波科外周Guidewires中文導(dǎo)絲.ppt

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1、Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Peripheral Guide Wires:外周介入導(dǎo)絲：Standard, Hydrophilic 通過迂曲的血管；smooth tracking of devices comes in multiple shapes: straight, angled, shapeable, J 遠(yuǎn)端頭端：導(dǎo)絲的工作端；有多種形狀：直型，成角型，可塑性，J型Lubricious Coating: PTF

2、E, Silicone, or Hydrophilic光滑涂層：PTFE，硅，或親水性Distal Tip遠(yuǎn)端Safety Ribbon安全帶Core wire軸芯Coil wire螺旋金屬絲Proximal End近端 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Floppy/Light Support (POBA): Starter Guide Wire松軟型/輕度支撐（POBA）：StarterTM 導(dǎo)絲 Most flexibl

3、e; least rail support 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Moderate Support (Stent): Magic Torque Guide Wire中度支撐（支架）： Magic Torque 導(dǎo)絲 Rail support between Floppy total occlusions.當(dāng)標(biāo)準(zhǔn)導(dǎo)絲無法通過時(shí)；完全阻塞的病變Amplatz Super Stiff Guide Wire When more support is needed such as filter placement

4、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 Wire Negotiating difficult vessels, sizing vessels, sizing IVC filters.Meier Wire AAA indicated; stiffer than Amplatz with a softer, radiopaque tip.Platinum PLUS Guide Wire IVUS, small vessel (.014” & .018”).V-18 Guide Wire

5、 Small vessels (.018”), tortuous anatomy, contralateral. 小血管（.018”），迂曲的血管，對(duì)側(cè)病變。Thruway Guide Wire Small vessels (.014” & .018”), renals, monorail.小血管（.014 ” & .018”），腎動(dòng)脈，快速交換 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guide Wires The

6、 information included in this section is considered proprietary to Lake Region Manufacturing, Inc. Any copying, sharing and/or distributing is prohibited. Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guide WireProduct PositioningA fami

7、ly of ultra-smooth, PTFE guide wires. Workhorse guide wire for routine procedures. Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guide WireIndicationsINTENDED USE: Starter guide wires are designed for percutaneous vessel entry using the

8、 Seldinger technique to facilitate subsequent introduction(s) of an intravascular device. Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guide WireProduct SpecsTips Diameters (in) Lengths (cm)Bentson .035, .038 150, 180, 260Newton .018,

9、.035, .038 150J-Tip* .035, .038 150, 180, 260Rosen .035 150, 180, 260Standard .025, .035, .038 80, 150, 260 *Most are finger straightenable Bentson, Newton, and Rosen are industry standard wire types sold by other companies as well. Available with or without heparin coating. Straight and J-tips avai

10、lable with fixed or moveable core (not available in all sizes). Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guide WireFeatures & Intended BenefitsStarter Wire Features Intended BenefitsPTFE coating applied using pre-coat technology (d

11、ipped vs sprayed) Increased coating consistency and durability to facilitate entry and smooth catheter tracking.Availability of heparin coating Decreased risk of thrombus formation.Finger straightenable J-tip Use in a wide range of clinical situations. Choice of fixed or moveable core Use in a wide

12、range of clinical situations. Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guide WireAreas of Clinical UseGaining access for routine procedures Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute

13、Externally Starter Guide WireKey CompetitorsThe following competitors also sell Bentson, Newton and Rosen wires, as well as other PTFE-coated competiting workhorse wires: Cook market leader in standard guide wires Angiodynamics Cordis St. Jude Bard Merit Boston Scientific Confidential - For Internal

14、 Use Only. Do Not Copy, Display or Distribute Externally Starter Guide WireKey TakeawaysAtraumatic, workhorse guide wire for routine procedures. Pre-Coat TechnologyDipped coating for excellent coating durability & consistency Finger straightenable J-tip Availability of heparin coating Moveable & fix

15、ed core options Sprayed CoatingStarter Guide Wire Dipped Coating (a.k.a. “Pre-Coat Technology”) Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally GuidewiresConstruction - non hydrophilic wires Boston Scientific Confidential - For Internal Use Only.

