jude Bard Merit,Starter Guide Wire Key Takeaways,Atraumatic, workhorse guide wire for routine procedures. Pre-Coat Technology Dipped coating for excellent coating durability & consistency Finger straightenable J-tip Availability of heparin coating Moveable & fixed core options,Sprayed Coating,Starter Guide Wire Dipped Coating (a.k.a. “Pre-Coat Technology”),Guidewires Construction - non hydrophilic wires,Starter Guidewire Fixed Core,Ideal first wire to use before or after Introducer Sheath Insertion Atraumatic Floppy Tip provides safety, Well balanced body provides ample pushability and support for Catheter Exchange Precoat technology allows for ease of Catheter Exchange Large Size Matrix covers majority of clinical requirements,Starter Guidewire Moveable Core,Ideal first wire to use before or after Introducer Sheath Insertion Moveable Core allows adjustment of the Floppy Tip length meaning one wire can provide both safety and support Well balanced body provides ample pushability and support for Catheter Exchange Precoat technology allows for ease of Catheter Exchange Large Size Matrix covers majority of clinical requirements,Starter Guidewire Newton,Ideal wire to use for accessing delicate vessels and crossing fragile lesions such as Renal, Dialysis Fistula, Subclavian, Fempop. Watch out 0.018” wires may be more suitable Also ideal for navigation of heavily diseased Iliacs and Aortas. Very Atraumatic Floppy tip, body support does allow catheter exchange,Starter Guidewire New Bentson,Ideal wire to use for accessing delicate vessels and crossing fragile lesions such as Renal, Dialysis Fistula, Subclavian, Fempop. Watch out 0.018” wires may be more suitable Also ideal for navigation of heavily diseased Iliacs and Aortas. Very Atraumatic Tip, less support than Newton means that catheter exchange may be limited,Starter Guidewire Rosen Heavy Duty,Ideal wire to use for catheter access where additional support is required especially in Ostial lesions due to short taper preventing flip out Renal, Dialysis Fistula, Subclavian, Fempop. Watch out 0.018” wires may be more suitable,ZIPwire Hydrophilic Guide Wires ZIPwire 亲水性导丝,ZIPwire Guide Wire,ZIPwire Guide Wire 产品定位,A family of hydrophilic guide wires designed for smooth passage through tortuous anatomy. 设计用于流畅的通过迂曲的解剖结构,ZIPwire Guide Wire 适应症,INDICATIONS: The ZIPwire Hydrophilic Guide Wire is intended to facilitate the placement of devices during diagnostic and interventional procedures. ZIPwire 亲水性导丝用于在诊断性和治疗性介入手术中协助置入器械。,ZIPwire Guide Wire 产品技术参数,ZIPwire is a trademark of Boston Scientific Corporation or its affiliates. Glidewire is a trademark of Terumo Corporation.,Note: See Guide Wires brochure or price book for all available combinations. 注意：请参见相关产品彩页或手册了解所有的产品型号,ZIPwire Guide Wire Enhanced Manufacturing Process,A polymer jacket is extruded over a kink-resistant nitinol core. 聚合物外壳覆盖在抗扭曲的镍钛诺合金轴芯表面 Hydrophilic coating is bonded to the polymer jacket. 亲水性涂层粘合在聚合物外壳上,Radiopaque Polyurethane Jacket 不透X线的聚亚安酯外壳,Nitinol Core 镍钛诺轴芯,Hydrophilic Polymer Coating 亲水性聚合物涂层,The manufacturing process enhancements treated the surface of the polyurethane jacket for consistent adhesion of the hydrophilic coating.,ZIPwire Properties,Kink-resistant 抗扭曲性 The nitinol metal alloy core provides the strength necessary to make the ZIPwire guidewire kink-resistant. 