波科外周Guidewires中文導(dǎo)絲實(shí)用教案

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1、PI Guide WiresOverview Purposes of a guide wire: 導(dǎo)絲的作用：導(dǎo)絲的作用： Gain access into vessels 到達(dá)目標(biāo)血管到達(dá)目標(biāo)血管 Deliver devices 輸送手術(shù)器械輸送手術(shù)器械 Cross lesions 穿越病變部位穿越病變部位 Used in vascular and non-vascular procedures 可用于血管和非血管介入手術(shù)可用于血管和非血管介入手術(shù) Used in all diagnostic and therapeutic procedures 可用于所有的診斷可用于所有的診斷(zhndu

2、n)和治療介入手術(shù)和治療介入手術(shù) The Backbone of every procedure 每例介入手術(shù)均需使用每例介入手術(shù)均需使用第1頁(yè)/共89頁(yè)第一頁(yè)，共90頁(yè)。PI Guide WiresGeneral Features & Intended BenefitsIdeal Guide Wire FeaturesIntended BenefitSteerability/torque control操控性/扭轉(zhuǎn)控制Easily directed through the body.從體外操控導(dǎo)絲Columnar strength縱向強(qiáng)度Kink resistant.抗扭曲Radiopaqu

3、e顯影性Good visualization.良好的可視性Frictionless潤(rùn)滑性Advancement through tortuous vessels; 通過(guò)迂曲的血管；smooth tracking of devices & catheters.沿導(dǎo)絲推送器械 & 導(dǎo)管Rail support支撐力Advancement and support of devices.推送和支撐器械A(chǔ)traumatic tip無(wú)創(chuàng)傷的頭端Reduced vessel damage.減少對(duì)血管的損傷第2頁(yè)/共89頁(yè)第二頁(yè)，共90頁(yè)。PI Guide Wires General Components外周

4、介入外周介入(jir)導(dǎo)絲的一般結(jié)構(gòu)導(dǎo)絲的一般結(jié)構(gòu)Core Wire: Usually Stainless Steel or Nitinol導(dǎo)絲軸芯：通常(tngchng)為不銹鋼和鎳鈦諾合金Distal Tip: Working end of wire; comes in multiple shapes: straight, angled, shapeable, J遠(yuǎn)端頭端：導(dǎo)絲的工作(gngzu)端；有多種形狀：直型，成角型，可塑性，J型Lubricious Coating: PTFE, Silicone, or Hydrophilic光滑涂層：PTFE，硅，或親水性Distal Tip遠(yuǎn)

5、端Safety Ribbon安全帶Core wire軸芯Coil wire螺旋金屬絲Proximal End近端 第3頁(yè)/共89頁(yè)第三頁(yè)，共90頁(yè)。Floppy/Light Support (POBA): Starter Guide Wire松軟型松軟型/輕度支撐（輕度支撐（POBA）：）：StarterTM 導(dǎo)絲導(dǎo)絲Most flexible; least rail support 最佳的柔韌性；最小的支撐力最佳的柔韌性；最小的支撐力Less likely to cause vessel damage 最小的血管損傷最小的血管損傷(snshng)Moderate Support (Stent

6、): Magic Torque Guide Wire中度支撐（支架）：中度支撐（支架）： Magic Torque 導(dǎo)絲導(dǎo)絲Rail support between Floppy & Extra Support 介于松軟型介于松軟型 & 超硬導(dǎo)絲之間超硬導(dǎo)絲之間Added support for stent delivery 為放置支架提供額外的支撐為放置支架提供額外的支撐Extra Support (Stent): Amplatz Guide Wire額外支撐（支架）：額外支撐（支架）： Amplatz 導(dǎo)絲導(dǎo)絲Long rail support region, but soft tip 桿

7、身支撐力更強(qiáng)，柔軟的頭端桿身支撐力更強(qiáng)，柔軟的頭端Designed for first generation stent delivery 設(shè)計(jì)用于放置第一代的支架設(shè)計(jì)用于放置第一代的支架PI Guide WiresCore Wire Flexibility & Support軸芯軸芯 柔韌性柔韌性 & 支撐力支撐力第4頁(yè)/共89頁(yè)第四頁(yè)，共90頁(yè)。 Diameters most commonly used in interventions: 在介入在介入(jir)手術(shù)中最常使用的導(dǎo)絲直徑：手術(shù)中最常使用的導(dǎo)絲直徑： .014” - Coronary and small vessel ball

8、oons - 冠狀動(dòng)脈和小血管球囊冠狀動(dòng)脈和小血管球囊 .018” - Renal and small vessel balloons - 腎動(dòng)脈和小血管球囊腎動(dòng)脈和小血管球囊 .035” - Balloons and catheters, “workhorse” - 球囊和導(dǎo)管，球囊和導(dǎo)管，“使用最普遍使用最普遍” .038” - Large devices requiring extra support (rarely used) - 需要額外支撐的較大器械（很少使用）需要額外支撐的較大器械（很少使用） Other less common diameters are .032” and .

