波科外周 Guidewires-中文(导丝)

1、Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 整理课件Peripheral Guide Wires:外周介入导丝：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

2、Boston Scientific.Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally PI Guide WiresOverviewPurposes of a guide wire:导丝的作用：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

3、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每例介入手术均需使用Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally PI Guide WiresGeneral Features & Intended BenefitsIdeal Guide Wire

4、 FeaturesIntended BenefitSteerability/torque control操控性/扭转控制Easily directed through the body.从体外操控导丝Columnar strength纵向强度Kink resistant.抗扭曲Radiopaque显影性Good visualization.良好的可视性Frictionless润滑性Advancement through tortuous vessels; 通过迂曲的血管；smooth tracking of devices & catheters.沿导丝推送器械 & 导管Rai

5、l support支撑力Advancement and support of devices.推送和支撑器械Atraumatic tip无创伤的头端Reduced vessel damage.减少对血管的损伤Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 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：

6、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 Boston Scientific Confidential - F

7、or Internal Use Only. Do Not Copy, Display or Distribute Externally Floppy/Light Support (POBA): Starter Guide Wire松软型松软型/轻度支撑（轻度支撑（POBA）：）：StarterTM 导丝导丝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）

8、：中度支撑（支架）： Magic Torque 导丝导丝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）：额外支撑（支架）： Amplatz 导丝导丝Long rail support region, but soft tip 杆身支撑力更强，柔软的头端Designed for first generation stent d

9、elivery 设计用于放置第一代的支架PI Guide WiresCore Wire Flexibility & Support轴芯 柔韧性 & 支撑力Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Diameters most commonly used in interventions:在介入手术中最常使用的导丝直径：在介入手术中最常使用的导丝直径：.014” - Coronary and small vessel b

10、alloons - 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 small

11、er diameters (.014”) 趋向于小直径导丝（.014”）Common guide wire lengths:通常的导丝长度：通常的导丝长度：75cm, 150cm, 180cm, 260cm, 300cmPI Guide WiresSizing Diameters & Lengths尺寸 直径 & 长度Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally PI Guide WiresDistal Tip Confi

12、gurations远端头端的类型Tip Configurations:头端类型：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Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally PI Guide WiresTypes for Gai

13、ning Initial AccessBentson Guide Wire Straight, floppy, atraumatic tipJ-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 workhorseZIPwire Guide Wire Not indicated as a starter wire, but often used by physicians.Boston S

14、cientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally PI Guide WiresBSC ProductsThe three classifications of wires sold by Boston Scientific are:Standard Guide Wires 标准导丝标准导丝Starter Guide Wire (includes Bentson, Newton, & Rosen shapes)Hydrophilic Guide Wir

15、es 亲水性导丝亲水性导丝ZIPwire Guide Wire (.18”, .025”, .035”, .038)Specialty Guide Wires 特殊导丝特殊导丝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 Wir

16、e (.035)Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally PI Guide Wires BSC Product PositioningStarter Guide WireAll routine procedures.ZIPwire Guide WireWhen a standard wire wont “go”; total occlusions.当标准导丝无法通过时；完全阻塞的病变Amplatz Super Stiff Guide

17、WireWhen more support is needed such as filter placement and carotid catheter placement.当需要更多的支撑时，如放置血栓保护装置和颈动脉导管。Magic Torque Guide WireNegotiating difficult vessels, sizing vessels, sizing IVC filters.Meier WireAAA indicated; stiffer than Amplatz with a softer, radiopaque tip.Platinum PLUS Guide W

18、ireIVUS, small vessel (.014” & .018”).V-18 Guide WireSmall vessels (.018”), tortuous anatomy, contralateral. 小血管（.018”），迂曲的血管，对侧病变。Thruway Guide WireSmall vessels (.014” & .018”), renals, monorail.小血管（.014 ” & .018”），肾动脉，快速交换Boston Scientific Confidential - For Internal Use Only. Do Not

