神经介入支架植入术选择ppt参考课件.ppt

Neuroform?重建血管 植入人体动脉瘤病例总结：尸检结果表明： 支架表面完全被内皮细胞覆盖 可见明显的新生弹力纤维组织 动脉瘤颈部内皮化（进一步封闭） 内皮细胞覆盖 动脉瘤内血栓 支架干 死腔内血凝块 （管腔中央的血凝块是死亡后形成的，与支架放置无关） 照片由Rush大学医学中心Demetrius Lopes医生提供 该病例为52岁，男性患者，右颈内动脉动脉瘤，术前抗血小板用药包括：325mg阿司匹林＋75mg 波力维＃ 术前连续应用3天，术中放置一个4.5mm×20mm Neuroform支架；未使用弹簧圈（弹簧圈未能急诊填塞入动脉瘤）。患者于术后122天因与支架放置术无关的原因死亡，尔后进行放射学追踪。 * Neuroform?的长期效果－血管重建 Neuroform支架放置前 Neuroform支架放置后 6个月后随访 影像由John Chaloupka医生提供 Iowa大学医院 * Neuroform?的长期效果－血管重建 Neuroform支架放置前 Neuroform支架放置后 6个月后随访 影像由Martin Schumacher教授 及Ansgar Berlis医生提供（Freiburg，Germany） * Neuroform?临床结果：降低动脉瘤再通率 未置入Neuroform支架的宽颈动脉瘤 置入Neuroform支架的宽颈动脉瘤 * 单用弹簧圈的宽颈动脉瘤Baseline Data Raymond Paper, 2003 132 例宽颈动脉瘤 再通率52.3% Murayama Paper, 2003 276 例宽颈动脉瘤 再通率31.4% 408 例动脉瘤 38% 再通率 * Neuroform治疗在Iowa大学医院的数据 127 例宽颈动脉瘤用Neuroform治疗，在6个月时随访 有9 例再通 Neuroform 组再通率为 9/127 = 7.1% * Neuroform在Duke大学医院的数据 104 例宽颈动脉瘤用 Neuroform治疗 60 例在6个月时随访 20% 再通率 * Neuroform在 Myers Madison的数据 66 例宽颈动脉瘤用Neuroform治疗 44 例在6个月时随访 7% 再通率 * * * * * * This data shows a strong trend, and we are working to formalize and build on this evidence moving forward, as we feel like continued research will show similar results. * This kind of situation has implications in terms of vessel/aneurysm re-access, as well as safety implications…thrombogenicity. Message - Vessel Conformability is CRITICAL, and can be optimized via an open-cell design, where the cells move independently from one another…this facilitates: Conformability in Tapered Vessels Conformability in Tortuous Anatomy Segment Purchase in Vessel at proximal/mid/distal portion of stent Appropriate Scaffolding at Neck, particularly with Treo Design. Enterprise is going to come hard at us based on pictures they took with the NF2 Stent (2-Interconnect). Their attacks will relate directly to stent herniation into the aneurysm dome. We need to SELL the Treo design improvements hard, to minimize the damage from these imminent attacks.