9、025” 其他較少使用的直徑：其他較少使用的直徑： .032” 和和 .025” Trend towards smaller diameters (.014”) 趨向于小直徑導(dǎo)絲（趨向于小直徑導(dǎo)絲（.014”） Common guide wire lengths: 通常的導(dǎo)絲長(zhǎng)度：通常的導(dǎo)絲長(zhǎng)度： 75cm, 150cm, 180cm, 260cm, 300cmPI Guide WiresSizing Diameters & Lengths尺寸尺寸(ch cun) 直徑直徑 & 長(zhǎng)度長(zhǎng)度第5頁(yè)/共89頁(yè)第五頁(yè)，共90頁(yè)。PI Guide WiresDistal Tip Configuratio

10、ns遠(yuǎn)端頭端的遠(yuǎn)端頭端的(dund)類型類型 Tip Configurations: 頭端類型頭端類型(lixng)： Straight, angled, J-Tip 直型，成角型，直型，成角型， J型型 Non-hydrophilic, hydrophilic 非親水性，親水性非親水性，親水性 Standard, floppy, stiff 標(biāo)準(zhǔn)型，松軟型，硬型標(biāo)準(zhǔn)型，松軟型，硬型 Tip taper 漸細(xì)的錐形頭端漸細(xì)的錐形頭端第6頁(yè)/共89頁(yè)第六頁(yè)，共90頁(yè)。PI Guide WiresTypes for Gaining Initial Access Bentson Guide Wire

11、 Straight, floppy, atraumatic tip J-Tip Guide Wire Atraumatic - use when worried about the potential for vessel perforation. 無(wú)創(chuàng)傷無(wú)創(chuàng)傷 用于避免用于避免(bmin)血管壁穿孔血管壁穿孔 Starter Guide Wire Standard workhorse ZIPwire Guide Wire Not indicated as a starter wire, but often used by physicians.第7頁(yè)/共89頁(yè)第七頁(yè)，共90頁(yè)。PI Guid

12、e WiresBSC Products The three classifications of wires sold by Boston Scientific are: Standard Guide Wires 標(biāo)準(zhǔn)(biozhn)導(dǎo)絲 Starter Guide Wire (includes Bentson, Newton, & Rosen shapes) Hydrophilic Guide Wires 親水性導(dǎo)絲 ZIPwire Guide Wire (.18”, .025”, .035”, .038) Specialty Guide Wires 特殊導(dǎo)絲 V-18 Control Wi

13、re Guide Wire (.018) Platinum PLUS Guide Wire (.014”, .018“, .025”) Thruway Guide Wire (.014 & .018) Magic Torque Guide Wire (.035) Amplatz Super Stiff Guide Wire (.035“ & .038”) Meier Guide Wire (.035)第8頁(yè)/共89頁(yè)第八頁(yè)，共90頁(yè)。PI Guide Wires BSC Product PositioningStarter Guide WireAll routine procedures.ZI

14、Pwire Guide WireWhen a standard wire wont “go”; total occlusions.當(dāng)標(biāo)準(zhǔn)導(dǎo)絲無(wú)法通過(guò)時(shí)；完全阻塞的病變Amplatz Super Stiff Guide WireWhen more support is needed such as filter placement and carotid catheter placement.當(dāng)需要更多的支撐時(shí)，如放置血栓保護(hù)裝置和頸動(dòng)脈導(dǎo)管。Magic Torque Guide WireNegotiating difficult vessels, sizing vessels, sizing

15、IVC filters.Meier WireAAA indicated; stiffer than Amplatz with a softer, radiopaque tip.Platinum PLUS Guide WireIVUS, small vessel (.014” & .018”).V-18 Guide WireSmall vessels (.018”), tortuous anatomy, contralateral. 小血管（.018”），迂曲的血管，對(duì)側(cè)病變。Thruway Guide WireSmall vessels (.014” & .018”), renals, mon

