支架地最优化释放.ppt

* * * * * There were several interesting findings from the POSTIT Study: he most compelling finding was that 71% of the patients did NOT receive optimal stent apposition with a semi-compliant balloon – these patients required a low or non-compliant balloon to provide uniform, complete stent strut apposition to the artery This information can be found in Table 3 – note that the data in Table 3 measured optimal apposition at 29% 2) Another interesting finding was that there were no predictors that could have been measured by angiography – in other words, lesion length, % stenosis or average RVD did not predict if optimal apposition was going to be achieved using a semi-compliant balloon. Optimal Stent Deployment支架的最优化释放吉林大学第二医院 刘 斌 后期支架血栓形成—考虑的因素 抗血小板治疗 停止 延迟的 内皮化 后期贴壁不全 多聚物过敏/ 炎症 后期支架 血栓形成 Predictors of DES Thrombosis Restenosis DES Thrombosis DES Restenosis Underexpansion Fujii et al. J Am Coll Cardiol 2005;45:995-8) Okabe et al., Am J Cardiol. 2007;100:615-20 Sonoda et al. J Am Coll Cardiol 2004;43:1959-63 Hong et al. Eur Heart J 2006;27:1305-10 TAXUS IV, V, VI meta-analysis Fujii et al. Circulation 2004;109:1085-1088 Edge problems (geographic miss, secondary lesions, large plaque burden, etc) Fujii et al. J Am Coll Cardiol 2005;45:995-8) Okabe et al., Am J Cardiol. 2007;100:615-20 Sakurai et al. Am J Cardiol 2005;96:1251-3 Liu et al, Am J Cardiol, in press Costa et al, Am J Cardiol, 2008;101:1704-11 使用 DES支架的LaST的病例 完全闭塞 暴露的支架 44岁的男性因急性心梗住院, 为最初的DES支架植入31 个月后 由 LIA结果判断后期支架血栓形成 Eur Heart J. 21 Oct 2005. The POSTIT Trial Stenting and Post-Dilatation 造影没有预示亚理想的贴壁, 包括: - 病变长度 - 狭窄百分率 - 参照血管直径 - 支架的类型 71% 的病人没有达到理想的支架贴壁1（n=256) Lesion Length % Stenosis Average RVD % Patients Meeting IVUS Criteria for Sub-Optimal Stent Deployment 12mm 12mm 70% 70% 3mm 3mm 1 Brodie, et al. Final Results From The POSTIT Trial. Catheterization and Cardiovascular Interventions 2003; 59: 184-192, Table 3 Copyright ?2004 by Boston S