肾动脉支架植入术图文详解.pptx

Endovascular Treatment of Renal Artery Stenosis肾动脉支架植入术图文详解第1页Clinical Indications(Procedures)肾动脉支架植入术图文详解第2页Anatomy肾动脉支架植入术图文详解第3页Kidney anatomy肾动脉支架植入术图文详解第4页Endovascular Treatment of Renal Artery StenosesAim of the treatment1)Renovascular Hypertension 2)Renal Insufficiency肾动脉支架植入术图文详解第5页Renovascular Hypertension5%of all hypertensive patientsDue to atherosclerosis or FMDDiagnosed after Surgical follow-up or PTRA.PTRA does not cure Essential Hypertension 肾动脉支架植入术图文详解第6页Renal InsufficiencyNephrosclerosis after RAS or occlusionPTRA is indicated to reverse or prevent the decline of kidney functions8cm long kidney is the lower limit after which kidney function might be compromised肾动脉支架植入术图文详解第7页Indications for PTRAFailed medical therapyReducing drug treatmentPressure gradient 10%More than 50%stenosisAssymmetrical loss of renal mass肾动脉支架植入术图文详解第8页Endovascular Treatment of Renal Artery Stenoses1)Treatment of artheriosclerotic ostial lesions(80%)dilatation+stenting2)Treatment of post ostial lesions dilatation(stenting if necessary)3)Treatment FMD dilatation(stenting if necessary)肾动脉支架植入术图文详解第9页Post-ostial lesion肾动脉支架植入术图文详解第10页Fibro-Muscular Dysplasia肾动脉支架植入术图文详解第11页Fibro-Muscular Dysplasia肾动脉支架植入术图文详解第12页Restenosis after stentingRecent studies have indicated rates are between 10-20%(much better than the 30%with just PTA).肾动脉支架植入术图文详解第13页Treatment OptionsMedical TreatmentPTA with StentingSurgeryDialysis:Renal Function never get better肾动脉支架植入术图文详解第14页Gold standard treatment todayMedical treatmentACE inhibitors and a new class of Angiotensin receptor blockers 肾动脉支架植入术图文详解第15页Endovascular Options:PTA or Stenting?1999:Peter Van de Ven,randomized trialPTA vs Stenting in ostial lesionPTAStentingNumber of patients4243Primary patency rate29%75%Primary success rate57%88%Restenosis post-procedure48%14%肾动脉支架植入术图文详解第16页Literature肾动脉支架植入术图文详解第17页Product Strategies014”Cardiologist,Radiologists,Vasc Surgeons.Balloon:M3 RxStents:Corinthian IQ on M3Wire,Stabilizer 7-8F Vista Brite Tip or IG035 Radiologist who are used to traditional PTA balloons,More range in PTA balloonsBalloons:P3,Opta ProStents:Genesis premounted on OPTA-PROWire 035,Jindo,Storq8F Vista brite Tip or IG肾动脉支架植入术图文详解第18页A new approach:.018!A GOOD COMPROMISE!Radiologist who are used to traditional PTA balloons,More range in PTA balloonsBalloons:SlalomStent:Genesis premounted on OPTA-PROWire 018,SV6-7F Vista brite Tip or IG肾动脉支架植入术图文详解第19页Advantages of.014 systemsLess spasm