19、Copy, Display or Distribute Externally 整理课件Starter Guide WiresThe information included in this section is considered proprietary to Lake Region Manufacturing, Inc. Any copying, sharing and/or distributing is prohibited.Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or D

20、istribute Externally Starter Guide WireProduct PositioningA family of ultra-smooth, PTFE guide wires. Workhorse guide wire for routine procedures.Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guide WireIndicationsINTENDED USE: Starter g

21、uide wires are designed for percutaneous vessel entry using the Seldinger technique to facilitate subsequent introduction(s) of an intravascular device.Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guide WireProduct SpecsTipsDiameters (

22、in)Lengths (cm)Bentson.035, .038150, 180, 260Newton.018, .035, .038150J-Tip*.035, .038150, 180, 260Rosen.035150, 180, 260Standard.025, .035, .03880, 150, 260*Most are finger straightenable Bentson, Newton, and Rosen are industry standard wire types sold by other companies as well. Available with or

23、without heparin coating. Straight and J-tips available with fixed or moveable core (not available in all sizes).Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guide WireFeatures & Intended BenefitsStarter Wire FeaturesIntended Benefi

24、tsPTFE coating applied using pre-coat technology (dipped vs sprayed)Increased coating consistency and durability to facilitate entry and smooth catheter tracking.Availability of heparin coatingDecreased risk of thrombus formation.Finger straightenable J-tipUse in a wide range of clinical situations.

25、Choice of fixed or moveable coreUse in a wide range of clinical situations.Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guide WireAreas of Clinical UseGaining access for routine proceduresBoston Scientific Confidential - For Internal U

26、se Only. Do Not Copy, Display or Distribute Externally Starter Guide WireKey CompetitorsThe 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 MeritBo

27、ston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guide WireKey TakeawaysAtraumatic, workhorse guide wire for routine procedures. Pre-Coat TechnologyDipped coating for excellent coating durability & consistency Finger straightenable J-tip

28、 Availability of heparin coating Moveable & fixed core optionsSprayed CoatingStarter Guide Wire Dipped Coating (a.k.a. “Pre-Coat Technology”)Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally GuidewiresConstruction - non hydrophilic wiresBoston

29、Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guidewire Fixed CoreIdeal 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

30、 Exchange Precoat technology allows for ease of Catheter Exchange Large Size Matrix covers majority of clinical requirementsBoston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guidewire Moveable CoreIdeal first wire to use before or after Int

31、roducer 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 majo

32、rity of clinical requirementsBoston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guidewire NewtonIdeal wire to use for accessing delicate vessels and crossing fragile lesions such asRenal, Dialysis Fistula, Subclavian, Fempop. Watch out 0.018

33、” wires may be more suitableAlso ideal for navigation of heavily diseased Iliacs and Aortas.Very Atraumatic Floppy tip, body support does allow catheter exchange Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guidewire New BentsonIdeal w

34、ire to use for accessing delicate vessels and crossing fragile lesions such asRenal, Dialysis Fistula, Subclavian, Fempop. Watch out 0.018” wires may be more suitableAlso ideal for navigation of heavily diseased Iliacs and Aortas.Very Atraumatic Tip, less support than Newton means that catheter exch

35、ange may be limited Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guidewire Rosen Heavy DutyIdeal wire to use for catheter access where additional support is required especially in Ostial lesions due to short taper preventing flip outRe

36、nal, Dialysis Fistula, Subclavian, Fempop. Watch out 0.018” wires may be more suitableBoston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 整理课件ZIPwire Hydrophilic Guide Wires ZIPwire 亲水性导丝亲水性导丝ZIPwire Guide WireBoston Scientific Confidential - For Int

37、ernal Use Only. Do Not Copy, Display or Distribute Externally 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Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire G

38、uide 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。Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPw

39、ire 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.Shafts杆身杆身Standard, Stiff标准型，加硬型Tips头端头端Straight, Angled, J, Long Taper, Short Taper直型，成角型，J型，长锥型，短锥型Diameters直径直径.018”, .025”, .035”, .038”Lengths长度长度80cm, 1

