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1、ChronicTotalOcclusion(CTO)CasePresentation:KeyConceptsandTechniquesTakatoshiHayashiMDHimejiCardiovascularCenter,Japan2008.4.12GuangzhouRoleofDESforCTOangioplatyImprovetheprognosis?RecentconceptsandtechniquesCanwetreatapatientsmartly?CTOangioplastyRoleofDESforCTOangioplatyCTOangioplastyinDESeraBMSDES
2、(SES)SICCOGISSOCSTOPTOSCANakamuraHoye0605040103020(%)Re-occlusionRestenosis24%47%34%32%20%12%8%8%8%3%6%Nakamura2%Ge3%9%9%SESforCTOlesions:CTOvsNon-CTOCypherPostMarketingStudy(PMS)inJapanStudyDesign(CypherPMSinJapan)BackgroundPostmarketevaluationtofulfillaRegulatoryApprovalConditionPurposeToevaluatet
3、hesafetyandefficacyoftheCypherSirolimus-elutingcoronarystentinroutinedailypracticeintheJapanesepopulationTargetEnrollment2,000patients(1styear=1,000patients,2ndyear=1,000patients)NoofSites50sites(Selectsitesonbasisofbalancedpopulationdensity,hospitalsdistributionaswellasscaleofhospitals)MethodProspe
4、ctiveNon-randomizedRegistryInclusionCriteriaConsecutivepatientstreatedwiththeCypherstent(includingofflabeluse)Follow-upIn-Hospital,3,8monthsand1,2,3,4,5yearsclinicalfollow-updata:Angiographicfollow-upismandatedat8months(Analysis:Corelab)EnrollmentPeriod1stYear:9/1/04~3/31/052ndYear:4/1/05~9/30/05Int
5、ent-to-treatActualEnrollment8MAngiographicF/U12MClinicalF/U2,054cases2,051cases1,752cases1,857casesFollowupRate:85.4%90.5%DeliverySuccessRate:99.8%StudyProfileofCypherPMSinJapanCTONon-CTOPValueNooflesions109(105pts)2,350(1946pts)-RVD,mm2.28±0.702.57±0.60<0.001LesionLength,mm26.9±17.117.2±9.9<0.001AC
6、C/AHATypeB2/C*109(100.0)1,872(80.0)<0.001Denovo90(82.6)1,856(79.0)0.367ISR14(12.8)342(14.6)0.620Bifurcation30(27.5)779(33.1)0.222Osital11(10.1)400(17.0)0.058Moderato/SevereCalcification23(21.1)403(17.1)0.287LesionCharacteristicsValuesaren(%).*:ExcludingUnevaluated10lesioninNon-CTO:Non-CTO:CTO(mm)0.
7、31mm0.22mmP=0.132(%)11.2%8.9%P=0.453(%)3.9%3.9%P=0.806EfficacyEvaluationTLR(12Months)LateLoss(8Months)BinaryRestenosis(8Months)CTONon-CTOPValueNoofpatients991,758-MACE5(5.1)137(7.8)0.421Death1(1.0)47(