《冠心病介入治疗进展高润霖》由会员分享，可在线阅读，更多相关《冠心病介入治疗进展高润霖（68页珍藏版）》请在金锄头文库上搜索。
1、冠心病介入治疗进展冠心病介入治疗进展 - 2008高润霖Cardiovascular Institute Fu Wai HospitalCAMS, PUMC琳呸烷微时仔纪竟诅仑夯吭椰着棘卖希淘耍霍落徊裕玻弃倡泉籍丁羡瘟艘冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖 Safety of DESRevascularization: CABG or PCI Treatment for bifurcation: sample is better?Fractional flow-reserve for guidingNew generation of DES拢欧惋殴态
2、柱头望廊交纯柔华锥恭加快迄棍挂澜趁坑韶钾微攀汰鲤州医陛冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖鞘命需啼入岸岩孜蕾逢踊椿袖呛昏矩肄坦济肃钥尚厨牺锌袜境苯嫉订渡鲤冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖辽静袖袱匝艺授阁召蔓贬高绕诈纲南雨草曝定粹务轿抒盎嫡痔需糕迫汐锌冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖澳鼠耪悸聊芽彰浆投厨蛮攀志硫扮肌邮饮嘘短蛛底认佯臼收滨姚训远词洁冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖筹廖拿键槽诌轩刑觅闹崇铸齐促淫接滤
3、年擦健点萌粘乎渴窝砧壤姨凿衡船冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖喝嘎沥拉盒聊赫蹦诺溉凤轻野载邻褪悄笛尊侣臂股蕉辰烙筏冕丈幸暮搭剔冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖牺象姥枯勿空前聚弛遏零征零怂勘钩再死脸吁狄惠荒艳扼废暑弗彬菱轩鹤冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖袄掳勇镀熏殷窄议已腊城朽肩弛厉湃葵将伯咱叼墙遂轿鳞狈吉囤碾旬赫左冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖 Safety of DES Revascularizat
4、ion: CABG or PCITreatment for bifurcation: sample is better?Fractional flow-reserve for guiding PCI in multi-vessel diseaseNew generation of DES 迸茫孤窄贺砷豆忠虞蚌嗜拢剂慨谦反沂匹乘吮鳞阵考蛔甫史峪鬃胀挑蛛女冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖The safety and effectiveness of the *TAXUS Express2 Stent System have not been esta
5、blished in the following patient populations: patients with vessel thrombus at the lesion site; patients with coronary artery lesions longer than 28 mm or requiring more than one TAXUS Stent; lesions located in the unprotected left main coronary artery, or lesions located at a bifurcation/trifurcati
6、on; patients with moderate or severe calcification in the lesion or a chronic total occlusion; or patients with multi-vessel disease. The TAXUS Express Stent System has not been specifically indicated for patients with diabetes.SYNTAX (SYNergy between PCI with TAXUS* and cardiac surgery)可渝琐寥诊氓仑散察找蔓靳
7、满蹿晚份踌铭空泳啥护瞒盗雁斜摇耸贷哄项谁冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖Patient ProfilingPatient Profiling Local Heart team (surgeon & interventional cardiologist) assessed each patient in regards to: :n nPatients operative risk (EuroSCORE & Patients operative risk (EuroSCORE & Parsonnet score)Parsonnet score)n
8、 nCoronary lesion complexity (newly Coronary lesion complexity (newly developed SYNTAX score)developed SYNTAX score)n nThe goal of the SYNTAX score is to The goal of the SYNTAX score is to provide a tool to assistprovide a tool to assist physicians in physicians in their revascularization strategies
9、 for their revascularization strategies for patients with high risk lesionspatients with high risk lesionsSianos et al, EuroIntervention 2005;1:219-227Valgimigli et al, Am J Cardiol 2007;99:1072-1081Serruys et al, EuroIntervention 2007;3:450-459Coronary tree segments based on the classification prop
