Download - Carotid stent 삽입시 Percusurge Guardwire 의 유용성
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Carotid stent Carotid stent 삽입시 삽입시
Percusurge GuardwirePercusurge Guardwire 의 의
유용성유용성
고 승 일
삼성서울병원
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대상과 방법대상과 방법20022002 년 년 55 월 – 월 – 20032003 년 년 44 월월Pt. 26Pt. 26 명명 ((M /23, F /3)M /23, F /3)연령 연령 : 48 – 84(: 48 – 84(mean 65)mean 65)Rt.ICA – 15Rt.ICA – 15Lt. ICA – 10Lt. ICA – 10VA – 1VA – 1협착율 협착율 : 70 – 95% : 70 – 95% 이상이상Pre & Post Diffusion / Perfusion MRIPre & Post Diffusion / Perfusion MRI
시행시행
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Percusurge Guardwire Percusurge Guardwire 구성구성
1. GuardWire 3 - 6 mm Temporary Occlusion Balloon Catheter (0.014”)
014” Guide Wire with Occlusion Balloon
Gold Marker connected to the Balloon
2. Micro Seal Adapter
Adapter Dial Knob
Latch Mechanism
Blue Clip
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Percusurge Guardwire Percusurge Guardwire 구성구성
3. Export Catheter
Aspiration Line
20cc Aspiration Syringe with Lock
4. EZ Flator Inflation Device
ExtensionTubing
Inflator Syringe (Fill Line (Max/Min), Inflation Dial, Deflation Handle)
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EZ Flator & Guard Wire
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Micro Seal Adapter
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Export Catheter
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Inflation
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Use by wire
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Deflation
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CASECASE
Pre-angiography
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Pre-dilatation(3mm balloon)
CASECASE
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Post-dilatation(6mm balloon)
CASECASE
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Post-angiography
CASECASE
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Pre Post
Diffusion MRI
CASECASE
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Debris
CASECASE
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DebrisDebris
Thrombus FragmentThrombus Fragment
Calciific Plaque FragmentCalciific Plaque Fragment
Fibrous Plaque DebrisFibrous Plaque Debris
Lipid or Cholesterol VacuolesLipid or Cholesterol Vacuoles
Intima FragmentIntima Fragment
Mean Particulate size: 250Mean Particulate size: 250µµm m
( 53 – 2846 ( 53 – 2846 µµm)m)
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Protection device typeProtection device type
Distal occusion type Filter type
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Filter type deviceFilter type device
Angioguard(cordis) Neuroshield(Mednova) Accunet(Guidant)
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결 과결 과
• 2626 명 중 명 중 small focal acute infarction small focal acute infarction 1313 명명 - - 신경학적 증상 발생 신경학적 증상 발생 11 례례 ((visual visual loss) MRIloss) MRI 에서 에서 acute lesion acute lesion 없었음없었음
• Protection deviceProtection device 를 사용하기 전 를 사용하기 전 4545 명 명 중 중 4141 명의 환자에서 명의 환자에서 small focal acute small focal acute
infarction infarction 발생 발생 - - Stroke 3Stroke 3 명명• 전전 .. 후 비교 후 비교 small focal acute small focal acute
infarction infarction
20% 20% 감소감소