Herz-Kreislauf I PDF

KHK, Herzkatheter, perkutane koronare Intervention Prof. Dr. med M. Buerke Medizinische Klinik II Herz- und Gefäßzentrum Südwestfalen Marien Kliniken St. Marien-Krankenhaus Siegen 21.11.2019...

KHK, Herzkatheter, perkutane koronare Intervention Prof. Dr. med M. Buerke Medizinische Klinik II Herz- und Gefäßzentrum Südwestfalen Marien Kliniken St. Marien-Krankenhaus Siegen 21.11.2019 KHK - PCI - Update 2018 Prof. Dr. M. Buerke  Koronare Herzerkrankung Koronare Herzerkrankung Herzkatheter PCI, Ballon, Stent Restenose Stentthrombose 21.11.2019 KHK - PCI - Update 2018 Prof. Dr. M. Buerke  1977 Gruentzig macht erste PTCA am wachen Patienten in Zürich; erstes PTCA Register 21.11.2019 KHK - PCI - Update 2018 Prof. Dr. M. Buerke  Ballon-Angioplastie 21.11.2019 KHK - PCI - Update 2018 Prof. Dr. M. Buerke  Stent-Implantation 21.11.2019 KHK - PCI - Update 2018 Prof. Dr. M. Buerke  In-Stent-Restenose Late loss 0.2 mm Late loss 0.6 mm Late loss 1.2 mm DS 6% DS 17% DS 34% Diameter stenosis 3.5-mm vessel Exposed struts? Patent lumen Late loss 0.2 mm Late loss 0.6 mm Late loss 1.2 mm DS 8% DS 24% DS 48% Diameter stenosis 2.5-mm vessel Exposed struts? Patent lumen 21.11.2019 KHK - PCI - Update 2018 Prof. Dr. M. Buerke  Drug-eluting Stents 21.11.2019 KHK - PCI - Update 2018 Prof. Dr. M. Buerke  Medikamenten- Freisetzung 21.11.2019 KHK - PCI - Update 2018 Prof. Dr. M. Buerke  Drug Eluting Stents Control Everolimus 21.11.2019 KHK - PCI - Update 2018 Prof. Dr. M. Buerke  Bioabsorbierbare Stents 1977 1988 2001 STOP 1977 Balloon Bare Coronary Drug Absorb Angioplasty Metal Stents Eluting Stents Bioresorbable (PTCA) (BMS) (DES) Vascular Scaffold (BVS) After After implant. resorption. 21.11.2019 KHK - PCI - Update 2018 Prof. Dr. M. Buerke  Bioresorbierbare Stents BVS Cohort A 1 month 6 months 1 year 2 years 3 years 4 years CYPHER 1 month 6 months 1 year 2 years 3 years 4 years Photos taken by and on file at Abbott Vascular. 21.11.2019 KHK - PCI - Update 2018 Prof. Dr. M. Buerke  Drug eluting Drug-eluting Stents: Stents: 1st1Generation st Generation TAXUS Paclitaxel Polyolefin derivative Liberté Drug Polymer Stent Cypher Sirolimus PEVA + PBMA blend BX Velocity 21.11.2019 KHK - PCI - Update 2018 Prof. Dr. M. Buerke  Target Lesion Revascularization at 5 Target Lesion Revascularization Years TAXUS at 5I,Years II-SR,TAXUS IV &I,VII-SR, IV & V 30% TAXUS (n=1400) 5-Year HR [95% CI]: BMS (n=1397) 0.53 [0.44, 0.65] 21.0% P