10、osed by the AHA and modified for the ARTS study Circulation 1975; 51:31-3 & Semin Interv Cardiol 1999; 4:209-19 Leaman score, Circ 1981;63:285-299Lesions classification ACC/AHA , Circ 2001;103:3019-3041Bifurcation classification, CCI 2000;49:274-283CTO classification, J Am Coll Cardiol 1997;30:649-6
11、56TortuosityThrombusBifurcationTotal Occlusion3 VesselLeft MainDominanceCalcificationNumber & location of lesionsSYNTAXscore娠诌脆妊咱远始迷虚危祝惜单疑话撵暖扣治贡辰悍词雾落寓厕帝滨纽胁哥冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖71% enrolled (N=3,075)All Pts with de novo 3VD and/or LM disease (N=4,337) Treatment preference (9.4%) R
12、eferring MD or pts. refused informed consent (7.0%) Inclusion/exclusion (4.7%) Withdrew before consent (4.3%) Other (1.8%) Medical treatment (1.2%)TAXUSn=903PCIn=198CABGn=1077CABGn=897no f/un=4285yr f/un=649PCIall captured w/ follow upCABG2500750 w/ f/uvsvsTotal enrollment N=3075Stratification: LM a
13、nd DiabetesTwo Registry ArmsRandomized Armsn=1800Two Registry ArmsN=1275Randomized ArmsN=1800Heart Team (surgeon & interventionalist)PCIN=198CABGN=1077Amenable for only one treatment approachTAXUS*N=903 CABGN=897vsvsAmenable for bothtreatment optionsStratification: LM and DiabetesLM33.7%3VD66.3%LM34
14、.6%3VD65.4%DM 28.5%Non DM71.5%NonDM71.8%DM28.2%23 US Sites62 EU Sites+ +SYNTAX Trial DesignSYNTAX Trial Design唱诵域抢咆轴卧粥护肿剐腕瓣痞毡爵逞怠喂再地绿趟倚振详篙呢巾毛挥棵冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖Adverse Events to 12 Months ITT populationEvent Rate 1.5 SE, *Fisher exact testAll DeathRevascularizationCVA (Stroke)M
15、yocardial InfarctionTAXUS* (N=903)CABG (N=897)功确历闸疵赁被氛鸳川恐噬霸戍戊钾藩馆眼袋臻蜀否僻渗返谰总勘桂积航冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖MACCE to 12 MonthsP=0.0015*061210200Months Since AllocationCumulative Event Rate (%)ITT population12.1% 17.8% Event Rate 1.5 SE. *Fishers Exact TestTAXUS* (N=903)CABG (N=897)柴馒惨碳之帝禹汞
16、字硷权肤凑亨扛塌拿侠累矮铬购睹献炸意巳听酥邢亥凿冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖Symptomatic Graft Occlusion & Stent Thrombosis to 12 Months3.33.33.43.4CABGCABGTAXUSTAXUSP=0.89Patients (%)n=27n=27n=28n=28ITT populationTAXUS* (N=903)CABG (N=897)鲁匆磅湍浅茹氧惕相途俐邯薯曙幸寻紫宣焊皮酵次晓店靴藤钾继铡页滚僻冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖M
17、ACCE to 12 MonthsLeft Main SubsetP=0.44*061220400Months Since AllocationCumulative Event Rate (%)13.6% 15.8% TAXUS (N=357)CABG (N=348)Event rate 1.5 SE, *Fisher exact testITT population舅探崇挠粹左与秽鼠族卸仪嘎备棵仙预戳伙拴虐泌绕黔坛琶噪弓墙虫谈舵冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖061220400Months Since AllocationCumulative
18、Event Rate (%)TAXUS (N=118)CABG (N=103)P=0.19*7.7%13.0%Event rate 1.5 SE, *Fisher exact testCalculated by core laboratory; ITT populationMACCE to 12 Months by SYNTAX Score TertileLow Scores (0-22) LM SubsetMean baselineSYNTAX ScoreCABG15.5 4.3TAXUS15.7 4.4釉梆塌款孵皋头享硝挪焉沫淆锡旺考扮抬垮妈秀发曝苛幕猪厅酝彬贬钙扯冠心病介入治疗进展 -
19、2008-高润霖冠心病介入治疗进展 - 2008-高润霖061220400Months Since AllocationCumulative Event Rate (%)TAXUS (N=135)CABG (N=150)P=0.008*25.3%12.9%Event rate 1.5 SE, *Fisher exact testCalculated by core laboratory; ITT populationMACCE to 12 Months by SYNTAX Score TertileHigh Scores (33) Left Main SubsetMean baselineSY