镍钛诺合金材质的导丝轴芯使ZIPwire导丝具有良好的抗扭曲性能。 Steerable 操控性 Single piece construction and atraumatic tip allow excellent steerability. 一体式结构和无创性头端使其具有优异的操控性。 The unique alloy core and polyurethane jacket of the ZIPwire guidewire provide a true 1:1 torque response. 独特的合金轴芯和聚亚安酯外壳实现了1:1扭控反应。 Frictionless 光滑度 The hydrophilic coating makes the ZIPwire guidewire virtually frictionless when wet. The ZIPwire guidewire slides easily into place and smoothly guides catheters. 亲水性涂层在水化后变得非常光滑，易于到达病变部位和推送导管。,ZIPwire Properties,Low Thrombogenicity (tendency to produce blood clots) 低血栓性（产生凝血块的趋势） The frictionless coating results in low potential for the formation of blood clots on the surface of the ZIPwire guidewire. 光滑的亲水涂层有效减少了在导丝表面形成血凝块的危险。 Radiopaque 显影性 The polyurethane is impregnated with tungsten, a radiopacifier for enhanced visibility. 聚亚安酯外壳中含有钨，在X线下具有良好的可视性。 Atraumatic 无创性 The various cores result in soft, flexible tip configurations. 不同的轴芯 各种类型的柔软而富有弹性的头端。,ZIPwire Guide Wire Features & Intended Benefits,ZIPwire Guide Wire 临床应用领域,Aortic bifurcation area 腹主动脉分叉,Carotids 颈动脉,HAM 血透通路,Crossing CTOs 通过完全阻塞的病变 Subintimal Angioplasty 内膜下血管成形术,ZIPwire Guide Wire Key Competitors,Glidewire Guide Wire (Terumo - previously sold by Boston Scientific) - Hydrophilic market leader Roadrunner Guide Wire (Cook) AQUALiner Guide Wire (Angiodynamics) HiWire Guide Wire (Cook) HydroSteer Guide Wire (St. Jude Medical),ZIPwire Guide Wire Key Takeaways,The ZIPwire Guide Wire is a hydrophilic guide wire designed for maneuvering through tortuous anatomy. ZIPwire 亲水性导丝设计用于通过迂曲的解剖结构。 Precise 1:1 torque response 精确的1:1扭控反应 Highly radiopaque jacket 高显影性外壳 Comprehensive selection of shafts, lengths, and tips 有多种不同硬度、长度和头端类型的型号,Amplatz Super Stiff Guide Wire Amplatz Super Stiff 超硬导丝,Amplatz Super Stiff Guide Wire 产品定位,A stiff, secondary (non-starter) wire when strength and stability are required for catheter placement and exchange. 硬度更高，具有更高的强度和稳定性，用于放置和更换导管。,Amplatz Super Stiff Guide Wire 适应症,INDICATIONS: The Amplatz Super Stiff Guide Wire facilitates catheter placement and exchange during diagnostic or interventional procedures. It is not intended for use in coronary arteries. Amplatz Super Stiff超硬导丝用于在诊断性和治疗性介入手术中放置和更换导管。不适用于冠脉手术。,Amplatz Super Stiff Guide Wire 产品技术参数,Note: See Guide Wire brochure or price book for all available combinations. 注意：请参见相关产品彩页或手册了解所有的产品型号,Amplatz Super Stiff Guide Wire Features & Intended Benefits,Amplatz Super Stiff Guide Wire 临床应用领域,Aortic bifurcation area 主动脉分叉,Carotid/aortic arch area 颈动脉/主动脉弓,Amplatz Super Stiff Guide Wire Key Competitors,“Amplatz” is a standard wire name sold by other companies including Cook and Cordis. Others competing wires include: Wholey HI-TORQUE (Covidien) HI-TORQUE Supra Core (Abbott Vascular),Amplatz Super Stiff Guide Wire Key Takeaways,Very supportive wire 具有高支撑力 For secondary use (not for gaining initial access) 第二根导丝（不作为进入导丝） Strong enough to get through tight lesions, yet tip is soft enough for reduced trauma during advancement. 具有足够的强度通过狭窄病变，同时柔软的头端可避免在推进导丝时损伤血管。,Amplatz Super Stiff Guidewire,Super stiff wire body with an atraumatic tip for catheter placement and exchange in uroradiology, biliary drainage, abscess drainage and vascular procedures. 具有良好硬度的杆身和无创性头端，可用于在泌尿系统、胆道引流、脓肿引流和血管介入手术中放置和更换导管。 