金属裸支架在药物洗脱支架时代的作用乔树宾课件.ppt

1、注：公布于2019年美国ACC大会Days060120180300360420480540Events Rate0.000.020.040.060.080.100.120.140.16Patients without PlavixPatients on PlavixCumulative incidence of ST=58/3021 pts(1.9%)ST within 6 mo 1.4%ST after 6 mo 0.5%240Source:Chieffo,TCT 06.Chieffo&Colombo:Showed 9 of the 16 LST patients were on Plavi

2、x Patients without Plavix had increased thrombosis in first 6 monthsEmphasized Plavix is needed for 1st six months不稳定不稳定心绞痛心绞痛血栓血栓糖尿病糖尿病无保护无保护左主干左主干分叉病变分叉病变肾功衰肾功衰既往血管腔既往血管腔内放射治疗内放射治疗抗小板治疗抗小板治疗过早终止过早终止支架血栓发生率支架血栓发生率 (%)(%)“过早中断持久的抗血小板治疗的患者有过早中断持久的抗血小板治疗的患者有29%29%发生发生支架血栓支架血栓,坚持药物的抗血小板治疗极为重要坚持药物的抗血小板治

3、疗极为重要 .”.”Iakovou et alOverall stent thrombosis=1.3%(P=0.09,N=2229)累计支架血栓单变量预测因素(9个月)对 TAXUS 支架和 CypherTM 支架的分析成功植入药物释放支架后支架血栓的发生率成功植入药物释放支架后支架血栓的发生率,预测因素预测因素,和结果和结果 Iakovou et al.,JAMA.2019;293:2126-2130 Iakovou et al.JAMA.2019;293:2126.CypherTM is a registered trademark of Cordis CorporationTAXUS

4、Stents are contraindicated in patients with lesions involving a bifurcation,unprotected left main and presence of definite or propable intraluminal thrombus.Daemon J et al.Lancet 2019;369:667-78LAD:LCX:OM:Vision 3.5*18No.1 2019,Vessel=2.8 mmNo.4,Mar 2019,Vessel=3.5 mmNo.5,Aug 2019,Vessel=3.5 mmNo.6,

5、Jun 2019,Vessel=4 mmNo.7,Aug 2019 Vessel=3.0No.3,2019,Vessel=3 mmNo.2 2019,Vessel=3 mmNo.8,2009,Vessel=3.2 mmVision 4.0*（28+18+18）TLR(%Patients)p=0.0003p=0.06ControlTAXUSTLR for 4.0 StentsTAXUS 4.0 mmCYPHER 4.0 mm15.75.08.60.0P=NSP=NS Vision 3.5*23Coroflex BlueRapid Exchange Coronary Stent SystemCoroflex Blue Worldwide RegistryGermanySwedenPolandUKFranceSpainPortugalCzech Rep.NorwaySlovak Rep.CyprusThailandMalaysiaas of April 18,2019