16、orail.小血管（.014 ” & .018”），腎動(dòng)脈，快速交換第9頁(yè)/共89頁(yè)第九頁(yè)，共90頁(yè)。Starter Guide WiresThe information included in this section is considered proprietary to Lake Region Manufacturing, Inc. Any copying, sharing and/or distributing is prohibited.第10頁(yè)/共89頁(yè)第十頁(yè)，共90頁(yè)。Starter Guide WireProduct PositioningA family of ultra-

17、smooth, PTFE guide wires. Workhorse guide wire for routine procedures.第11頁(yè)/共89頁(yè)第十一頁(yè)，共90頁(yè)。Starter Guide WireIndicationsINTENDED USE: Starter guide wires are designed for percutaneous vessel entry using the Seldinger technique to facilitate subsequent introduction(s) of an intravascular device.第12頁(yè)/共8

18、9頁(yè)第十二頁(yè)，共90頁(yè)。Starter Guide WireProduct SpecsTipsDiameters (in)Lengths (cm)Bentson.035, .038150, 180, 260Newton.018, .035, .038150J-Tip*.035, .038150, 180, 260Rosen.035150, 180, 260Standard.025, .035, .03880, 150, 260*Most are finger straightenable Bentson, Newton, and Rosen are industry standard wire

19、 types sold by other companies as well. Available with or without heparin coating. Straight and J-tips available with fixed or moveable core (not available in all sizes).第13頁(yè)/共89頁(yè)第十三頁(yè)，共90頁(yè)。Starter Guide WireFeatures & Intended BenefitsStarter Wire FeaturesIntended BenefitsPTFE coating applied using

20、pre-coat technology (dipped vs sprayed)Increased coating consistency and durability to facilitate entry and smooth catheter tracking.Availability of heparin coatingDecreased risk of thrombus formation.Finger straightenable J-tipUse in a wide range of clinical situations.Choice of fixed or moveable c

21、oreUse in a wide range of clinical situations.第14頁(yè)/共89頁(yè)第十四頁(yè)，共90頁(yè)。Starter Guide WireAreas of Clinical UseGaining access for routine procedures第15頁(yè)/共89頁(yè)第十五頁(yè)，共90頁(yè)。Starter Guide WireKey CompetitorsThe following competitors also sell Bentson, Newton and Rosen wires, as well as other PTFE-coated competiti

22、ng workhorse wires: Cook market leader in standard guide wires Angiodynamics Cordis St. Jude Bard Merit第16頁(yè)/共89頁(yè)第十六頁(yè)，共90頁(yè)。Starter Guide WireKey Takeaways Atraumatic, workhorse guide wire for routine procedures. Pre-Coat Technology Dipped coating for excellent coating durability & consistency Finger

23、straightenable J-tip Availability of heparin coating Moveable & fixed core optionsSprayed CoatingStarter Guide Wire Dipped Coating (a.k.a. “Pre-Coat Technology”)第17頁(yè)/共89頁(yè)第十七頁(yè)，共90頁(yè)。GuidewiresConstruction - non hydrophilic wires第18頁(yè)/共89頁(yè)第十八頁(yè)，共90頁(yè)。Starter Guidewire Fixed CoreIdeal first wire to use bef

24、ore or after Introducer Sheath Insertion Atraumatic Floppy Tip provides safety, Well balanced body provides ample pushability and support for Catheter ExchangePrecoat technology allows for ease of Catheter Exchange Large Size Matrix covers majority of clinical requirements第19頁(yè)/共89頁(yè)第十九頁(yè)，共90頁(yè)。Starter

25、Guidewire Moveable CoreIdeal first wire to use before or after Introducer Sheath Insertion Moveable Core allows adjustment of the Floppy Tip length meaning one wire can provide both safety and support Well balanced body provides ample pushability and support for Catheter Exchange Precoat technology

26、allows for ease of Catheter ExchangeLarge Size Matrix covers majority of clinical requirements第20頁(yè)/共89頁(yè)第二十頁(yè)，共90頁(yè)。Starter Guidewire NewtonIdeal wire to use for accessing delicate vessels and crossing fragile lesions such asRenal, Dialysis Fistula, Subclavian, Fempop.Watch out 0.018” wires may be more

