雅培ProGlide-血管缝合器.ppt

Proglide March 19,2010 Beijing ProGlide OverviewApril 2007LT29258741.2007 Abbott LaboratoriesProGlide ComponentsProGlide OverviewApril 2007LT29258742.2007 Abbott LaboratoriesSheathHemostasis ValveRestricts the blood flow through the sheath while the sheath is in the artery.Guide Wire Exit PortDirects the guide wire out of the sheath through the GW port Tapered Sheath6F compatibleProGlide OverviewApril 2007LT29258743.2007 Abbott LaboratoriesDistal Guide and FootDistal Guide Houses the foot,suture bearing and O-ringDesigned to provide easy device insertion FootProvides tactile resistance against the arterial wallProGlide OverviewApril 2007LT29258744.2007 Abbott LaboratoriesProximal GuideAuto-Tie monofilament knot is housed in the distal Proximal GuideProGlide OverviewApril 2007LT29258745.2007 Abbott LaboratoriesHeat-Formed KnotHeat forming process creates permanent shape of knot in sutureProGlide OverviewApril 2007LT29258746.2007 Abbott LaboratoriesMonofilament SutureNon-absorbable 3-0 polypropylene suture(Prolene)Suture of choice by vascular surgeons due to:Minimized inflammatory responseHigh-knot tensile strengthReduced perception of infectionKnot at 28 DaysPost implantProGlide OverviewApril 2007LT29258747.2007 Abbott LaboratoriesBody ComponentsBodyQuickCutMarker LumenLeverHandleCollarPlungerProGlide OverviewApril 2007LT29258748.2007 Abbott LaboratoriesBody ComponentsMarker LumenProvides visual confirmation that device is correctly positioned in the vesselProGlide OverviewApril 2007LT29258749.2007 Abbott LaboratoriesBody ComponentsQuickCutAllows for sterile cutting of suture limbsProGlide OverviewApril 2007LT292587410.2007 Abbott LaboratoriesBody ComponentsLeverOpens and Closes FootProGlide OverviewApril 2007LT292587411.2007 Abbott LaboratoriesBody ComponentsBodyHouses Suture,Needles and Lever MechanismsProGlide OverviewApril 2007LT292587412.2007 Abbott LaboratoriesSuture TrimmerThumb KnobOpens Suture Gate when slid backwardsProGlide OverviewApril 2007LT292587413.2007 Abbott LaboratoriesSuture TrimmerSuture Trimmer LeverTrims/Cuts suture above arteriotomyProGlide OverviewApril 2007LT292587414.2007 Abbott LaboratoriesSuture TrimmerSuture GateAllows suture to be placed coaxial to Suture TrimmerProGlide OverviewApril 2007LT292587415.2007 Abbott LaboratoriesDeployment StepsProGlide OverviewApril 2007LT292587416.2007 Abbott LaboratoriesDevice Pre-Deployment ReviewFemoral angio to evaluate L(location),S(size)D(disease)IEAIEA$CFASheath Insertion SiteCFASheath Insertion SiteProGlide OverviewApril 2007LT292587417.2007 Abbott LaboratoriesDeployment Positioning Advance ProGlide into artery until pulsatile flow is achievedProGlide OverviewApril 2007LT292587418.2007 Abbott LaboratoriesFoot DeploymentLift lever to deploy footRetract device a)until tactile sensation of foot against anterior wall of artery b)cessation of mark occursProGlide OverviewApril 2007LT292587419.2007 Abbott LaboratoriesNeedle DeploymentDepress plunger until collar meets bodyProGlide OverviewApril 2007LT292587420.2007 Abbott LaboratoriesSuture RemovalPlunger withdrawalProGlide OverviewApril 2007LT292587421.2007 Abbott LaboratoriesFoot ParkingProGlide OverviewApril 2007LT292587422.2007 Abbott LaboratoriesSuture PresentationDeliberately retract device until GW exit port is at skin levelHarvest suture limbsWhite non-rail makes it tightBlue limb-rail ProGlide OverviewApril 2007LT292587423.2007 Abbott LaboratoriesKnot AdvancementWrap rail limb around left index finger,holding gentle tension on rail,coaxialRemove device with right hand as you pull tension on rail ProGlide OverviewApril 2007LT292587424.2007 Abbott LaboratoriesKnot Advancement with Suture TrimmerPlace non-rail onto left index finger and pinch with thumbWith right hand,load both limbson suture trimmerAdvance suture trimmer down to arteriotomyRelease non-rail limb and move to one-handed techniqueProGlide OverviewApril 2007LT292587425.2007 Abbott LaboratoriesKnot Advancement with Suture TrimmerWith guitar string tension,keep the trimmer coaxial to suture with rail limb over thumb knob for 10 secondsMove trimmer to 75 cranial and then back down to 45Tighten knot by gently pulling back on white non-railProGlide OverviewApril 2007LT292587426.2007 Abbott LaboratoriesHemostasisRemove suture trimmer from tissue tractTest security of close by having patient bend legProGlide OverviewApril 2007LT292587427.2007 Abbott LaboratoriesSuture TrimmingWhile holding constant back tension on the suture limbs,load both limbs into the suture trimmer and advance to the arteriotomyTrim suture limbs with red leverKeep lever retracted upon withdrawalProGlide OverviewApril 2007LT292587428.2007 Abbott LaboratoriesProglide Thank you!And any question?ProGlide OverviewApril 2007LT292587429.2007 Abbott Laboratories