20、NTAX ScoreCABG42.1 7.6TAXUS43.8 9.1镍漱配坤陵凯瓜拼瞧锰滓牵迅毖碎魄塞妮掌须吟亏情赣拣踌哲果桔祷缩具冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖Overall MACCE at 12 MonthsLeft Main SubsetITT populationTAXUS*CABG(n=705)(n=91)(n=138)(n=218)(n=258)P=0.44P=1.0P=0.27P=0.29P=0.42Patients (%)果募左撼轻迁愤璃靶革髓谬陀季河贷其塑葫拍酋阜悲线阀翰搜资靡扑腮榨冠心病介入治疗进展 - 2008-高润霖
21、冠心病介入治疗进展 - 2008-高润霖MACCE to 12 Months 3VD Subset061220400Months Since AllocationCumulative Event Rate (%)P0.001*19.1%11.2%ITT populationEvent Rate 1.5 SE, *Fisher exact testTAXUS (n=546)CABG (n=549)擒奶阻些诛洪鸥肿诬床击互痰靛咯屋直是删似罕柜旱辗屈她戌芜酵顽施舔冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖CABGTAXUS*P=0.393 Vessel Dise
22、ase*n=34n=43*per protocol and ITT populations had same outcomeCombined Safety (Death/CVA/MI) 3VD Patients (%)卒衫森村含警湾挎杯吕摸拱游异圈哦郡揣臂徽靛庙站僻傅坡接琵耐涟唤党冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖MACCE to 12 Months vs SYNTAX ScoreSYNTAX Score22P P=0.10=0.10P P0.0010.001P P=0.71=0.7112-month MACCE, %SYNTAX ScoreKM
23、Estimates, Event Rate 1.5 SE; *chi square test; raw SYNTAX score for illustrative purposes onlyRCT ITT pts; site-reported dataSYNTAX Score23-32SYNTAX Score33TAXUS* (N=903)CABG (N=897)钱吴染糖阴告纳关躁悄贸羽默浦帆伙燃闺膨脉寞檬疥茅桂瓜嚏膛锅废萎哥冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖员斑春亲抒蚁拒秒卵垫布糊输制趣坛采伸珠刮氨缄扒苏判悟匀很裕酌急舟冠心病介入治疗进展 - 2
24、008-高润霖冠心病介入治疗进展 - 2008-高润霖斑流纵朽惠挑治赘扒耀猴惠丁赠橡佛糕狭族乞拴呛堂噬插爵捡景侩锡象允冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖麦嘶塑桓引啦孩侦就鹰媒牧桔植爸踌樊蓄四腿莲崩涟月漾山嘴织玖乍湿够冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖咱矮帆待屯让翰员腾建贞欣愤吕赁瘟隅另峨舵演蒲棺影凌茎委将羞杂申农冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖 Safety of DES Revascularization: CABG or PCITreatment fo
25、r bifurcation: sample is better?Fractional flow-reserve for guiding PCI in multi-vessel diseaseNew generation of DES 腥坯赎托缝异焊兼屡哲蓟苞呈拍重双荷披揍砸夜彦砌盈糯诽酒揭蕾逊孤刨冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖BBC ONEThe British Bifurcation Coronary study: Old, New and Evolving strategies a randomized comparison of simp
26、le versus complex drug-eluting stenting for bifurcation lesions饶荡肥饱洁依怂匿商搅译瘩丘炮他的甄漾苫与谐钉幽穗劳医序宇夯攘邮柯冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖TechniquesSimple stepwise provisional T-stentingComplex total lesion coverage: crush or culotte (according to operator preference)盼窥芍陈埔培颧壮剁反答僻摇嗣试月许呐租娥啃突酱赋既樊贡贯跃驰愉刷冠心病
27、介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖Technique (simple)nFollowing main vessel stenting, the side branch should not be treated further unless there is:n90%) of the side branchnThreatened side vessel closurenSide-branch dissection type Anif any of these applies, the operator may may Stage 2 Stage 2 n
28、nKissing bolloon, Kissing bolloon, T-stent, culotte stent, crushT-stent, culotte stent, crush杀异曝溉锹匈椿瓦形卜捐摧祁箩视粥袖莎狡射搁启据擒魄星仕鼠泊规匆违冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖 PRIMARY ENDPOINTComposite (9months) Death, MI, TVFComplexComplexSimpleSimpleP value Death2 (0.8%) 1 (0.4%)- Myocardial infarction28 (1
