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Carotid stent 삽입시 Percusurge Guardwire 의 유용성

Carotid stent 삽입시 Percusurge Guardwire 의 유용성. 고 승 일 삼성서울병원. 대상과 방법. 2002년 5월 – 2003년 4월 Pt. 26 명( M /23, F /3) 연령 : 48 – 84( mean 65) Rt.ICA – 15 Lt. ICA – 10 VA – 1 협착율 : 70 – 95% 이상 Pre & Post Diffusion / Perfusion MRI 시행. Percusurge Guardwire 구성. Percusurge Guardwire 구성.

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Carotid stent 삽입시 Percusurge Guardwire 의 유용성

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  1. Carotid stent 삽입시 Percusurge Guardwire의 유용성 고 승 일 삼성서울병원

  2. 대상과 방법 • 2002년 5월 – 2003년 4월 • Pt. 26명(M /23, F /3) • 연령 : 48 – 84(mean 65) • Rt.ICA – 15 • Lt. ICA – 10 • VA – 1 • 협착율 : 70 – 95% 이상 • Pre & Post Diffusion / Perfusion MRI시행

  3. Percusurge Guardwire 구성

  4. Percusurge Guardwire 구성

  5. EZ Flator & Guard Wire

  6. Micro Seal Adapter

  7. Export Catheter

  8. a) b) c) d) e)

  9. Inflation

  10. Use by wire

  11. Deflation

  12. CASE Pre-angiography

  13. CASE Pre-dilatation(3mm balloon)

  14. CASE Post-dilatation(6mm balloon)

  15. CASE Post-angiography

  16. CASE Pre Post Diffusion MRI

  17. CASE Debris

  18. Debris • Thrombus Fragment • Calciific Plaque Fragment • Fibrous Plaque Debris • Lipid or Cholesterol Vacuoles • Intima Fragment • Mean Particulate size: 250µm • ( 53 – 2846 µm)

  19. Protection device type Distal occusion type Filter type

  20. Filter type device Angioguard(cordis) Neuroshield(Mednova) Accunet(Guidant)

  21. 결 과 • 26명 중 small focal acute infarction 13명- 신경학적 증상 발생 1례(visual loss) MRI에서 acute lesion 없었음 • Protection device를 사용하기 전 45명 • 중 41명의 환자에서 small focal acute infarction 발생 - Stroke 3명 • 전.후 비교 small focal acute infarction • 20% 감소

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