肾动脉支架植入术图文详解课件
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• Medical treatment
• ACE inhibitors and a new class of Angiotensin receptor blockers
学习交流PPT
15
Endovascular Options: PTA or Stenting ?
• 1999: Peter Van de Ven, randomized trial PTA vs Stenting in ostial lesion
学习交流PPT
19
Advantages of .014 systems
Less spasm with .014 wire Less wire length Smaller puncture site Stent protected by GC Good support
Aim of the treatment
1) Renovascular Hypertension 2) Renal Insufficiency
学习交流PPT
5
Renovascular Hypertension
• 5% of all hypertensive patients • Due to atherosclerosis or FMD • Diagnosed after Surgical follow-up or PTRA. • PTRA does not cure Essential Hypertension
11
Fibro-Muscular Dysplasia
学习交流PPT
12
Restenosis after stenting
• Recent studies have indicated rates are between 10-20% (much better than the 30% with just PTA).
学习交流PPT
6
Renal Insufficiency
• Nephrosclerosis after RAS or occlusion • PTRA is indicated to reverse or prevent the
decline of kidney functions • 8cm long kidney is the lower limit after which
• Wire 035, Jindo, Storq
• 8F Vista brite Tip or IG
学习交流PPT
18
A new approach: .018 !
A GOOD COMPROMISE ! • Radiologist who are used to traditional PTA
balloons, • More range in PTA balloons • Balloons: Slalom • Stent: Genesis premounted on OPTA -PRO • Wire 018, SV • 6-7F Vista brite Tip or IG
Endovascular Treatment of Renal Artery Stenosis
学习交流PPT
1
Clinical Indications
(Procedures)
学习交流PPT
2
Anatomy
学习交流PPT
3
Kidney anatomy
学习交流PPT
4
Endovascular Treatment of Renal Artery Stenoses
dilatation (stenting if necessary)
3) Treatment FMD
dilatation (stentin学g习i交f流nPPeT cessary)
9
Post-ostial lesion
学习交流PPT
10
Fibro-Muscular Dysplasia
学习交流PPT
Number of patients
PTA Stenting
42
43
Primary patency rate
29% 75%
Primary success rate
57% 88%
Restenosis post-procedure 48% 14%
学习交流PPT
16
Literature…
学习交流PPT
17
学习交流PPT
13
Treatment Options
• Medical Treatment • PTA with Stenting • Surgery • Dialysis: Renal Function never get better
学习交流PPT
14
Gold standard treatment today…
kidney function might be compromised
学习交流PPT
7
Indications for PTRA
• Failed medical therapy • Reducing drug treatment • Pressure gradient >10% • More than 50% stenosis • Assymmetrical loss of renal mass
学习交流PPT
8
Endovascular Treatment of Renal Artery Stenoses
1) Treatment of artheriosclerotic ostial lesions
(80%)
dilatation + stenting
2) Treatment of post ostial lesions
Байду номын сангаас Product Strategies
• 014” • Cardiologist, Radiologists,
Vasc Surgeons. • Balloon: M3 Rx • Stents: Corinthian IQ on M3 • Wire, Stabilizer • 7-8F Vista Brite Tip or IG
• 035’
• Radiologist who are used to traditional PTA balloons,
• More range in PTA balloons
• Balloons: P3, Opta Pro
• Stents: Genesis premounted on OPTA PRO
• ACE inhibitors and a new class of Angiotensin receptor blockers
学习交流PPT
15
Endovascular Options: PTA or Stenting ?
• 1999: Peter Van de Ven, randomized trial PTA vs Stenting in ostial lesion
学习交流PPT
19
Advantages of .014 systems
Less spasm with .014 wire Less wire length Smaller puncture site Stent protected by GC Good support
Aim of the treatment
1) Renovascular Hypertension 2) Renal Insufficiency
学习交流PPT
5
Renovascular Hypertension
• 5% of all hypertensive patients • Due to atherosclerosis or FMD • Diagnosed after Surgical follow-up or PTRA. • PTRA does not cure Essential Hypertension
11
Fibro-Muscular Dysplasia
学习交流PPT
12
Restenosis after stenting
• Recent studies have indicated rates are between 10-20% (much better than the 30% with just PTA).
学习交流PPT
6
Renal Insufficiency
• Nephrosclerosis after RAS or occlusion • PTRA is indicated to reverse or prevent the
decline of kidney functions • 8cm long kidney is the lower limit after which
• Wire 035, Jindo, Storq
• 8F Vista brite Tip or IG
学习交流PPT
18
A new approach: .018 !
A GOOD COMPROMISE ! • Radiologist who are used to traditional PTA
balloons, • More range in PTA balloons • Balloons: Slalom • Stent: Genesis premounted on OPTA -PRO • Wire 018, SV • 6-7F Vista brite Tip or IG
Endovascular Treatment of Renal Artery Stenosis
学习交流PPT
1
Clinical Indications
(Procedures)
学习交流PPT
2
Anatomy
学习交流PPT
3
Kidney anatomy
学习交流PPT
4
Endovascular Treatment of Renal Artery Stenoses
dilatation (stenting if necessary)
3) Treatment FMD
dilatation (stentin学g习i交f流nPPeT cessary)
9
Post-ostial lesion
学习交流PPT
10
Fibro-Muscular Dysplasia
学习交流PPT
Number of patients
PTA Stenting
42
43
Primary patency rate
29% 75%
Primary success rate
57% 88%
Restenosis post-procedure 48% 14%
学习交流PPT
16
Literature…
学习交流PPT
17
学习交流PPT
13
Treatment Options
• Medical Treatment • PTA with Stenting • Surgery • Dialysis: Renal Function never get better
学习交流PPT
14
Gold standard treatment today…
kidney function might be compromised
学习交流PPT
7
Indications for PTRA
• Failed medical therapy • Reducing drug treatment • Pressure gradient >10% • More than 50% stenosis • Assymmetrical loss of renal mass
学习交流PPT
8
Endovascular Treatment of Renal Artery Stenoses
1) Treatment of artheriosclerotic ostial lesions
(80%)
dilatation + stenting
2) Treatment of post ostial lesions
Байду номын сангаас Product Strategies
• 014” • Cardiologist, Radiologists,
Vasc Surgeons. • Balloon: M3 Rx • Stents: Corinthian IQ on M3 • Wire, Stabilizer • 7-8F Vista Brite Tip or IG
• 035’
• Radiologist who are used to traditional PTA balloons,
• More range in PTA balloons
• Balloons: P3, Opta Pro
• Stents: Genesis premounted on OPTA PRO