27、 suitableAlso ideal for navigation of heavily diseased Iliacs and Aortas.Very Atraumatic Floppy tip, body support does allow catheter exchange 第21頁(yè)/共89頁(yè)第二十一頁(yè)，共90頁(yè)。Starter Guidewire New BentsonIdeal wire to use for accessing delicate vessels and crossing fragile lesions such asRenal, Dialysis Fistula

28、, Subclavian, Fempop.Watch out 0.018” wires may be more suitableAlso ideal for navigation of heavily diseased Iliacs and Aortas.Very Atraumatic Tip, less support than Newton means that catheter exchange may be limited 第22頁(yè)/共89頁(yè)第二十二頁(yè)，共90頁(yè)。Starter Guidewire Rosen Heavy DutyIdeal wire to use for cathet

29、er access where additional support is required especially in Ostial lesions due to short taper preventing flip outRenal, Dialysis Fistula, Subclavian, Fempop.Watch out 0.018” wires may be more suitable第23頁(yè)/共89頁(yè)第二十三頁(yè)，共90頁(yè)。ZIPwire Hydrophilic Guide Wires ZIPwire 親水性導(dǎo)絲親水性導(dǎo)絲ZIPwire Guide Wire第24頁(yè)/共89頁(yè)第二

30、十四頁(yè)，共90頁(yè)。ZIPwire Guide Wire產(chǎn)品產(chǎn)品(chnpn)定位定位A family of hydrophilic guide wires designed for smooth passage through tortuous anatomy.設(shè)計(jì)用于流暢(lichng)的通過(guò)迂曲的解剖結(jié)構(gòu)第25頁(yè)/共89頁(yè)第二十五頁(yè)，共90頁(yè)。ZIPwire Guide Wire適應(yīng)癥適應(yīng)癥INDICATIONS: The ZIPwire Hydrophilic Guide Wire is intended to facilitate the placement of devices du

31、ring diagnostic and interventional procedures.ZIPwire 親水性導(dǎo)絲用于在診斷性和治療性介入手術(shù)親水性導(dǎo)絲用于在診斷性和治療性介入手術(shù)(shush)中協(xié)助置入器械。中協(xié)助置入器械。第26頁(yè)/共89頁(yè)第二十六頁(yè)，共90頁(yè)。ZIPwire Guide Wire產(chǎn)品產(chǎn)品(chnpn)技術(shù)參數(shù)技術(shù)參數(shù)ZIPwire is a trademark of Boston Scientific Corporation or its affiliates. Glidewire is a trademark of Terumo Corporation.Shafts

32、桿身?xiàng)U身Standard, Stiff標(biāo)準(zhǔn)型，加硬型Tips頭端頭端Straight, Angled, J, Long Taper, Short Taper直型，成角型，J型，長(zhǎng)錐型，短錐型Diameters直徑直徑.018”, .025”, .035”, .038”Lengths長(zhǎng)度長(zhǎng)度80cm, 150cm, 180cm, 260cmNote: See Guide Wires brochure or price book for all available combinations.注意(zh y)：請(qǐng)參見(jiàn)相關(guān)產(chǎn)品彩頁(yè)或手冊(cè)了解所有的產(chǎn)品型號(hào)第27頁(yè)/共89頁(yè)第二十七頁(yè)，共90頁(yè)。ZIPw

33、ire Guide WireEnhanced Manufacturing ProcessA polymer jacket is extruded over a kink-resistant nitinol core. 聚合物外殼覆蓋聚合物外殼覆蓋(fgi)在抗扭曲的鎳鈦諾合金軸芯表面在抗扭曲的鎳鈦諾合金軸芯表面Hydrophilic coating is bonded to the polymer jacket.親水性涂層粘合在聚合物外殼上親水性涂層粘合在聚合物外殼上Radiopaque Polyurethane Jacket 不透不透X線的聚亞安酯外殼線的聚亞安酯外殼(wi k)Nitino

34、l Core鎳鈦諾軸芯鎳鈦諾軸芯Hydrophilic Polymer Coating親水性聚合物涂層親水性聚合物涂層(t cn)The manufacturing process enhancements treated the surface of the polyurethane jacket for consistent adhesion of the hydrophilic coating.第28頁(yè)/共89頁(yè)第二十八頁(yè)，共90頁(yè)。ZIPwire PropertiesKink-resistant抗扭曲性抗扭曲性The nitinol metal alloy core provides