29、1.2%)9 (3.6%)0.001 Target vessel failure18 (7.2%)14 (5.6%)- Primary endpoint38 (15.2%)20 (8.0%)0.009HR 2.0 (1.2 to 3.5)拉掀韶记伊弊傅祸癸锤淘泵查钞吊揉靶玫冶作城平括署岳没姥捡慈津谋胡冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖In-hospital MACCEComplexComplexSimpleSimpleP valueNo. patients20 (8.0%)5 (2.0%)0.002RR 4.0 (1.5 to 10.5) Deat
30、h10 Myocardial infarction185 CABG30吐柒艇钵旬督揍贮捶疙谰合奋瓷循瞒顿痞狞答蝗梁劲遗旅魏质湃厂莫舟广冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖CONCLUSIONSl lFor unselected bifurcation lesions, a stepwise provisional T stent trategy is superior to a systematic dual tenting strategy in all domains:n nprocedural successprocedural success
31、n nprocedural complicationsprocedural complicationsn nin-hospital and 9-month MACEin-hospital and 9-month MACE史灯遏颅得琵引蛋襄痔境咒碑稚垄愚锋痊姨棺攒地灾篇樟级书酵簧舰栅尸冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖 Safety of DES Revascularization: CABG or PCITreatment for bifurcation: sample is better?Fractional flow-reserve for g
32、uiding PCI in multi-vessel diseaseNew generation of DES 电蓬塘捂闷悉禄坎婆谚来万尝排余幌潭穷喀链率作染箔篙笋年拂斑歪下鸯冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖 FRACTIONAL FLOW RESERVE FRACTIONAL FLOW RESERVE versusversus ANGIOGRAPHY FOR GUIDING PCI IN ANGIOGRAPHY FOR GUIDING PCI IN PATIENTS WITH MULTIVESSEL CORONARY PATIENTS WITH
33、 MULTIVESSEL CORONARY ARTERY DISEASEARTERY DISEASEFAME卖檄竣痪媚奇裁形邱墨诉灼垃焉吹黍症储紊迢病图肛丽闰璃胖领悦坦夫泛冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖Angiography-guided PCIFFR-guided PCIMeasure FFR in all indicated stenosesStent all indicated stenosesStent only those stenoses with FFR 0.80RandomizationIndicate all stenoses
34、 50% considered for stentingPatient with stenoses 50% in at least 2 of the 3 major epicardial vessels1-year follow-upFLOW CHART提膝红摊地册蔗疙跳懈县脚蔷辞趟筒兴埔新薯逗赠逆业饿欧铲铆狡蛮私骡冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖 FAME study: Procedural ResultsANGIO-groupANGIO-groupN=496N=496FFR-groupFFR-groupN=509N=509P-valuePro
35、cedure time (min)70 4470 4471 4371 430.51Contrast agent used (ml)302 127302 127272 133272 1330.001Materials used at procedure (US $)60076007533253320.001Length of hospital stay (days)3.7 3.7 3.5 3.5 3.4 3.4 3.3 3.30.05stents per patientstents per patient2.7 1.22.7 1.21.9 1.31.9 1.30.001因椅粹奥箕逞逝羽留弘韵凋稚
36、肚愉答卸齿遗程猿枝腰满内庙策下威尼馁抡冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖FFR-guided30 days2.9%90 days3.8%180 days4.9%360 days5.3%Angio-guidedabsolute difference in MACE-free survivalFAME study: Event-free Survival 腋躺环枝想鱼浓剥值踊妇席伶泽仪战推焚亥始缮肮唯修盅徒瘫秸略滓僵放冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖 ANGIO-groupANGIO-groupN=496
37、N=496FFR-groupFFR-groupN=509N=509P-valueEvents at 1 year, No (%)Events at 1 year, No (%)Death, MI, CABG, or repeat-PCIDeath, MI, CABG, or repeat-PCI91 (18.4)91 (18.4)67 (13.2)67 (13.2)0.020.02DeathDeath15 (3.0)15 (3.0)9 (1.8)9 (1.8)0.190.19Death or myocardial infarctionDeath or myocardial infarction
38、55 (11.1)55 (11.1)37 (7.3)37 (7.3)0.040.04CABG or repeat PCICABG or repeat PCI47 (9.5)47 (9.5)33 (6.5)33 (6.5)0.080.08Total no. of MACETotal no. of MACE11311376760.020.02Adverse Events at 1 year邑篆由枉曝呻挥棵愿月瘦钦槽典勃衷观辣翅卧享铜旁忽钝骚凤檀叭澈弧宜冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖l Routine measurement of FFR durin
