導(dǎo)引導(dǎo)絲的設(shè)計(jì)

1、Guide Wire Design導(dǎo)引導(dǎo)絲的設(shè)計(jì) Guide Wire Function 導(dǎo)絲的功能 Guide Wire Selection Goals 選擇導(dǎo)絲時(shí)要達(dá)到的目標(biāo) Guide Wire Performance Characteristics 導(dǎo)絲的性能 Guide Wire Components & Design 導(dǎo)絲的結(jié)構(gòu)和設(shè)計(jì)Guide Wire Function導(dǎo)絲的功能 Facilitate access to diseased vessels and the delivery of interventional equipment 協(xié)助介入器械輸送至病變部位 Trac

2、k through the vessel 在血管中走行 Access and cross lesions 到達(dá)并通過(guò)病變 Support & deliver interventional devices 支撐并輸送介入器械 Steer into and protect side branches 進(jìn)入并保護(hù)分支血管Guide Wire Selection Goals 選擇導(dǎo)絲時(shí)要達(dá)到的目標(biāo) Traverse the coronary anatomy safely, independently and without damaging the vessel 安全通過(guò)冠脈血管，對(duì)血管不造成損傷 A

3、ppropriate match for clinical setting 滿足不同的臨床需求Workhorse/front-line use 主力/一線導(dǎo)絲Navigate tortuous anatomy 通過(guò)迂曲血管Provide extra support 提供更強(qiáng)支撐力Crossing highly stenosed lesions 通過(guò)高度狹窄的病變Guide Wire Performance Characteristics導(dǎo)絲的性能Flexibility 柔軟度Support 支撐力Steering 操控性Lubricity 順滑度Tracking 跟蹤性Torque respo

4、nse 扭矩傳遞Visibility 可視性Tactile Feedback 觸覺(jué)反饋Crossability 通過(guò)能力Performance性能Design設(shè)計(jì) What will affect Guide Wire Performance Characteristics? 導(dǎo)絲的性能由何決定？ Guide Wire Components & Design導(dǎo)絲的結(jié)構(gòu)和設(shè)計(jì) Core Diameter 核芯直徑 Core Taper 核芯椎體 Core Material 核芯材料 Tip Style 頭端類(lèi)型 Coils and Covers 彈簧圈和聚合物護(hù)套 Coating 涂層Core

5、Diameter 核芯直徑 Diameter affects flexibility, support and torque 核芯直徑影響導(dǎo)絲的柔軟度、支撐力和扭矩傳遞Smaller Diameter = More Flexibility直徑越小 = 更柔軟Larger Diameter = More Support & Torque直徑越大 = 支撐力更強(qiáng) & 扭矩傳遞更好Core Taper 核芯椎體 Tracking 跟蹤性Ability of wire body to follow tip around bends 導(dǎo)絲體部隨著頭端的彎曲而彎曲的能力 Degree of support

6、 支撐力的大小Core Taper 核芯椎體Longer taper 較長(zhǎng)椎體Shorter taper較短椎體Parabolic grind流線型核芯錐體PORABOLIC GRINDGradual transitions, provide less prolapse and improves ability to follow itself into acute bends較長(zhǎng)且過(guò)渡平緩的核芯椎體，減少導(dǎo)絲頭端脫垂的可能性，提高導(dǎo)絲的跟蹤性Core Taper 核芯椎體Abrupt transitions or shorter taper may result in difficulty

7、accessing acute angles突然變細(xì)或較短的椎體，導(dǎo)絲頭端容易脫垂，難以通過(guò)成角的部位prolapseCore Taper 核芯椎體Core Material 核芯材料Affects flexibility, support, steering and tracking 核芯材料影響導(dǎo)絲的柔軟度、支撐力、操控性和跟蹤性Stainless Steel 不銹鋼Nitinol 鎳鈦合金High Tensile Strength Stainless Steel 高強(qiáng)度不銹鋼Stainless steel 不銹鋼不銹鋼 Original core material technology

8、最初應(yīng)用于導(dǎo)絲的材料 Good support, push force and torque 提供良好的支撐力、推送力和扭矩傳遞 Less flexible than newer core materials 與新型材料相比柔軟度欠佳Core Material 核芯材料Nitinol 鎳鈦合金鎳鈦合金 Super-elastic alloy designed for kink resistance 超彈性合金，抗打折能力強(qiáng) Excellent flexibility and steering 柔軟度高、操控性好 Durable nature may facilitate treatment o