35、the strength necessary to make the ZIPwire guidewire kink-resistant. 鎳鈦諾合金材質(zhì)的導(dǎo)絲軸芯使鎳鈦諾合金材質(zhì)的導(dǎo)絲軸芯使ZIPwire導(dǎo)絲具有良好的抗扭曲性能。導(dǎo)絲具有良好的抗扭曲性能。Steerable操控性操控性Single piece construction and atraumatic tip allow excellent steerability. 一體式結(jié)構(gòu)和無(wú)創(chuàng)性頭端使其具有優(yōu)異的操控性。一體式結(jié)構(gòu)和無(wú)創(chuàng)性頭端使其具有優(yōu)異的操控性。The unique alloy core and polyurethane

36、 jacket of the ZIPwire guidewire provide a true 1:1 torque response. 獨(dú)特的合金軸芯和聚亞安酯外殼獨(dú)特的合金軸芯和聚亞安酯外殼(wi k)實(shí)現(xiàn)了實(shí)現(xiàn)了1:1扭控反應(yīng)。扭控反應(yīng)。Frictionless光滑度光滑度The hydrophilic coating makes the ZIPwire guidewire virtually frictionless when wet. The ZIPwire guidewire slides easily into place and smoothly guides catheter

37、s. 親水性涂層在水化后變得非常光滑，易于到達(dá)病變部位和推送導(dǎo)管。親水性涂層在水化后變得非常光滑，易于到達(dá)病變部位和推送導(dǎo)管。第29頁(yè)/共89頁(yè)第二十九頁(yè)，共90頁(yè)。ZIPwire PropertiesLow Thrombogenicity (tendency to produce blood clots)低血栓性（產(chǎn)生低血栓性（產(chǎn)生(chnshng)凝血塊的趨勢(shì)）凝血塊的趨勢(shì)）The frictionless coating results in low potential for the formation of blood clots on the surface of the ZIPw

38、ire guidewire. 光滑的親水涂層有效減少了在導(dǎo)絲表面形成血凝塊的危險(xiǎn)。光滑的親水涂層有效減少了在導(dǎo)絲表面形成血凝塊的危險(xiǎn)。Radiopaque顯影性顯影性The polyurethane is impregnated with tungsten, a radiopacifier for enhanced visibility. 聚亞安酯外殼中含有鎢，在聚亞安酯外殼中含有鎢，在X線下具有良好的可視性。線下具有良好的可視性。Atraumatic無(wú)創(chuàng)性無(wú)創(chuàng)性The various cores result in soft, flexible tip configurations. 不同的

39、軸芯不同的軸芯 各種類型的柔軟而富有彈性的頭端。各種類型的柔軟而富有彈性的頭端。第30頁(yè)/共89頁(yè)第三十頁(yè)，共90頁(yè)。ZIPwire Guide WireFeatures & Intended BenefitsZIPwire Guide Wire FeaturesIntended BenefitsHydrophilic coating親水性涂層親水性涂層Facilitation of crossing of tight lesions.易于通過(guò)高度狹窄的病變Precise 1:1 torque response精確的精確的1:1扭控反應(yīng)扭控反應(yīng)Secure control when sub-s

40、electing distal and angulated branch vessels.安全進(jìn)入遠(yuǎn)端血管和成角較大的分支血管Highly radiopaque jacket高顯影性外殼高顯影性外殼Excellent visibility for accurate positioning.良好的可視性，便于準(zhǔn)確定位Super-elastic nitinol core有良好彈性的鎳鈦諾軸芯有良好彈性的鎳鈦諾軸芯Excellent kink-resistance.優(yōu)異的抗扭曲性能第31頁(yè)/共89頁(yè)第三十一頁(yè)，共90頁(yè)。ZIPwire Guide Wire臨床臨床(ln chun)應(yīng)用領(lǐng)域應(yīng)用領(lǐng)域A

41、ortic bifurcation area腹主動(dòng)脈分叉(fn ch)Carotids頸動(dòng)脈HAM血透通路(tngl)Crossing CTOs通過(guò)完全阻塞的病變Subintimal Angioplasty內(nèi)膜下血管成形術(shù)第32頁(yè)/共89頁(yè)第三十二頁(yè)，共90頁(yè)。ZIPwire Guide WireKey Competitors Glidewire Guide Wire (Terumo - previously sold by Boston Scientific)- Hydrophilic market leader Roadrunner Guide Wire (Cook) AQUALiner

