肾动脉支架植入术图文详解ppt课件

EndovascularTreatmentofRenalArteryStenosis,ClinicalIndications(Procedures),Anatomy,Kidneyanatomy,EndovascularTreatmentofRenalArteryStenoses,Aimofthetreatment1)RenovascularHypertension2)RenalInsufficiency,RenovascularHypertension,5%ofallhypertensivepatientsDuetoatherosclerosisorFMDDiagnosedafterSurgicalfollow-uporPTRA.PTRAdoesnotcureEssentialHypertension,RenalInsufficiency,NephrosclerosisafterRASorocclusionPTRAisindicatedtoreverseorpreventthedeclineofkidneyfunctions8cmlongkidneyisthelowerlimitafterwhichkidneyfunctionmightbecompromised,IndicationsforPTRA,FailedmedicaltherapyReducingdrugtreatmentPressuregradient10%Morethan50%stenosisAssymmetricallossofrenalmass,EndovascularTreatmentofRenalArteryStenoses,1)Treatmentofartherioscleroticostiallesions(80%)dilatation+stenting2)Treatmentofpostostiallesionsdilatation(stentingifnecessary)3)TreatmentFMDdilatation(stentingifnecessary),Post-ostiallesion,Fibro-MuscularDysplasia,Fibro-MuscularDysplasia,Restenosisafterstenting,Recentstudieshaveindicatedratesarebetween10-20%(muchbetterthanthe30%withjustPTA).,TreatmentOptions,MedicalTreatmentPTAwithStentingSurgeryDialysis:RenalFunctionnevergetbetter,Goldstandardtreatmenttoday,MedicaltreatmentACEinhibitorsandanewclassofAngiotensinreceptorblockers,EndovascularOptions:PTAorStenting?,1999:PeterVandeVen,randomizedtrialPTAvsStentinginostiallesion,Literature,ProductStrategies,014”Cardiologist,Radiologists,VascSurgeons.Balloon:M3RxStents:CorinthianIQonM3Wire,Stabilizer7-8FVistaBriteTiporIG,035RadiologistwhoareusedtotraditionalPTAballoons,MorerangeinPTAballoonsBalloons:P3,OptaProStents:GenesispremountedonOPTA-PROWire035,Jindo,Storq8FVistabriteTiporIG,Anewapproach:.018!,AGOODCOMPROMISE!RadiologistwhoareusedtotraditionalPTAballoons,MorerangeinPTAballoonsBalloons:SlalomStent:GenesispremountedonOPTA-PROWire018,SV6-7FVistabriteTiporIG,Advantagesof.014systems,Lessspasmwith.014wireLesswirelengthSmallerpuncturesiteStentprotectedbyGCGoodsupport,EndovascularTreatmentofRenalArteryStenoses,Throughthegroinusing8FmaterialsCanbedownsizedto7FusingM3,Emerald.035,Emerald.035+PigtailTempo4-5F65cm,Emerald.035+RenalCurveTempo4F65cm,Emerald.035+RenalCurveTempo4F65cm,Emerald.035+RDCVistaBriteTip8F55cm,Emerald.035+RDCVBT8F55cm+OptaPro,Emerald.035+RDCVBT8F55cm+OptaPro,Emerald.035+RDCVBT8F55cm+OptaPro,Emerald.035+RDCVBT8F55cm,Emerald.035+RDCVBT8F55cm+CorinthianIQonOptaPro,Emerald.035+RDCVBT8F55cm+CorinthianIQonOptaPro,Emerald.035+RDCVBT8F55cm+CorinthianIQonOptaPro,Emerald.035+RDCVBT8F55cm+CorinthianIQonOptaPro,Emerald.035+RDCVBT8F55cm+CorinthianIQ,EndovascularTreatmentofRenalArteryStenoses,2)Throughthegroinusingthenew6Fmaterials,.014Stabilizer,.014Stabilizer+6FBriteTipSheath55cm,.014Stabilizer+6FBTS55cm+RDCTempo4F,.014Stabilizer+6FBTS55cm+RDCTempo4F,.014Stabilizer+6FBTS55cm+RDCTempo4F,.014Stabilizer+6FBTS55cm+RDCTempo4F,.014Stabilizer+6FBTS55cm+M3,.014Stabilizer+6FBTS55cm+M3,.014Stabilizer+6FBTS55cm+CorinthianIQonM3,.014Stabilizer+6FBTS55cm+CorinthianIQ,EndovascularTreatmentofRenalArteryStenoses,3)Throughabrachialaccess,Tempo4FMP+.014Stabilizer,BriteTipSheath6F90cm+.014Stabilizer,BriteTipSheath6F90cm+.014Stabilizer,BriteTipSheath6F90cm+RDCTempo4F+.014Stabilizer,BTS6F90cm+.014Stabilizer,BTS6F90cm+.014Stabilizer+M3,BTS6F90cm+.014Stabilizer+M3,BTS6F90cm+.014Stabilizer+CorinthianIQonM3,BTS6F90cm+.014Stabilizer+CorinthianIQonM3,BTS6F