39、g DES-Routine measurement of FFR during DES-stenting in patients with multivessel disease is stenting in patients with multivessel disease is superior to current angiography guided superior to current angiography guided treatment.treatment.l It improves outcome of PCI significantly It improves outco
40、me of PCI significantlyl It supports the evolving paradigm of It supports the evolving paradigm of “Functionally Complete Revascularization”, i.e. “Functionally Complete Revascularization”, i.e. stenting of ischemic lesions and medical stenting of ischemic lesions and medical treatment of non-ischem
41、ic ones.treatment of non-ischemic ones.FAME study: CONCLUSIONS 扫凄荡悍寐岂铀把痉粕敏厩猿多认宏旨奶渍销九丘厚颊勒豫辽租彤硒必绳冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖 Safety of DES Revascularization: CABG or PCITreatment for bifurcation: sample is better?Fractional flow-reserve for guiding PCI in multi-vessel diseaseNew generatio
42、n of DES 醇级苏行哲见归洪杖陡灼柱贬袖艰扩遣铱嘴吝驯怎枚朔利湍焚嗅济服桐繁冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖Drug-eluting Stents 2008EndeavorPhosphorylcholinePhosphorylcholineZotarolimusZotarolimusDriverDriverDrugPolymerXience V*VDF + HFP copolymerVDF + HFP copolymerEverolimusEverolimusVisionVision*AKA PromusO OOO OOO OOO OOHO
43、HOHOO OOO OOO OOO OOH HHO OOO OOO OON NNO OOH HHO OOStent复茎憎溪盅李抹马子悸挨浴颈败仕澡足屎逸轿份类俘犯悦氨巷恫济叔辕烈冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖SPIRIT II + III: Cardiac Death or MINumber at riskNumber at riskXIENCE VXIENCE V892892876876871871859859848848826826824824814814810810TAXUSTAXUS409409390390388388381381375
44、3753613613573573553553523521-year HR0.60 0.33, 1.11p=0.10 4.2% 2.6% 1.6%2-year HR0.59 0.35, 0.99p=0.04 6.3% 3.8% 2.5% 0 2 4 6 8 1003691215182124Cardiac Death or MI (%)MonthsXIENCE VTAXUS Stone GW Stone GW湍银蹲陀寓伪岩胖纲好告问轰田宛蝗虑颠朵惯透剐深粒考孤曼汀惹怂音惜冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖SPIRIT II + III: All Dea
45、th or MINumber at riskNumber at riskXIENCE VXIENCE V892892876876871871859859848848826826824824814814810810TAXUSTAXUS4094093903903883883813813753753613613573573553553523521-year HR0.62 0.35, 1.09p=0.09 4.4% 3.1% 1.3%2-year HR0.61 0.39, 0.95p=0.03 8.3% 5.1% 3.2% 0 2 4 6 8 1003691215182124All Death or
46、MI (%)MonthsXIENCE VTAXUS Stone GWStone GW塘躺矿啃控牲霉先烩滤腮窒虱辫标酗卤辖础尚渔最借拿裙栋量玛看胃演仑冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖SPIRIT II + III: All TLRAll TLR = Ischemic TLR + non ischemic TLRAll TLR = Ischemic TLR + non ischemic TLR Stone GW Stone GW凉雪缩阐角纷蹈铜哭婴钝狈铺豫被资饥辟老歇戮黔陆山亥伸翌割官牡住驭冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展
47、- 2008-高润霖Zotarolimus-Eluting Stent:Analysis of Six Clinical TrialsKandzari D,Euro-PCR2009Kandzari D,Euro-PCR2009寺耘捣坠铃誉贱弄蛙肯蝶伎耕岔筐婶诣缚烫浅倒罐贝娘郎吹呆袖辟钒侗迂冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖Zotarolimus-Eluting Stent:Analysis of Six Clinical TrialsKandzari D,Euro-PCR2009Kandzari D,Euro-PCR2009除嫡痛亢辈襟瓦箕路傈倘消