42、Guide Wire (Angiodynamics) HiWire Guide Wire (Cook) HydroSteer Guide Wire (St. Jude Medical)第33頁(yè)/共89頁(yè)第三十三頁(yè)，共90頁(yè)。ZIPwire Guide WireKey TakeawaysThe ZIPwire Guide Wire is a hydrophilic guide wire designed for maneuvering through tortuous anatomy.ZIPwire 親水性導(dǎo)絲設(shè)計(jì)用于通過(guò)迂曲的解剖結(jié)構(gòu)。親水性導(dǎo)絲設(shè)計(jì)用于通過(guò)迂曲的解剖結(jié)構(gòu)。 Precise 1

43、:1 torque response 精確的精確的1:1扭控反應(yīng)扭控反應(yīng) Highly radiopaque jacket 高顯影高顯影(xin yng)性外殼性外殼 Comprehensive selection of shafts, lengths, and tips 有多種不同硬度、長(zhǎng)度和頭端類型的型號(hào)有多種不同硬度、長(zhǎng)度和頭端類型的型號(hào)第34頁(yè)/共89頁(yè)第三十四頁(yè)，共90頁(yè)。Amplatz Super Stiff Guide Wire Amplatz Super Stiff 超硬導(dǎo)絲超硬導(dǎo)絲第35頁(yè)/共89頁(yè)第三十五頁(yè)，共90頁(yè)。Amplatz Super Stiff Guide Wi

44、re 產(chǎn)品產(chǎn)品(chnpn)定位定位A stiff, secondary (non-starter) wire when strength and stability are required for catheter placement and exchange.硬度更高，具有更高的強(qiáng)度和穩(wěn)定性，用于放硬度更高，具有更高的強(qiáng)度和穩(wěn)定性，用于放置和更換置和更換(gnhun)導(dǎo)管。導(dǎo)管。第36頁(yè)/共89頁(yè)第三十六頁(yè)，共90頁(yè)。Amplatz Super Stiff Guide Wire 適應(yīng)癥適應(yīng)癥INDICATIONS:The Amplatz Super Stiff Guide Wire fa

45、cilitates catheter placement and exchange during diagnostic or interventional procedures. It is not intended for use in coronary arteries.Amplatz Super Stiff超硬導(dǎo)絲用于在診斷性和治療性超硬導(dǎo)絲用于在診斷性和治療性介入手術(shù)中放置介入手術(shù)中放置(fngzh)和更換導(dǎo)管。不適用于冠脈和更換導(dǎo)管。不適用于冠脈手術(shù)。手術(shù)。第37頁(yè)/共89頁(yè)第三十七頁(yè)，共90頁(yè)。Amplatz Super Stiff Guide Wire 產(chǎn)品產(chǎn)品(chnpn)技術(shù)

46、參數(shù)技術(shù)參數(shù)Tip Shape頭端形狀頭端形狀Tip Length頭端長(zhǎng)度頭端長(zhǎng)度 (cm)Diameters (in)直徑直徑Lengths (cm)長(zhǎng)度長(zhǎng)度3mm J3mmJ型3.035, .038145, 180, 260Straight直型6.018, .035, .03875, 145, 180, 260Short Tip短頭端1, 3.5.035, .038150, 180, 260Note: See Guide Wire brochure or price book for all available combinations.注意：請(qǐng)參見(jiàn)相關(guān)(xinggun)產(chǎn)品彩頁(yè)或手冊(cè)了解

47、所有的產(chǎn)品型號(hào)第38頁(yè)/共89頁(yè)第三十八頁(yè)，共90頁(yè)。Amplatz Super Stiff Guide WireFeatures & Intended BenefitsAmplatz Super Stiff FeaturesIntended BenefitsStiff core硬的軸芯硬的軸芯Added strength for easier access and better stability during catheter placement and exchange.強(qiáng)度更高，進(jìn)入更方便，在放置和更換導(dǎo)管時(shí)具有更佳的穩(wěn)定性。Atraumatic tip & gradual dista

48、l core taper無(wú)創(chuàng)性頭端無(wú)創(chuàng)性頭端 & 漸細(xì)的遠(yuǎn)端軸芯漸細(xì)的遠(yuǎn)端軸芯Safety during advancement.在推進(jìn)導(dǎo)絲時(shí)具有良好的安全性Teflon coating特氟隆涂層特氟隆涂層Smooth entry and catheter tracking.進(jìn)入血管和推送導(dǎo)管更加流暢第39頁(yè)/共89頁(yè)第三十九頁(yè)，共90頁(yè)。Amplatz Super Stiff Guide Wire臨床臨床(ln chun)應(yīng)用領(lǐng)域應(yīng)用領(lǐng)域Aortic bifurcation area主動(dòng)脈分叉(fn ch)Carotid/aortic arch area頸動(dòng)脈/主動(dòng)脈弓(zhdngmigng