with.014 wireLess wire lengthSmaller puncture siteStent protected by GCGood support肾动脉支架植入术图文详解第20页Endovascular Treatment of Renal Artery Stenoses 1)Through the groin using 8F materialsCan be downsized to 7F using M3肾动脉支架植入术图文详解第21页肾动脉支架植入术图文详解第22页Emerald.035肾动脉支架植入术图文详解第23页Emerald.035+Pigtail Tempo 4-5F 65cm肾动脉支架植入术图文详解第24页Emerald.035+Renal Curve Tempo 4F 65cm肾动脉支架植入术图文详解第25页Emerald.035+Renal Curve Tempo 4F 65cm肾动脉支架植入术图文详解第26页Emerald.035+RDC Vista Brite Tip 8F 55cm肾动脉支架植入术图文详解第27页Emerald.035+RDC VBT 8F 55cm+Opta Pro肾动脉支架植入术图文详解第28页Emerald.035+RDC VBT 8F 55cm+Opta Pro肾动脉支架植入术图文详解第29页Emerald.035+RDC VBT 8F 55cm+Opta Pro肾动脉支架植入术图文详解第30页Emerald.035+RDC VBT 8F 55cm肾动脉支架植入术图文详解第31页Emerald.035+RDC VBT 8F 55cm+Corinthian IQ on Opta Pro肾动脉支架植入术图文详解第32页Emerald.035+RDC VBT 8F 55cm+Corinthian IQ on Opta Pro肾动脉支架植入术图文详解第33页Emerald.035+RDC VBT 8F 55cm+Corinthian IQ on Opta Pro肾动脉支架植入术图文详解第34页Emerald.035+RDC VBT 8F 55cm+Corinthian IQ on Opta Pro肾动脉支架植入术图文详解第35页Emerald.035+RDC VBT 8F 55cm+Corinthian IQ肾动脉支架植入术图文详解第36页Endovascular Treatment of Renal Artery Stenoses2)Through the groin using the new 6F materials肾动脉支架植入术图文详解第37页肾动脉支架植入术图文详解第38页.014 Stabilizer肾动脉支架植入术图文详解第39页.014 Stabilizer+6F Brite Tip Sheath 55cm肾动脉支架植入术图文详解第40页.014 Stabilizer+6F BTS 55cm+RDC Tempo 4F肾动脉支架植入术图文详解第41页.014 Stabilizer+6F BTS 55cm+RDC Tempo 4F肾动脉支架植入术图文详解第42页.014 Stabilizer+6F BTS 55cm+RDC Tempo 4F肾动脉支架植入术图文详解第43页.014 Stabilizer+6F BTS 55cm+RDC Tempo 4F肾动脉支架植入术图文详解第44页.014 Stabilizer+6F BTS 55cm+M3肾动脉支架植入术图文详解第45页.014 Stabilizer+6F BTS 55cm+M3肾动脉支架植入术图文详解第46页.014 Stabilizer+6F BTS 55cm+Corinthian IQ on M3肾动脉支架植入术图文详解第47页.014 Stabilizer+6F BTS 55cm+Corinthian IQ肾动脉支架植入术图文详解第48页Endovascular Treatment of Renal Artery Stenoses3)Through a brachial access肾动脉支架植入术图文详解第49页Tempo 4F MP+.014 Stabilizer肾动脉支架植入术图文详解第50页Brite Tip Sheath 6F 90cm+.014 Stabilizer肾动脉支架植入术图文详解第51页Brite Tip Sheath 6F 90cm+.014 Stabilizer肾动脉支架植入术图文详解第52页Brite Tip Sheath 6F 90cm+RDC Tempo 4F+.014 Stabilizer肾动脉支架植入术图文详解第53页BTS 6F 90cm+.014 Stabilizer肾动脉支架植入术图文详解第54页BTS 6F 90cm+.014 Stabilizer+M3肾动脉支架植入术图文详解第55页BTS 6F 90cm+.014 Stabilizer+M3肾动脉支架植入术图文详解第56页BTS 6F 90cm+.014 Stabilizer+Corinthian IQ on M3肾动脉支架植入术图文详解第57页BTS 6F 90cm+.014 Stabilizer+Corinthian IQ on M3肾动脉支架植入术图文详解第58页BTS 6F 90cm+.014 Stabilizer+Corinthian IQ on M3肾动脉支架植入术图文详解第59页Endovascular Treatment of Renal Artery StenosesProceduralPost procedure肾动脉支架植入术图文详解第60页Endovascular Treatment of Renal Artery StenosesPre operativePost operative肾动脉支架植入术图文详解第61页