PTFE Coating helps to reduce friction and allows for easy catheter passage PTFE涂层减少了摩擦力，便于推进导管。,在具有出色的硬度、强度、稳定性的同时柔软的无创伤头端有良好的安全性,Magic Torque Guide Wire,Magic Torque Guide Wire Product Positioning,.035,3CM,50CM,GLIDEX,180 / 260CM,Excellent torque control and radiopaque Magic Markers for enhanced visualization to meet the challenges of difficult anatomy.,Magic Torque Guide Wire Indications,INDICATIONS: The Magic Torque Guide Wire facilitates placement of a catheter during diagnostic or interventional procedures. The wire can be torqued to facilitate navigation through tortuous arteries and/or avoid unwanted side branches.,Magic Torque Guide Wire Product Specs,Magic Torque Guide Wire Features & Intended Benefits,.035,3CM,50CM,GLIDEX,180 / 260CM,Magic Torque Guide Wire Areas of Clinical Use,.035,3CM,50CM,GLIDEX,180 / 260CM,Aortic bifurcation area,Carotid/aortic arch area,SFA/BTK,Magic Torque Guide Wire Key Competitors,The Graduate Measuring Wire (Cook) Wholey-HI-TORQUE Guide Wire (Covidien) HI-TORQUE Supra Core Guide Wire (Abbott Vascular),Precise 1:1 torque response Radiopaque “Magic Markers” allow for accurate measurement visualization,Magic Torque Guide Wire Key Takeaways,Magic Torque Glidex Coated Hydrophilic Guidewire,Combining 4 distal platinum Magic markers with Glidex hydrophilic coating and an excellent torque control*. Great for navigating tortuous anatomy and accessing side branches. Support is great for delivering Stent / Balloon Catheters Markers make correct stent sizing easy and avoid any parallax effect,Meier Wire (Backup Meier),Meier Guide Wire Product Positioning,.035,3CM,50CM,GLIDEX,180 / 260CM,First guide wire indicated for AAA endovascular graft procedures. Stiff shaft provides excellent support, while flexible tip reduces the risk of vessel trauma.,Meier Guide Wire Indications,INDICATIONS: The Back-Up Meier Steerable Guide Wire facilitates catheter placement and exchange during diagnostic or interventional procedures including AAA endovascular graft procedures.,Meier Guide Wire Product Specs,.035,3CM,50CM,GLIDEX,180 / 260CM,Meier Guide Wire Features & Intended Benefits,.035,3CM,50CM,GLIDEX,180 / 260CM,Meier Guide Wire Areas of Clinical Use,GLIDEX,AAA,Meier Guide Wire Key Competitors,Cook Lunderquist Extra Stiff Guide Wire Also referred to as the “coat hanger”,Very supportive wire for AAA procedures. Highly radiopaque gold-plated tungsten spring coil tip is designed to enhance visualization for more accurate placement.,Meier Guide Wire Key Takeaways,Back-up Meier Steerable Guidewire,Balancing the support, flexibility and radiopacity required for efficient catheter placement,Optimally stiff stainless steel shaft core Straightens tortuous anatomy Provides the “railroad tracks” for large device to follow Very flexible and soft distal tip (J or C tip construction) A soft and flexible tip minimizes the risk of perforating the aortic arch or causing other vessel trauma (dissection) Minimizes the risk of dislodging thrombus from the aorta Highly radiopaque gold-plated tungsten spring coil tip Provides excellent visibility of the wire under fluoroscopy for accurate placement PTFE coated proximal shaft Promotes smooth catheter advancement Reduces the risk of thrombus formation Large device easily tracks on PTFE