40、50cm, 180cm, 260cmNote: 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Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire Guide WireEnhanced Manufacturing ProcessA polymer jacket is extruded ove

41、r 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亲水性涂层粘合在聚合物外壳上Radiopaque Polyurethane Jacket 不透不透X线的聚亚安酯外壳线的聚亚安酯外壳Nitinol Core镍钛诺轴芯镍钛诺轴芯Hydrophilic Polymer Coating亲水性聚合物涂层亲水性聚合物涂层The manufacturing process en

42、hancements treated the surface of the polyurethane jacket for consistent adhesion of the hydrophilic coating.Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire PropertiesKink-resistant抗扭曲性抗扭曲性The nitinol metal alloy core provides the strengt

43、h 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

44、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。Boston Scientific Confidential - For Internal Use Only

45、. Do Not Copy, Display or Distribute Externally ZIPwire PropertiesLow Thrombogenicity (tendency to produce blood clots)低血栓性低血栓性（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

46、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。Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Dist

47、ribute Externally ZIPwire Guide WireFeatures & Intended BenefitsZIPwire Guide Wire FeaturesIntended BenefitsHydrophilic coating亲水性涂层亲水性涂层Facilitation of crossing of tight lesions.易于通过高度狭窄的病变Precise 1:1 torque response精确的精确的1:1扭控反应扭控反应Secure control when sub-selecting distal and angulated branch

48、vessels.安全进入远端血管和成角较大的分支血管Highly radiopaque jacket高显影性外壳高显影性外壳Excellent visibility for accurate positioning.良好的可视性，便于准确定位Super-elastic nitinol core有良好弹性的镍钛诺轴芯有良好弹性的镍钛诺轴芯Excellent kink-resistance.优异的抗扭曲性能Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Extern

49、ally 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Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire Guide WireKey Competitors Glidewire Guide Wire (Terumo - previ

50、ously 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)Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire

51、 Guide WireKey TakeawaysThe 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。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

52、同硬度、长度和头端类型的型号Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 整理课件Amplatz Super Stiff Guide Wire Amplatz Super Stiff 超硬导超硬导丝丝Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Amplatz Super Stiff

53、 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，用于硬度更高，具有更高的强度和稳定性，用于放置和更换导管。放置和更换导管。Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Amplatz Super

54、 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。Boston Scientific Confidential - For

55、Internal Use Only. Do Not Copy, Display or Distribute Externally Amplatz Super Stiff Guide Wire 产品技术参数Tip Shape头端形状头端形状Tip Length头端长度头端长度 (cm)Diameters (in)直径直径Lengths (cm)长度长度3mm J3mmJ型3.035, .038145, 180, 260Straight直型6.018, .035, .03875, 145, 180, 260Short Tip短头端1, 3.5.035, .038150, 180, 260Note:

56、 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Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Amplatz Super Stiff Guide WireFeatures & Intended BenefitsAmplatz Super Stiff FeaturesIntended Benef

57、itsStiff core硬的轴芯硬的轴芯Added strength for easier access and better stability during catheter placement and exchange.强度更高，进入更方便，在放置和更换导管时具有更佳的稳定性。Atraumatic tip & gradual distal core taper无创性头端无创性头端 & 渐细的远端轴芯渐细的远端轴芯Safety during advancement.在推进导丝时具有良好的安全性Teflon coating特氟隆涂层特氟隆涂层Smooth entry and

58、 catheter tracking.进入血管和推送导管更加流畅Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 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Boston Scientific Confidential - For Internal Use Only. Do Not Copy, D

59、isplay or Distribute Externally Amplatz Super Stiff Guide WireKey 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)Boston Scientific Confidential - For Int

60、ernal Use Only. Do Not Copy, Display or Distribute Externally Amplatz Super Stiff Guide WireKey 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。Boston Scientific Confidential - For Internal Use