49、)第40頁(yè)/共89頁(yè)第四十頁(yè)，共90頁(yè)。Amplatz Super Stiff Guide WireKey Competitors“Amplatz” is a standard wire name sold by other companies including Cook and Cordis. Others competing wires include: Wholey HI-TORQUE (Covidien) HI-TORQUE Supra Core (Abbott Vascular)第41頁(yè)/共89頁(yè)第四十一頁(yè)，共90頁(yè)。Amplatz Super Stiff Guide WireKe

50、y Takeaways Very supportive wire 具有高支撐力 For secondary use (not for gaining initial access) 第二根導(dǎo)絲（不作為進(jìn)入導(dǎo)絲） Strong enough to get through tight lesions, yet tip is soft enough for reduced trauma during advancement. 具有足夠的強(qiáng)度(qingd)通過(guò)狹窄病變，同時(shí)柔軟的頭端可避免在推進(jìn)導(dǎo)絲時(shí)損傷血管。第42頁(yè)/共89頁(yè)第四十二頁(yè)，共90頁(yè)。Amplatz Super Stiff Guidew

51、ireSuper stiff wire body with an atraumatic tip for catheter placement and exchange in uroradiology, biliary drainage, abscess drainage and vascular procedures. 具有良好硬度的桿身和無(wú)創(chuàng)性頭端，可用于在泌尿系統(tǒng)、膽道引流、膿腫引具有良好硬度的桿身和無(wú)創(chuàng)性頭端，可用于在泌尿系統(tǒng)、膽道引流、膿腫引流和血管介入流和血管介入(jir)手術(shù)中放置和更換導(dǎo)管。手術(shù)中放置和更換導(dǎo)管。PTFE Coating helps to reduce frict

52、ion and allows for easy catheter passage PTFE涂層減少了摩擦力，便于推進(jìn)導(dǎo)管。涂層減少了摩擦力，便于推進(jìn)導(dǎo)管。在具有出色的硬度、強(qiáng)度在具有出色的硬度、強(qiáng)度(qingd)、穩(wěn)、穩(wěn)定性的同時(shí)柔軟的無(wú)創(chuàng)傷頭端有良好的安定性的同時(shí)柔軟的無(wú)創(chuàng)傷頭端有良好的安全性全性第43頁(yè)/共89頁(yè)第四十三頁(yè)，共90頁(yè)。Magic Torque Guide Wire第44頁(yè)/共89頁(yè)第四十四頁(yè)，共90頁(yè)。Magic Torque Guide Wire Product Positioning.0353CM50CMGLIDEX180 / 260CMExcellent torque

53、 control and radiopaque Magic Markers for enhanced visualization to meet the challenges of difficult anatomy.第45頁(yè)/共89頁(yè)第四十五頁(yè)，共90頁(yè)。Magic Torque Guide Wire IndicationsINDICATIONS:The Magic Torque Guide Wire facilitates placement of a catheter during diagnostic or interventional procedures. The wire can

54、 be torqued to facilitate navigation through tortuous arteries and/or avoid unwanted side branches.第46頁(yè)/共89頁(yè)第四十六頁(yè)，共90頁(yè)。Magic Torque Guide Wire Product SpecsTip ShapeTip Length (cm)Diameters (in)Lengths (cm)Shapeable5.035180, 260第47頁(yè)/共89頁(yè)第四十七頁(yè)，共90頁(yè)。Magic Torque Guide Wire Features & Intended Benefits

55、.0353CM50CMGLIDEX180 / 260CMMagic Torque FeaturesIntended BenefitsShapeable 3cm tipFlexibility for facilitating accurate placement, even in difficult anatomy.Single piece core with torque jacket1:1 torque control with superior body.Radiopaque distal markers spaced at 1cm incrementsAccurate measureme

56、nt of vessel size.Exclusive Glidex hydrophilic coating on distal 10cmFacilitation of advancement and negotiation of tortuous anatomy.第48頁(yè)/共89頁(yè)第四十八頁(yè)，共90頁(yè)。Magic Torque Guide Wire Areas of Clinical Use.0353CM50CMGLIDEX180 / 260CMAortic bifurcation areaCarotid/aortic arch areaSFA/BTK第49頁(yè)/共89頁(yè)第四十九頁(yè)，共90頁(yè)。

