颈动脉狭窄支架置入术

1、SAPPHIRE723 patients with high risk for CEA g50% stenosis in symptomatic patientsg80% stenosis in asymptomatic patientsg1 co-morbid conditiongTeam of vascular surgeon, neurologist and interventionalist determined if patient was too high risk for randomization; these patients were entered in a regist

2、ry and not randomizedTreatment Group AStenting with protection(n = 156)Treatment Group BCarotid endarterectomy(n = 151)Endpoints:gPrimary 30 day Death, Stroke or MIYadav et al, AHA 2002StentCEAP=0.047Death / MI / StrokeYadav et al, AHA 2002n=156n=151 The trial was discontinued early due to low enrol

3、lment However, despite the lower than expected enrollment, the rate of the 30 day composite primary endpoint was lower in the stent arm vs the CEA armP=0.13Death / MI / Stroke SymptomaticP=0.33Death / MI / StrokeAsymptomaticYadav et al, AHA 2002StentCEAn=48n=39StentCEAn=104n=98ECAICACCATerumo guidew

4、ire0.035”100cmHeadhunter5F Tempo200cm送入导丝、造影导管送入导丝、造影导管ECAICACCATerumo guidewire0.035”100cmHeadhunter5F Tempo200cm送入导丝、造影导管送入导丝、造影导管ECAICACCA造影导管置入造影导管置入ECAECATerumo guidewire0.035”100cmHeadhunter5F Tempo200cmECAICACCAHeadhunter5F Tempo200cm更换导丝更换导丝Terumo guidewire0.035”100cmECAICACCAHeadhunter5F Te

5、mpo200cm更换导丝更换导丝ECAICACCAHeadhunter5F Tempo200cm更换导丝更换导丝Amplatz Emerald0.035”260cmECAICACCAHeadhunter5F200cmAmplatz Emerald0.035”260cm更换长鞘更换长鞘ECAICACCAAmplatz Emerald0.035”260cm更换长鞘更换长鞘ECAICACCAAmplatz Emerald0.035”260cmBrite Tip Sheath7F80cm更换长鞘更换长鞘ECAICACCAAmplatz Emerald0.035”260cmBrite Tip Sheat

6、h7F80cm移出导丝移出导丝ECAICACCABrite Tip Sheath7F80cm移出导丝移出导丝ECAICACCABrite Tip Sheath7F80cm置入保护伞置入保护伞ECAICACCAAngioguard0.014”300cmBrite Tip Sheath7F80cm置入保护伞置入保护伞ECAICACCABrite Tip Sheath7F80cm通过狭窄段通过狭窄段Angioguard0.014”300cmECAICACCABrite Tip Sheath7F80cm通过狭窄段通过狭窄段Angioguard0.014”300cmECAICACCA释放保护伞释放保护伞

7、Brite Tip Sheath7F80cmAngioguard0.014”300cmECAICACCA植入支架植入支架 Smart Carotid stent7-8mm30-40mmBrite Tip Sheath7F80cmAngioguard0.014”300cmECAICACCABrite Tip Sheath7F80cm Smart Carotid stent7-8mm30-40mm植入支架植入支架Angioguard0.014”300cmECAICACCABrite Tip Sheath7F80cm Smart Carotid stent7-8mm30-40mm植入支架植入支架An

8、gioguard0.014”300cmECAICACCABrite Tip Sheath7F80cm Smart Carotid stent7-8mm30-40mm造影确认造影确认Angioguard0.014”300cmECAICACCABrite Tip Sheath7F80cm Smart Carotid stent7-8mm30-40mm造影确认造影确认Angioguard0.014”300cmECAICACCABrite Tip Sheath7F80cm Smart Carotid stent7-8mm30-40mm回收保护伞回收保护伞Angioguard0.014”300cmECA

9、ICACCA回收保护伞回收保护伞Brite Tip Sheath7F80cm Smart Carotid stent7-8mm30-40mmAngioguard0.014”300cmECAICACCABrite Tip Sheath7F80cm Smart Carotid stent7-8mm30-40mm回收保护伞回收保护伞Angioguard0.014”300cmECAICACCABrite Tip Sheath7F80cm Smart Carotid stent7-8mm30-40mm回收保护伞回收保护伞Angioguard0.014”300cmECAICACCABrite Tip Sheath7F80cm Smart Ca