1450_Soukas.pdf

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1、Pave and Crack Technique:Role of Covered Stents in Calcified LesionsPeter A.Soukas,MD,FACC,FSVM,FSCAI,FACP,RPVIDirector,Vascular Medicine&Interventional PV LabDirector,Brown Vascular&Endovascular Medicine Fellowship The Miriam&RI Hospitals,Providence,RIAssociate Professor of MedicineBrown Medical Sc

2、hoolDisclosures Institutional Grant/Research Support:AcoArt,Akura,AngioSafe,AVS,BD,BSC,Cagent Vascular,Cordis,Contego Medical,Endologix,Medtronic,Penumbra,r3Vascular,Reva Medical,Shockwave Medical,W.L.Gore Consultant:Abbott,BSC,Cagent Vascular,Contego Medical,Endologix,Medtronic,Shockwave Medical,W.

3、L.Gore Advisory Board:Abbott,AngioSafe,BSC,Cagent Vascular,Endologix,Medtronic,Shockwave Medical,W.L.GoreTraditional Crack and PaveHeavily calcified SFAIneffectivePTAIneffectiveCB PTAViabahn S-GResidualStenosisw/in stentPost-dilation tohigh pressurew/NC balloonCrack&Pave Technique:Role of Covered St

4、ents(and IVL)in Calcified LesionsPeter A.Soukas,MD,FACC,FSVM,FSCAI,FACP,RPVIDirector,Vascular Medicine&Interventional PV LabDirector,Brown Vascular&Endovascular Medicine Fellowship The Miriam&RI Hospitals,Providence,RIAssociate Professor of MedicineBrown Medical SchoolChallenges of Severely Calcifie

5、d LesionsDissectionsPerforationsEmbolizationVessel Recoil*Complications following treatment with endovascular procedures increase in calcified lesionsIncomplete Stent Expansion/FractureCalcification restricts vessel expansion resulting in higher residual stenosis and lower procedural effectiveness*B

6、aumann et al,Early recoil after balloon angioplasty of tibial artery obstructions in patients with critical limb ischemia,J Endovasc Ther 2014 Covered stents:Advantages Exclude plaque Prevent in-stent neointimal hyperplasia Decrease risk of complications caused by distal embolization,dissections Pre