16、 Do Not Copy, Display or Distribute Externally Starter Guidewire Fixed CoreIdeal first wire to use before or after Introducer Sheath Insertion Atraumatic Floppy Tip provides safety, Well balanced body provides ample pushability and support for Catheter Exchange Precoat technology allows for ease of

17、Catheter Exchange Large Size Matrix covers majority of clinical requirements Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guidewire Moveable CoreIdeal first wire to use before or after Introducer Sheath Insertion Moveable Core allows a

18、djustment 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 allows for ease of Catheter Exchange Large Size Matrix covers majority of clinical requirements Boston Scientific

19、 Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 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 suitableAlso ideal for nav

20、igation of heavily diseased Iliacs and Aortas.Very Atraumatic Floppy tip, body support does allow catheter exchange Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guidewire New BentsonIdeal wire to use for accessing delicate vessels and

21、crossing fragile lesions such asRenal, Dialysis Fistula, 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 Boston Scientific Confiden

22、tial - For Internal Use Only. Do Not Copy, Display or Distribute Externally Starter Guidewire Rosen Heavy DutyIdeal wire to use for catheter access where additional support is required especially in Ostial lesions due to short taper preventing flip outRenal, Dialysis Fistula, Subclavian, Fempop. Wat

23、ch out 0.018” wires may be more suitable Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire Hydrophilic Guide Wires ZIPwire 親水性導(dǎo)絲ZIPwire Guide Wire Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Ex

24、ternally ZIPwire Guide Wire產(chǎn)品定位A family of hydrophilic guide wires designed for smooth passage through tortuous anatomy.設(shè)計(jì)用于流暢的通過迂曲的解剖結(jié)構(gòu) Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire Guide Wire適應(yīng)癥INDICATIONS: The ZIPwire Hydrophilic Gui

25、de Wire is intended to facilitate the placement of devices during 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)中協(xié)助置入器械。 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire Guide Wire產(chǎn)品技術(shù)參數(shù) ZIPwire is a trademark of Bost

26、on Scientific Corporation or its affiliates. Glidewire is a trademark of Terumo Corporation. Shafts桿身Standard, Stiff標(biāo)準(zhǔn)型，加硬型Tips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.018”, .025”, .035”, .038”Lengths長(zhǎng)度80cm, 150cm, 180cm, 260cmNote: See Guide Wires brochure or price

27、 book for all available combinations.注意：請(qǐng)參見相關(guān)產(chǎn)品彩頁或手冊(cè)了解所有的產(chǎn)品型號(hào) Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire Guide WireEnhanced Manufacturing ProcessA polymer jacket is extruded over a kink-resistant nitinol core. 聚合物外殼覆蓋在抗扭曲的鎳鈦諾合金軸芯表面Hy

28、drophilic coating is bonded to the polymer jacket.親水性涂層粘合在聚合物外殼上Radiopaque Polyurethane Jacket 不透X線的聚亞安酯外殼 Nitinol Core鎳鈦諾軸芯Hydrophilic Polymer Coating親水性聚合物涂層The manufacturing process enhancements treated the surface of the polyurethane jacket for consistent adhesion of the hydrophilic coating. Bos

29、ton Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire PropertiesKink-resistant抗扭曲性 The nitinol metal alloy core provides 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ZIPwire導(dǎo)絲具有良好的抗扭曲性能。Steerable操控性 Single piec

30、e construction and atraumatic tip allow excellent steerability. 一體式結(jié)構(gòu)和無創(chuàng)性頭端使其具有優(yōu)異的操控性。 The unique alloy core and polyurethane 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實(shí)現(xiàn)了1:1扭控反應(yīng)。Frictionless 光滑度 The hydrophilic coating makes the ZIPwire guidewire virtually fr

31、ictionless when wet. The ZIPwire guidewire slides easily into place and smoothly guides catheters. 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。 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire PropertiesLow Thrombogenicity (tendency to produce blood clo

32、ts)低血栓性（產(chǎn)生凝血塊的趨勢(shì)） The frictionless coating results in low potential for the formation of blood clots on the surface of the ZIPwire 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)。Radiopaque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X線下具有良好的可視性。Atraum