9、f multiple lesions and/or tortuous vessels 性質(zhì)耐用，可治療多個(gè)病變和/或迂曲血管病變Core Material 核芯材料Core Material 核芯材料 Nitinol 鎳鈦合金 Nitinol 鎳鈦合金鎳鈦合金 Super-elastic alloy designed for kink resistance 超彈性合金，抗打折能力強(qiáng)High Tensile Strength Stainless Steel 高強(qiáng)高強(qiáng)度不銹鋼度不銹鋼 Durasteel More durable than regular stainless steel 比常規(guī)不銹

10、鋼更耐用 Retains shape 形狀保持能力強(qiáng) Good flexibility 良好的柔軟度 Excellent steering and tracking 出色的操控性和跟蹤性Core Material 核芯材料Tip Style 頭端類(lèi)型 Affects steering 影響操控性 Design options 頭端設(shè)計(jì)類(lèi)型Core-to-tipShaping ribbonCore-to-tipShaping ribbonTip Style 頭端類(lèi)型 - Core-to-Tip Precise steering and tip control 可實(shí)現(xiàn)對(duì)導(dǎo)絲頭端的精細(xì)操作 Grea

11、ter tactile feedback 良好的觸覺(jué)反饋 Stiffness for crossing resistant lesions 提供適當(dāng)頭端硬度以通過(guò)高阻力病變 Tip Style 頭端類(lèi)型 - Shaping Ribbon Flexible 柔軟 Softer tip 頭端硬度較小 Allows shape retention 頭端塑形保持較好Coils 彈簧圈護(hù)套 Affect support, steering, tracking and visibility 影響導(dǎo)絲的支撐力、操控性、跟蹤性和可視性 Impact dimension of wire 影響導(dǎo)絲的直徑 Affe

12、ct tactile feedback 影響導(dǎo)絲的觸覺(jué)反饋Outer Coils 外部彈簧圈Tip Coils Only 僅有頭端彈簧圈Intermediate Coils 中段彈簧圈護(hù)套 Provide device trackability 改善器械輸送性 Contribute to diameter 維持導(dǎo)絲的通體直徑一致 Tip Coils 頭端彈簧圈護(hù)套 Distal 2-3 cm of wire 導(dǎo)絲遠(yuǎn)端 2-3 cm的部位 Radiopaque 可視性 Stretched for tip shaping and softness 可以伸展，利于頭端塑形及其柔軟度Polymer 聚

13、合物護(hù)套 Polymer or plastic 聚合物或塑料 Provide lubricity 改善順滑性 Smooth tracking through tortuosity 跟蹤性好，更容易通過(guò)迂曲的血管Polymer Cover 聚合物護(hù)套Combinations 護(hù)套的組合 Tip coils plus 頭端彈簧圈加上:Intermediate coils 中段彈簧圈Bare core 裸核芯Plastic cover 塑料護(hù)套Polymer 聚合物護(hù)套 Polymer over tip coils 彈簧圈外覆有聚合物護(hù)套R(shí)adiopacity 可視性Affected by coil

14、s and covers 受彈簧圈和聚合物護(hù)套影響Tip Coils頭端彈簧圈護(hù)套頭端彈簧圈護(hù)套Coatings 涂層 Affect lubricity and tracking 影響導(dǎo)絲的順滑性和跟蹤性 Facilitate smooth movement 使器械在導(dǎo)絲上面的移動(dòng)更順滑 Distal 30-35 cm 導(dǎo)絲遠(yuǎn)段30-35 cm Types 類(lèi)型Hydrophilic 親水涂層Hydrophobic 疏水涂層Coatings 涂層 Hydrophilic 親水涂層Attracts water 吸引水分子Applied over polymer and stainless ste

15、el, including tip coils 涂在聚合物護(hù)套、不銹鋼核芯和頭端彈簧圈護(hù)套外Thin, non-slippery solid when dry 干燥狀態(tài)下為一薄層、不光滑物質(zhì)Becomes gel when wet 潤(rùn)濕時(shí)呈光滑的凝膠狀Reduces friction 降低摩擦阻力Increases trackability 提高跟蹤性Coatings 涂層 Hydrophobic 疏水涂層Repels water 排斥水分子Silicone on working area of wire, excluding tip 涂在導(dǎo)絲工作區(qū)域（頭端除外）的硅樹(shù)脂No actuatio

16、n required 無(wú)需激活Reduces friction 降低摩擦阻力Increases trackability 提高跟蹤性Guide Wire Covers and Coatings導(dǎo)絲的護(hù)套和涂層No Coating 無(wú)涂層Hydrophobic Coating 疏水涂層Hydrophilic Coating 親水涂層Polymer Cover With Hydrophilic Coating 聚合物護(hù)套加親水涂層Lubricity 光滑性Tactile Feedback (related coils) 觸覺(jué)反饋Summary 總結(jié) Variation in guide wire compone