57、Magic Torque Guide Wire Key Competitors The Graduate Measuring Wire (Cook) Wholey-HI-TORQUE Guide Wire (Covidien) HI-TORQUE Supra Core Guide Wire (Abbott Vascular)第50頁(yè)/共89頁(yè)第五十頁(yè)，共90頁(yè)。 Precise 1:1 torque response Radiopaque “Magic Markers” allow for accurate measurement visualizationMagic Torque Guide

58、 Wire Key Takeaways第51頁(yè)/共89頁(yè)第五十一頁(yè)，共90頁(yè)。Magic TorqueGlidex Coated Hydrophilic GuidewireCombining 4 distal platinum Magic markers with Glidex hydrophilic coating and an excellent torque control*.Great for navigating tortuous anatomy and accessing side branches.Support is great for delivering Stent / B

59、alloon CathetersMarkers make correct stent sizing easy and avoid any parallax effect第52頁(yè)/共89頁(yè)第五十二頁(yè)，共90頁(yè)。Meier Wire (Backup Meier)第53頁(yè)/共89頁(yè)第五十三頁(yè)，共90頁(yè)。Meier Guide Wire Product Positioning.0353CM50CMGLIDEX180 / 260CMFirst guide wire indicated for AAA endovascular graft procedures. Stiff shaft provides

60、excellent support, while flexible tip reduces the risk of vessel trauma. 第54頁(yè)/共89頁(yè)第五十四頁(yè)，共90頁(yè)。Meier Guide Wire IndicationsINDICATIONS:The Back-Up Meier Steerable Guide Wire facilitates catheter placement and exchange during diagnostic or interventional procedures including AAA endovascular graft proc

61、edures.第55頁(yè)/共89頁(yè)第五十五頁(yè)，共90頁(yè)。Meier Guide Wire Product Specs.0353CM50CMGLIDEX180 / 260CMTip ShapeTip Length (cm)Diameters (in)Lengths (cm)J15.035185C10.035260, 300第56頁(yè)/共89頁(yè)第五十六頁(yè)，共90頁(yè)。Meier Guide Wire Features & Intended Benefits.0353CM50CMGLIDEX180 / 260CMMeier Wire FeaturesIntended BenefitsStainless s

62、teel shaft coreExcellent support for catheter delivery because of shaft stiffness.Flexible tip constructionReduced risk of vessel trauma during advancement.Highly radiopaque designEnhanced visualization for more accurate placement.第57頁(yè)/共89頁(yè)第五十七頁(yè)，共90頁(yè)。Meier Guide Wire Areas of Clinical UseGLIDEXAAA第5

63、8頁(yè)/共89頁(yè)第五十八頁(yè)，共90頁(yè)。Meier Guide Wire Key CompetitorsCook Lunderquist Extra Stiff Guide Wire Also referred to as the “coat hanger”第59頁(yè)/共89頁(yè)第五十九頁(yè)，共90頁(yè)。 Very supportive wire for AAA procedures. Highly radiopaque gold-plated tungsten spring coil tip is designed to enhance visualization for more accurate p

64、lacement. Meier Guide Wire Key Takeaways第60頁(yè)/共89頁(yè)第六十頁(yè)，共90頁(yè)。Back-up Meier Steerable GuidewireBalancing the support, flexibility and radiopacity required for efficient catheter placementOptimally stiff stainless steel shaft coreStraightens tortuous anatomyProvides the “railroad tracks” for large devic

65、e to followVery flexible and soft distal tip (J or C tip construction)A soft and flexible tip minimizes the risk of perforating the aortic arch or causing other vessel trauma (dissection)Minimizes the risk of dislodging thrombus from the aorta Highly radiopaque gold-plated tungsten spring coil tipPr

66、ovides excellent visibility of the wire under fluoroscopy for accurate placementPTFE coated proximal shaftPromotes smooth catheter advancementReduces the risk of thrombus formationLarge device easily tracks on PTFE shaft第61頁(yè)/共89頁(yè)第六十一頁(yè)，共90頁(yè)。Platinum PLUS Guide Wire第62頁(yè)/共89頁(yè)第六十二頁(yè)，共90頁(yè)。Platinum PLUS Guide WireProduct Positioning.0353CM50CM180 / 260CMFor negotiation of tortuous anatomy and contralateral approaches including smaller vessels (.014” & .018”) and those with short distal purchase (short