1130_Fanelli.pdf

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1、What is Vessel Prepand Do I Need it Prior to Therapy?Fabrizio Fanelli,MD,EBIRProfessor of Interventional RadiologyDirector Vascular and Interventional Radiology DepartmentCareggi University HospitalFlorence-ItalyDisclosures Consultant/Speaker/Proctor/Advisory Board Abbott BD Bard Boston Scientific C

2、ook iVascular Medtronic Merit Penumbra Philips Volcano W.L.Gore&Associates Zylox TonbridgeVessel PreparationVessel Compliance Lumen GainLumen size stabilityVessel scaffoldingDrug transfer and uptakeEarly recoilFlow limiting dissectionsBail-out stentOptimization of acute result is important to both a

3、cute and long term outcomes in complex settings such as CTO,ISR,Ca+Calcium:potential barrier to optimal drug absorptionCircumferential distribution strongest influencing factorFanelli F,Cannavale A,Gazzetti M,Lucatelli P,Wlderk A,Cirelli C,dAdamo A,Salvatori FM.Calcium burden assessment and impact o

4、n drug-eluting balloons in peripheral arterial disease.Cardiovasc Intervent Radiol.2014 Aug;37(4):898-907 a=3cm Calcium evaluation by CTA(circumf.)and DSA(longitud.)N=60N=60SFA lesions 6 cm(de-novo)CTO:31.7%DCB with standard pre-dilatationEx-vivo and pre-clinical experiments confirm Calcium,not plaq

5、ue burden,remains the real barrier for DCB drug uptake1.Tzafriri AR,Garcia-Polite F,Zani B,Stanley J,Muraj B,Knutson J,Kohler R,Markham P,Nikanorov A,Edelman ER.Calcified plaque modification alters local drug delivery in the treatment of peripheral atherosclerosis.J Control Release.2017 Sep 1;264:20

6、3-2102.Tellez A,Dattilo R,Mustapha JA,Gongora CA,Hyon CM,Palmieri T,Rousselle S,Kaluza GL,Granada JF.Biological effect of orbital atherectomy and adjunctive paclitaxel-coated balloon therapy on vascular healing and drug retention:early experimental insights into the familial hypercholesterolaemic sw