CTO导丝

CTO导丝的选择中山大学附属第一医院杜志民CTO导丝的选择•CTO病变的特点•CTO正向导丝通行技巧•导丝的基本结构•几种新导丝的特点30-50%CTOwithMicro-channelsCTO导丝的选择•CTO病变的特点•CTO正向导丝通行技巧•导丝的基本结构•几种新导丝的特点钻行技术穿行技术滑行技术CTO导丝的选择•CTO病变的特点•CTO正向导丝通行技巧•导丝的基本结构•几种新导丝的特点PolymercoverwithHydrophilicCoatingHydrophilicCoatingHydrophobicCoatingNoCoatingCTO导丝的选择•CTO病变的特点•CTO正向导丝通行技巧•导丝的基本结构•几种新导丝的特点几种滑导丝FielderFC&FielderXT0.009”FielderXTFielderFC11cmSpringCoil3cmRadio-opaqueCoil0.014”20cmPolymerSleeve&SLIPCOAT®PTFECoatingStainlessSteelCore16cmRadio-opaquespringcoil16cmPolymerSleeve&SLIPCOAT®0.014”PTFECoatingStainlessSteelCoreFielderFC11cm弹簧圈段3cm显影段0.014”20cm聚合物及亲水涂层PTFE涂层不锈钢核心FielderX-treme16cm显影的弹簧圈段16cm聚合物包裹及涂层0.014”不锈钢核心0.009”XT-AXT-RPTFEcoatingRopecoil&Radiopaquesegment3cmSLIPCOAT®Hydrophiliccoating21cmSpringcoil18cmStainlesssteelhigh-tensioncore0.014”TIPLOAD:0.5G3300mm80mm1600mm（硅油涂层）φ0.26mm(0.010”)φ0.26mm(0.010”)30mm：Pt50mm：SUS1700mm（亲水涂层）•GW直径；0.026mm(0.010”)•有效长度；330cm•弹簧圈长度；80mm（Pt：SUS=30mm：50mm）•亲水涂层长度；1700mm•头端负荷；3gProductInformation33CoreTechnologiesinWireDesignDrawingTorque+WireFormingTorque+CoatingCoreCoilGuideWire34Structure・Radiopaquelength：3cm・Coatinglength：28cm（Fullcoating）・Tipload：0.7gJoint-lessspringcoilCompositeCore35ACTONECoilTwistcoreCorewireCompositeCoreSixwireropeHollowtube36CoilCorewireCompositeCoreTwistcore37CompositeCoreTheCompositeCoreImprovesTorqueandTipShapeRetention1．Tipbreakage＝KinkinCorewire→ACTONEprotectstheCorewire2．PreventsTorque“Whip”→Preventswhipbystoppingtorquebuild-up38CompositeCoreACTONEbenefits1．Shapeprotection2．TorquetransmissionTwistcorebenefits1．Strongertip→CompositeCoreallowsforasmallerdiametercorewire2．Negates“whipping”几种硬导丝HI-TORQUEPROGRESSGuideWireIn-ServiceforOUSLT2929781RevG©2010AbbottLaboratories.InformationcontainedhereinfordistributionoutsideoftheUS&JapanonlyHI-TORQUEPROGRESS:新一代慢性闭塞病变导丝AsahiMiracleBros3不锈钢聚合物护套/混合涂层穿透力高性能标准穿透力低穿透力高TestsperformedbyanddataonfileatAbbottVascularAsahiMiracleBros12CROSS-IT200XT|300XTCROSS-IT100XTAsahiMiracleBros4.5CROSS-IT400XTAsahiConfianzaPro9|12AsahiFielderXTHTPROGRESS40HTPILOT50|150|200HTPROGRESS80HTPROGRESS120HTPROGRESS140THTPROGRESS200THI-TORQUEPROGRESSGuideWireIn-ServiceforOUSLT2929781RevG©2010AbbottLaboratories.InformationcontainedhereinfordistributionoutsideoftheUS&Japanonly3cmradiopaquecoil29.5cmpolymersleeveTestsperformedanddataonfileatAbbottVascularSMOOTHGLIDE:疏水涂层有助于器械在导丝的近段移动TURBOCOAT:亲水涂层使导丝远段在长时间手术过程中保持润滑头端直径:0.012”(40,80,120)0.0105”(140T,锥形)0.009”(200T,锥形)中段聚合物护套覆盖亲水涂层:使导丝在病变中具有最大的可操控性CORE-TO-TIPDURASTEEL:高强度的核芯材质和核芯至头端设计提供了出色的扭控反应和导丝的保持塑形能力RESPONSEASE:距离导丝头端12cm无过渡节段的核芯避免了脱垂点的产生最大幅度地减少了导丝打折，并提供可靠的导丝操控头端弹簧圈:5mm裸露头端便于产生触觉反馈引领慢性闭塞病变导丝技术:HI-TORQUEPROGRESS系列导丝HI-TORQUEPROGRESSGuideWireIn-ServiceforOUSLT2929781RevG©2010AbbottLaboratories.InformationcontainedhereinfordistributionoutsideoftheUS&JapanonlyHI-TORQUEPROGRESS系列导丝HI-TORQUEPROGRESS40其特点为具有保持塑形的头端，是探索或滑行的理想器械HI-TORQUEPROGRESS80头端设计便于滑行或钻行HI-TORQUEPROGRESS120提供更硬的头端以便钻行HI-TORQUEPROGRESS140T锥形头端(0.0105”)便于穿刺慢性闭塞病变HI-TORQUEPROGRESS200T具有0.009”直径的头端以便穿刺慢性闭塞HI-TORQUEPROGRESSGuideWireIn-ServiceforOUSLT2929781RevG©2010AbbottLaboratories.InformationcontainedhereinfordistributionoutsideoftheUS&JapanonlyHI-TORQUEProgress设计优点穿透力采用穿透力便于慢性闭塞导丝的直接比较050100150200250MiracleBros3MiracleBros4.5PROGRESS40MiracleBros6PROGRESS80MiracleBros12PROGRESS120Confianza9PROGRESS140TConfianzaProConfianzaPro12PROGRESS200TTestsperformedbyanddataonfileatAbbottVascularKg/inch²导丝的选择•Alwaysstartwith–thesoftwires•Quicklyupgrade–tostifferwires–inastepupstrategyAs30-50%CTOwithMicro-channelsAsmicro-channelsaresometimesnotvisible导丝的选择Whichwireandwhen？Micro-channelvisible：Plasticjacketorhydrophilicwire–FilelderXT,FilelderFC&Fleider–Pilot50–RunthroughNSSeverefibrocalcificsegment：Stiffextrasupportwires–Miracleseries3,4.5,6,12gm–CrossIT100,200,,300,400–Intermediatewires–Conquestpro,9/12gm