shaft,Platinum PLUS Guide Wire,Platinum PLUS Guide Wire Product Positioning,.035,3CM,50CM,180 / 260CM,For negotiation of tortuous anatomy and contralateral approaches including smaller vessels (.014” & .018”) and those with short distal purchase (short taper).,Platinum PLUS Guide Wire Indications,.035,3CM,50CM,GLIDEX,180 / 260CM,INDICATIONS: The Platinum PLUS guide wire facilitates placement of a catheter during diagnostic or interventional intravascular procedures. The wire can be torqued to facilitate navigation through tortuous arteries and/or avoid unwanted side branches.,Platinum PLUS Guide Wire Product Specs,Short Taper,Long Taper,Platinum PLUS Guide Wire Features & Intended Benefits,Platinum PLUS Guide Wire Areas of Clinical Use,GLIDEX,180 / 260CM,SFA,BTK,Platinum PLUS Guide Wire Key Competitors,.035,3CM,50CM,GLIDEX,180 / 260CM,Hi-Torque Spartacore 14 Guide Wire (Abbott Vascular),Platinum PLUS Guide Wire Key Takeaways,.035,3CM,50CM,GLIDEX,180 / 260CM,Available in smaller diameters (.014” & .018”) Tip has polymer jacket to facilitate crossing tight lesions Great SFA wire,Platinum Plus Guidewire,Short Tip,Long Tip,V-18 Control Wire Guide Wire V-18 可控导丝,V-18 Control Wire Guide Wire 产品定位,.018” hydrophilic performance with excellent torque control and rail support for distal, peripheral access and contralateral approaches. 带有亲水涂层的.018” 导丝，具有出色的扭控性和支撑力，可用于远端的外周血管和对侧性病变。,V-18 Control Wire Guide Wire 适应症,.035,3CM,50CM,GLIDEX,180 / 260CM,INDICATIONS The V-18 Control Wire Guide Wire is available in 110, 150, 200 and 300 cm lengths. The wire can be torqued to facilitate the selective placement of diagnostic or therapeutic catheters. This device is intended for peripheral use only. A torque device (pin vise) is included with each wire to facilitate directional manipulation of the guide wire. V-18 可控导丝有110， 150， 200和300cm四种长度。导丝可以扭转以有选择的放置诊断或治疗导管。该产品只供用于外周血管。每根导丝都附有一个扭转装置以控制导丝的前进方向。 The 110cm V-18 Control Wire Guide Wire is intended for general intravascular use including the placement of PTA balloon catheters requiring an 0.018” guide wire in hemodialysis AV access procedures. 110cm长的V-18 可控导丝可用于在血透通路等普通血管介入手术中放置兼容0.018 ”导丝的PTA球囊扩张导管。 The 150, 200 and 300 cm V-18 Control Wire Guide Wires are intended for general intravascular use. 150，200和300cm长V-18可控导丝可用于普通血管介入手术。,V-18 Control Wire Guide Wire 产品技术参数,V-18 Control Wire Guide Wire Features & Intended Benefits,V-18 Control Wire Guide Wire 临床应用领域,GLIDEX,SFA 股浅动脉,BTK 膝下血管,HAM 血透通路,V-18 Control Wire Guide Wire Key Competitors,.035,3CM,50CM,GLIDEX,180 / 260CM,SV .018“ Guidewire (Cordis) HI-TORQUE SteelCore 18 Guide Wire (Abbott Vascular) Roadrunner PC Wire Guides (Cook),V-18 Control Wire Guide Wire Key Takeaways,Small diameter (.018”) good for LE & small vessel balloons 小直径（.018”）- 尤其适用于下肢和小血管球囊 Shapeable, hydrophilic tip good for highly stenosed vessels 带亲水性涂层的可塑形头端 便于通过严重狭窄的血管 Excellent torque & rail support 优异的扭控性 & 支撑性,V-18 Control Wire,0.018“ hydrophilic performance with excellent torque control for distal peripheral access and controlateral approaches. 直径0.018“，有亲水性涂层，出色的扭转控制，尤适用于远端外周血管和对侧病变。,Scitanium不锈钢合金轴芯具有良好的扭转控制和操控性；ICETM亲水性涂层；柔软的2cm可塑形头端。,Thruway Guide Wire,Thruway Guide Wire 产品定位,50CM,Offers precision, strength and deliverability with a broad .014” & .018” matrix designed to meet any requirement, pa