rovus機(jī)器銷售專用與練兵無關(guān)-ivus introduction

超聲導(dǎo)回撤裝置：步進(jìn)馬達(dá) 滑

超聲主455血管內(nèi)超聲(IVUS)是一種成像技1高1高頻聲波發(fā)射至血管回波信號反射回超聲探X線投照角度對病變判斷產(chǎn)生影響冠脈造影可能低估或不能發(fā)現(xiàn)病冠脈造 血管內(nèi)超只顯示管腔輪廓，不能顯示管壁病 顯示管腔，同時顯示管壁病受血管彎曲、、透照角度的影 不受血管彎曲、的影管腔內(nèi)病變不能清楚顯 可顯示管腔內(nèi)結(jié)評估病變的嚴(yán)重性，是否需要進(jìn)行干術(shù) 靶病變區(qū)域形態(tài)學(xué)評估,判斷使用球囊、支架或旋尋找病變的近端及遠(yuǎn)端參考，以幫助確定支架的長測量血管大小從而幫助選擇合適直徑的支 評估支架“地理缺失”(Geographic邊緣夾層判靶病變血管重建(LR)和靶血管失敗(VF)評術(shù)后 ? 和心梗評估血栓形成評4mm2時考慮進(jìn)行干預(yù)*MintzG,IntracoronaryUltrasound,2005;*如果之前進(jìn)行了IVUS檢查治療方案則應(yīng)包含斑塊處理步MintzG,PopmaJ,PichardA,etal.PatternsofcalcificationinCoronaryArteryDisease.Circulation.April1995,91:No**MoussaI,DiMarioC,MosesJ,etal.CoronaryStentingAfterRotationalAtherectomyinCalcifiedandComplexLesions.Circulation1997;96:128-近端參 病變區(qū) 遠(yuǎn)端參

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支架完全貼壁重要性臨床數(shù)44%TLRFitzgeraldP,OshimaA,HayaseM,etal.CRUISEStudy.CheneauE,LoborgneL,MintzG,etPredictorsofsubacutestentCirculation.2003;108:43-TakebayashiH,MintzG,CarlierS,etal.Nonuniformstrutcorrelateswithmoreneointimalhyperplasiaaftersirolimus-elutingstentimplantation.Circulation.2004;110:3430-3434HwangC,WuD,EdelmanE.Physiologicaltransportforcesdrugdistrubitionforstent-baseddelivery.Circulation.2001;104:600- 4

確認(rèn)支架貼測量最狹窄處管腔面與遠(yuǎn)端參考管腔面積比最大管腔直徑達(dá)到遠(yuǎn)端參考點(diǎn)可被認(rèn)為支架擴(kuò)張完使用IVUSCostaM,AngiolilloD,TannebaumM,etal.Impactofstentdeploymentproceduralfactorsonlong-termeffectivenessandsafetyofsirolimus-elutingstents(finalresultsofthemulticenterprospectiveS.T.L.L.R.Trial).AmericanJournalofCardiology.2008;12:1704-1711. TLRTLRTVF醫(yī)院對1768TCT2010,Claessen匯報(bào)了關(guān)于 ClaessenB,MehranR,MintzG,etal.Impactofintravascularultrasoundimagingonearlyandlateclinical esfollowingpercutaneouscoronaryinterventionwithdrug-elutingstents.AmericanJournalofCardiology.2011;4:974-981.三組不同的DES植研究顯IVUS以后，支架內(nèi)血栓形成率顯著下亞急性支架內(nèi)血47%支架貼壁不完52%支架擴(kuò)張不完24%支架內(nèi)

在IVUS引導(dǎo)下研suboptimal高風(fēng)險(xiǎn)靶病變SAT建議使用AtlantisAtlantisSRPro回撤距離 遠(yuǎn)端管鞘直徑影像窗口直徑3.2F病變進(jìn)入直徑1.7F40MHz40MHz分辨率，6F導(dǎo)管適用，目前市場上圖像質(zhì)量最好的IVUS導(dǎo)BostonScientific40MHz探每分鐘1800轉(zhuǎn)，360其他公20MHz探電子探64

超聲發(fā)出高頻聲波信號，通過血流超聲探將聲波信號和電信號進(jìn)行互相轉(zhuǎn)其其他產(chǎn)超聲影像質(zhì)量受到兩個因素影(軸向和徑向分辨率(灰階影像的層次感，動態(tài)范圍根據(jù)不同密度組織對聲波信號的反射強(qiáng)度不同了一幅截面影baaelectricalelectrical

