支架内再狭窄IVUS知识讲解.ppt

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1、支架内再狭窄IVUSAngiographyofOct29,20092.0×15mmsprinter10atmRCAPredilatation1.5×15mmsprinter8atm3.0×30mmEndeavor14atmRCAStenting3.0×30mmEndeavor12atmFinalAngiographyAngiographyofMar15,2010RCAandLADStenting3.0×13mmFirebird12atm3.0×18mmFirebird12atmFinalAngiographyAngiographyofFeb11,2015RCAIVUSMLA=2

2、.51mm2RCAIVUSProximalUnderexpansion?DistalDistalreferenceDistalstentMidstentProximalstentProximalreferenceRCAIntervention2.5×15mmMaverick10atm2.75×17mmSeQuentPleaseDCB14atm40sFinalAngiographyRCAFinalIVUSMLA=4.09mm2DefinitionUseofIVUSinISREvaluationforthepatternsandmechanismGuidethetreatments

3、electionsImportanceofIVUSforISRAngiographicISRClassificationconfirmedbyIVUSMehran,etal.Circulation.1999;100:1872-1878(<10mm)(>10mm)MechanismsofDESRestenosisVasimFarooq,etal.ThePCR-EAPCITextbook–PercutaneousInterventionalCardiovascularMedicineIn-stentRestenosis.FindingsofIVUSforISRStentUndere

4、xpansion:FinalStentArea：MSA≤5mm2,StentlengthStentEdgeRestenosisStentFractureDESGaporGeographicMiss(Incompletestentcoverage)Non-UniformStentExpansion:Non-uniformStrutDistribution，DESDamageIntimalHyperplasiaBalloonPTCA(also"Cutting"Balloon)Drug-CoatingBalloonsDrug-ElutingStents(DES):SameorDiff

5、erent?BioresorbableScaffordBareMetalStent(BMS)Brachytherapy(VBT)Rotablation(RA)/LaserMedicalManagementCABGTreatmentOptionsofDESISRStrategiesforISRTreatmentDCBorDESSummaryCurrentrestenosisratesarelowerthaneverbutcanstillpresentachallengeWewilltreatrestenosisdifferentlybaseduponthemechanismThe

6、currentmaincauseofISRisstentunderexpansionindifficultlesionssuchascalcified,long,smallvesselsForcomplexlesions,IVUSguidedtailor-madePCIstrategyisimportantTHANKYOU此课件下载可自行编辑修改，仅供参考！感谢您的支持，我们努力做得更好！谢谢