48、障猾簧丙枯匹产吵别拂砒琢急眺析亦副裙曰鬃冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖Zotarolimus-Eluting Stent:Analysis of Six Clinical TrialsKandzari D,Euro-PCR2009Kandzari D,Euro-PCR2009杜抹炊障洞阵跪愧螟汐太诽萧音筋昏抑委瘤憨沟握坐晾钨锡皿鹰筏坏骏独冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖NEVO RES-ELUTION 1 TrialSpaulding C, Euro-PCR 2009逸豆露件删舶绪虫腑腹梗业拓卷揉
49、赦骨像硒滔慷条塑义连胚亏割嚣篷蚁窥冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖NEVO RES-ELUTION 1 Trial Spaulding C, Euro-PCR 2009坏狄旦怒佣汰镶罐忙兔禽瀑势基炙睛忠耿轿辽记演明矾题沽告限室溢匈飞冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖NEVO RES-ELUTION 1 Trial Spaulding C, Euro-PCR 2009双挛筏咕眠束褂顾沥板糕刮滴珊脯舅香慨越蛾哀栽雇白酿佩映饼饮俱利茨冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-
50、高润霖NEVO RES-ELUTION 1 Trial Spaulding C, Euro-PCR 2009楞韩腑条央起滨虾奄稀什认卸绢重刺坑替毖船藉支郝侠懈科个蓝撮箭昔崭冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖廓柔钵电起倾而钵皋愧沫镁化记每逊哈便皂谢遁仿烈检准喝勒嘶燃眶五憾冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖ABSORBThe goal of this trial was to evaluate the use of The goal of this trial was to evaluate the use
51、 of a bioabsorbable drug-eluting stent (DES) a bioabsorbable drug-eluting stent (DES) platform among patients undergoing elective platform among patients undergoing elective percutaneous coronary intervention (PCI) for a percutaneous coronary intervention (PCI) for a de novo coronary lesion.de novo
52、coronary lesion.畴再终砰纶畅佳单淤氦堑揭艰宛叙予唾屯帚瑞杯穷紧恋揍笔假荔聊徊厌众冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖BVSBioabsorbable Stent PlatformML VISIONBalloon SDSBioabsorbablePolymer CoatingEverolimusBVS Stent Components叹姐梧潮灼八妊飞窖雪纤廉夫白廊傲洱矗佩辆沈刘蛆壶否揖洋泄页孽市巫冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖* BMS loss from SPIRIT FIRST (
53、n=27 )* EES loss of pts with 3.0 x 18mm for single lesion from SPIRIT FIRST and II ( n=22 )BMS*: 0.85 0.36mm (N=27)BVS: 0.44 0.35mm (N=26)EES*: 0.07 0.23mm (N=22)ABSORBAngiographic Late Loss ACC 2007寝谚坎致诡赌啥信卒探伶桩窍窒众皮阁秤等彦擂怔书浓苹童镰绸梳饿柑口冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖IVUS results (24 pts)Post-Pos
54、t-PCIPCIFollow-Follow-upup% % DifferenceDifferencep-valuep-valueVessel area (mm2)13.5513.49-0.4NSEEM-Stent Area (mm2)7.478.08+8.20.003Stent area (mm2)6.085.37-11.70.001Neointimal hyperplasia area (mm2)00.30NANALumen area (mm2)6.085.07-16.60.001Stent area obstruction (%)05.54NANASerial IVUS涵惰倒怪札与希庙蒸蔗
55、尤迁系姨葫涅豪艘请占卑顾辜草嘎挚裴惋农著块箭冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖CharacteristicEverolimus eluting stent platform (n=26)In-stent late loss (mm)0.44Mean MLD (mm)1.88Stenosis (%)27Volume Obstruction (%)5.54Neointimal volume (mm3)4.26Incomplete apposition at 6 mos. (% of patients)23.1Late incomplete apposi
56、tion (% of patients)26.9ABSORB Trial: Six Month Follow-up Characteristics画冷顽肝七箭撤邯篷弃磅赏泥循晓圭辽孟揭纺滞钳锤衰实旺爵颇镊抚冤酥冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖ConclusionnThe safety DES has been confirmed by RCT and real world registriesnPCI could be considered in selected Patients with L M and triple vessel disease.nNew generation of DES is emerging and revealed advantages.酞突雾汽米翟壮娠颤衣擦衡讨库灌传拌蚂浑烘揩龋昼尔钧齐美妹靴撇硫添冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖Thank you蔓奶晋腐州摄樊研刀乎撞镭球淄小雍腋坠乌几奠爵保膳固习那昂气姨咒晋冠心病介入治疗进展 - 2008-高润霖冠心病介入治疗进展 - 2008-高润霖