33、atic無創(chuàng)性 The various cores result in soft, flexible tip configurations. 不同的軸芯 各種類型的柔軟而富有彈性的頭端。 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire Guide WireFeatures & Intended BenefitsZIPwire Guide Wire Features Intended BenefitsHydrophilic c

34、oating親水性涂層Facilitation of crossing of tight lesions.易于通過高度狹窄的病變Precise 1:1 torque response精確的1:1扭控反應(yīng)Secure control when sub-selecting 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Excellent visibility for accurate positioning.良好的可視性，便于準(zhǔn)確定位Super-elastic nitinol

35、 core有良好彈性的鎳鈦諾軸芯Excellent kink-resistance.優(yōu)異的抗扭曲性能 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire Guide Wire臨床應(yīng)用領(lǐng)域Aortic bifurcation area腹主動(dòng)脈分叉Carotids頸動(dòng)脈HAM血透通路 Crossing CTOs通過完全阻塞的病變Subintimal Angioplasty內(nèi)膜下血管成形術(shù) Boston Scientific Conf

36、idential - For Internal Use Only. Do Not Copy, Display or Distribute Externally ZIPwire Guide WireKey Competitors Glidewire Guide Wire (Terumo - previously sold by Boston Scientific)- Hydrophilic market leader Roadrunner Guide Wire (Cook) AQUALiner Guide Wire (Angiodynamics) HiWire Guide Wire (Cook)

37、 HydroSteer Guide Wire (St. Jude Medical) Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 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)用于通過迂曲的解剖

38、結(jié)構(gòu)。 Precise 1:1 torque response 精確的1:1扭控反應(yīng) Highly radiopaque jacket 高顯影性外殼 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) Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Amplatz Super Stiff Guide Wire Amplatz Super Stiff

39、超硬導(dǎo)絲 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Amplatz Super Stiff Guide Wire 產(chǎn)品定位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，用于放置和更換導(dǎo)管。 Boston Scientif

40、ic Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Amplatz Super Stiff Guide Wire 適應(yīng)癥INDICATIONS:The Amplatz Super Stiff Guide Wire facilitates catheter placement and exchange during diagnostic or interventional procedures. It is not intended for use in coronary a

41、rteries.Amplatz Super Stiff超硬導(dǎo)絲用于在診斷性和治療性介入手術(shù)中放置和更換導(dǎo)管。不適用于冠脈手術(shù)。 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Amplatz Super Stiff Guide Wire 產(chǎn)品技術(shù)參數(shù)Tip Shape頭端形狀Tip Length頭端長(zhǎng)度 (cm) Diameters (in)直徑Lengths (cm)長(zhǎng)度3mm J3mmJ型3 .035, .038 145, 180, 2

42、60Straight直型6 .018, .035, .038 75, 145, 180, 260Short Tip短頭端1, 3.5 .035, .038 150, 180, 260 Note: See Guide Wire brochure or price book for all available combinations.注意：請(qǐng)參見相關(guān)產(chǎn)品彩頁或手冊(cè)了解所有的產(chǎn)品型號(hào) Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Amplat

43、z Super Stiff Guide WireFeatures & Intended BenefitsAmplatz Super Stiff Features Intended BenefitsStiff core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 distal core taper無創(chuàng)性頭端 & 漸細(xì)的遠(yuǎn)端軸芯Safety du

44、ring 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Smooth entry and catheter tracking.進(jìn)入血管和推送導(dǎo)管更加流暢 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Amplatz Super Stiff Guide Wire臨床應(yīng)用領(lǐng)域Aortic bifurcation area主動(dòng)脈分叉Carotid/aortic arch area頸動(dòng)脈/主動(dòng)脈弓 Bo

45、ston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 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

46、Supra Core (Abbott Vascular) Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Amplatz Super Stiff Guide WireKey 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 ti

47、ght lesions, yet tip is soft enough for reduced trauma during advancement. 具有足夠的強(qiáng)度通過狹窄病變，同時(shí)柔軟的頭端可避免在推進(jìn)導(dǎo)絲時(shí)損傷血管。 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Amplatz Super Stiff GuidewireSuper stiff wire body with an atraumatic tip for catheter