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a軸向分辨b徑向分辨 40MHz超聲探頭能清晰地顯示血管的內(nèi)膜、中膜、外膜和血栓對細(xì)小結(jié)構(gòu)的識別能力更強(qiáng)不同分辨率下的血管內(nèi)超聲影20

iLabiLab配 導(dǎo)管室內(nèi)安裝在彈簧臂床旁控制器可操作導(dǎo)管回撤、測臺車配可移動式臺直觀觸摸屏用戶界集成的自動傳感旋轉(zhuǎn)驅(qū)動馬達(dá)和回撤系進(jìn)行自動回提供到導(dǎo)管恒定速率的線形運(yùn)LCD顯示推進(jìn)距離距離數(shù)iLabiLabiLabTMSmartTGC?無iLabTMSmartTGC?圖像放大功能：“Icon-Magnifier”圖標(biāo)放大具有景深自動調(diào)節(jié)功能，在主屏上放大圖標(biāo)并給出描圖像的測量范圍：LongView?軟件長軸影像實(shí)時顯自動測量功能：TraceAssist?軟血管管腔面積、狹窄率、血管邊界等自動自動輪廓勾畫和測自動描繪管腔和血管提供血管最小、最大直徑和面提供病變直徑和面積狹窄DynamicReview?iMap?Dynamic靜態(tài)的IVUS圖像僅是一用前后多幀圖像組成動iMap?組織學(xué)斑塊組成的分并列灰階圖容積,面積和百分比計(jì)橫縱軸的詳細(xì)分自動回40of40ofConfidenceConfidenceLabelsadjustedtothesimilarityofRFintravascularultrasoundsignalsandpatronsspectrumfor41ofiLab?SystemSoftware22DFUSupplementAllimagestakenbyBostonScientificImagesnotindicativeof41of42of42ofiMap?應(yīng)特征要點(diǎn)AllimagesbyBostonScientific.Imagesnotindicativeofproductperformance.*iSize?offerssizingparametersintendedtoenhancethetreatingphysician’ssizingdecisions;itisnotintendedtosubstituteforthedoctor’smedicaljudgmentinselectingthesizeofanancillarydevice.圖像后處理離線閱讀&分析功能：iReview?軟在任意電腦上 量、分析、注釋、編輯及幻燈轉(zhuǎn)化，并可在導(dǎo)管工站中合成電基本識1:Adventitiaiscomposedocollagenthathighlyreflectedbyultrasound (appears2:Mediaismadeofhomogeneoussmooth musclecellsandisreflectedbyultrasound(appearsdark)113:Intimaisdenseandwillappearasa“white”layerbetweenthemediaandthebloodspeckles.11 WireBlood‘speckling’(liveMedialborder/ExternalelasticSideWireBlood‘speckling’image>>stillEndothelialMedialborder/ExternalelasticSideWireBlood‘speckling’image>>stillEndothelialMedialborder/ExternalelasticSideWireBlood‘speckling’image>>stillEndothelialMedialborder/ExternalelasticSideWireBlood‘speckling’image>>stillEndothelialMedialborder/ExternalelasticSideWireBlood‘speckling’image>>stillEndothelialMedialborder/ExternalelasticSideWireBlood‘speckling’image>>stillEndothelialMedialborder/ExternalelasticSideWireBlood‘speckling’image>>stillEndothelialMedialborder/ExternalelasticSide Plaquevisiblealongallthearterial

Plaquevisiblealongpartofarterial 軟斑塊軟斑塊Soft FibroticNotasbrightastheadventitia(hypoechoic):“Soft”referstoechogenicity,duetohighlipidcontentBrightechos(brighterthanObstructsthepenetrationultrasound(acousticOnlytheleadingedgeisdetectedandthicknesscannotbedetermined

‘Between’thelumen/endotheliumandtheexternalelasticlaminaDarkerthanMostplaquesare纖維化斑塊（低脂質(zhì)‘Between’thelumen/endotheliumandexternalelasticlaminaAslight,orlighterthan,MostplaquesareIntraluminalmass,oftenwithalayered,lobulatedorpedunculatedRelativelyecholucentorwithvariablegray-scalewithspecklingorscintillationBl