冠脉内支架常用评价指标及概述.ppt

支架或球囊的常用的评价术语 可视性（Visibility） 柔顺性或灵活性（Flexibility） 跟踪性（trackbility） 推送性（pushbility） 顺应性（compliance） 美国学术研究协会(ARC，Academic Research Consortium)为规范冠脉支架血栓的定义标准 明确的支架血栓: 造影或病理证实的支架内血栓闭塞 极有可能的支架血栓: 1. 支架植入术后30天内发生的无法解释的死亡 2. 支架植入术后任何时间发生的支架植入血管供血区域的心肌梗死 可能的支架血栓:支架植入术30天后发生的难以解释的死亡. ARC 支架血栓的时相分期 急性支架血栓: 介入术中或24小时内。 亚急性支架血栓：介入术后24小时至30天内。 晚期支架血栓：介入术后30天至1年。 极晚期支架血栓介入术后1年以上。 * MLD—narrowest mean lumen diameter through the center of the vessel lumen; derived from 2 orthogonal views (by QCA) Binary restenosis—Used to summarize a group of patients simply as having or not having restenosis; restenosis is defined as 50% restenosis; angiographic restenosis MACE—death, MI, CABG, repeat TLR TLR—any repeat PCI of target lesion or bypass surgery TVR—revascularization in same vessel treated during index procedure TVF—TVR, MI, death attributed to the treated vessel (includes TLR) Stent thombosis—Closure of an artery; presents clinically * * State what we’ve been teaching…mktg message and what we’re shifting to…distribution. Twice as many patients with late loss in Taxus IV. Why would you want to start with a smaller lumen…CAD is a progressive disease. Endothelial cells are one-cell layer! Late loss is regrowth of SMC’s! * Calculating cross-sectional area loss: (7.07-3.80)/7.07=46% * BMS restenosis rates were still an improvement over PTCA (~40%) * ? Compared with the control, the CYPHER? Stent showed a 100% reduction of in-stent late loss ? The CYPHER Stent was successful at significantly reducing late loss both in-stent and at the stent margins * * * * * * * ? Cordis Corporation 2003 ? Cordis Corporation 2003 – FOR INTERNAL EDUCATION ONLY Page * * Cardiology 冠状动脉内支架常用评价指标 广东省人民医院 黄文晖 ? Cordis Corporation 2003 – FOR INTERNAL EDUCATION ONLY Page * 冠脉造影结果: 通过冠脉造影随访获得的证据 临床试验结果术语 临床术语 支架内和节段内再狭窄 晚期丢失 主要不良心脏事件(MACE) 靶病变再次血管重建术(TLR) 靶血管再次血管重建术( TVR) 支架内血栓形成 临床结果: 通过患者随访获得的证据 造影再狭窄 A＝Reference Vessel Diameter (RVD) 参考血管直径 B =Minimum Lumen Diameter (MLD)