48、placement and exchange in uroradiology, biliary drainage, abscess drainage and vascular procedures. 具有良好硬度的桿身和無創(chuàng)性頭端，可用于在泌尿系統(tǒng)、膽道引流、膿 腫引流和血管介入手術(shù)中放置和更換導(dǎo)管。PTFE Coating helps to reduce friction and allows for easy catheter passage PTFE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、穩(wěn)定性的同時(shí)柔軟的無創(chuàng)傷頭端有良好的安全性 Boston Scientific Co

49、nfidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Magic Torque Guide Wire Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Magic Torque Guide Wire Product Positioning.035 3CM 50CM GLIDEX 180 / 260CMExcellent torque

50、control and radiopaque Magic Markers for enhanced visualization to meet the challenges of difficult anatomy. Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Magic Torque Guide Wire IndicationsINDICATIONS:The Magic Torque Guide Wire facilitates pl

51、acement of a catheter during diagnostic or interventional procedures. The wire can be torqued to facilitate navigation through tortuous arteries and/or avoid unwanted side branches. Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Magic Torque Gui

52、de Wire Product SpecsTip Shape Tip Length (cm) Diameters (in) Lengths (cm)Shapeable 5 .035 180, 260 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Magic Torque Guide Wire Features & Intended Benefits.035 3CM 50CM GLIDEX 180 / 260CMMagic Torque F

53、eatures Intended BenefitsShapeable 3cm tip Flexibility for facilitating accurate placement, even in difficult anatomy.Single piece core with torque jacket 1:1 torque control with superior body.Radiopaque distal markers spaced at 1cm increments Accurate measurement of vessel size.Exclusive Glidex hyd

54、rophilic coating on distal 10cm Facilitation of advancement and negotiation of tortuous anatomy. Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Magic Torque Guide Wire Areas of Clinical Use.035 3CM 50CM GLIDEX 180 / 260CMAortic bifurcation areaC

55、arotid/aortic arch area SFA/BTK Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally 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) Bo

56、ston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Precise 1:1 torque responseRadiopaque “Magic Markers” allow for accurate measurement visualizationMagic Torque Guide Wire Key Takeaways Boston Scientific Confidential - For Internal Use Only. Do Not C

57、opy, Display or Distribute Externally 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

58、alloon CathetersMarkers make correct stent sizing easy and avoid any parallax effect Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Meier Wire (Backup Meier) Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distrib

59、ute Externally Meier Guide Wire Product Positioning.035 3CM 50CM GLIDEX 180 / 260CMFirst guide wire indicated for AAA endovascular graft procedures. Stiff shaft provides excellent support, while flexible tip reduces the risk of vessel trauma. Boston Scientific Confidential - For Internal Use Only. D

60、o Not Copy, Display or Distribute Externally 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 procedures. Boston Scientific Confidential - For Int

61、ernal Use Only. Do Not Copy, Display or Distribute Externally Meier Guide Wire Product Specs.035 3CM 50CM GLIDEX 180 / 260CMTip Shape Tip Length (cm) Diameters (in) Lengths (cm)J 15 .035 185C 10 .035 260, 300 Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute

62、Externally Meier Guide Wire Features & Intended Benefits.035 3CM 50CM GLIDEX 180 / 260CMMeier Wire Features Intended BenefitsStainless steel shaft core Excellent support for catheter delivery because of shaft stiffness.Flexible tip construction Reduced risk of vessel trauma during advancement.Highly

63、 radiopaque design Enhanced visualization for more accurate placement. Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Meier Guide Wire Areas of Clinical Use GLIDEXAAA Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display o

64、r Distribute Externally Meier Guide Wire Key CompetitorsCook Lunderquist Extra Stiff Guide Wire Also referred to as the “coat hanger” Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Very supportive wire for AAA procedures. Highly radiopaque gold-

65、plated tungsten spring coil tip is designed to enhance visualization for more accurate placement. Meier Guide Wire Key Takeaways Boston Scientific Confidential - For Internal Use Only. Do Not Copy, Display or Distribute Externally Back-up Meier Steerable GuidewireBalancing the support, flexibility a

66、nd radiopacity required for efficient catheter placementOptimally stiff stainless steel shaft coreStraightens tortuous anatomyProvides the “railroad tracks” for large device 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 tip Provides excellent visibility