CAN IVUS MANAGE CORONARY ARTERY INTERVENTIONS

描述(改编自申请者摘要)：经皮介入治疗 现在管理冠状动脉疾病的主要手段，超过一种 进行了100万次手术，包括50多万个冠状动脉支架 在1999年。尽管取得了这些进展，再狭窄仍然是一个主要问题。 经皮冠状动脉血运重建术的局限性。即使是在 最好的心导管实验室10%-20%的治疗病变必须 进行血运重建。血管内超声(IVUS)被常规用于许多 这些实验室要指导程序。尽管图像质量有所改善 稳步地，仍然只有大约7%-8%的程序使用这项技术。 这一低比率的主要原因是静脉内超声检查可以增加可感知的 在没有显著改善结果的情况下完成手术的时间。这将是 只有当IVUS可以有效地指导干预时才进行更改 结果。这项研究计划的长期目标仍然是管理近 血管内超声冠状动脉介入治疗的方方面面 (IVUS)。重点介绍了气囊常见的机械干预 血管成形术(PCTA)和血管内支架植入。然而，这些方法是通用的。 并可应用于其他程序，如消融/汽化和 近距离放射治疗。根据最初供资期间的进展情况，现在 似乎IVUS可以提供有关解剖和弹性的关键信息 动脉壁流动的特性和管腔内的流动动力学。vt.给出 在这些发展中，已经制定了一项雄心勃勃的研究计划来解决 血管内超声如何帮助管理冠状动脉介入治疗的几乎每一个方面。 球囊血管成形术和血管内成形术的机械干预 支架置入术时，申请者假设IVUS可以识别机械性 动脉病变的性质，指导和监测经皮冠状动脉腔内成形术和支架 部署以最大限度地减少组织损伤，同时确保支架完全延长， 评估干预前后的血流动力学，并确定可能性 再狭窄的可能性。此外，还将建立一个综合的IVUS交付系统，以 在全超声引导下进行机械干预，包括 实时弹性和流量监控。这样的导管是优化 支架置入，同时将组织损伤和随后的再狭窄降至最低。在……里面 此外，一个集成的装置可以显著减少导管的数量 在一个典型的程序中使用。

DESCRIPTION (Adapted from Applicant's Abstract): Percutaneous interventions are now the primary means of managing coronary artery disease, where over one million procedures, including over 500,000 coronary stents, were performed during 1999. Despite these advances, restenosis continues to be a major limitation of percutaneous coronary revascularization procedures. Even in the best cardiac catheterization labs between 10-20 percent of treated lesions must be revascularized. Intravascular ultrasound (IVUS) is routinely used in many of these laboratories to guide procedures. Although image quality has improved steadily, still only about 7-8 percent of total procedures use this technology. The primary reason for this low rate is that an IVUS study can add appreciable time to a procedure without significantly improving the outcome. This will change only when IVUS can efficiently guide interventions with improved outcomes. The long range goal of this research program remains to manage nearly every aspect of coronary artery interventions with intravascular ultrasound (IVUS). It focuses on the common mechanical interventions of balloon angioplasty (PCTA) and endovascular stenting. However, the methods are general and can apply to other procedures such as ablation/vaporization and brachytherapy. Based on progress during the initial funding period, it now appears that IVUS can provide key information about anatomical and elastic properties of the artery wall flow and flow dynamics within the lumen. Given these developments, an ambitious research plan has been developed to address how IVUS can help manage nearly every aspect of coronary artery interventions. For the mechanical interventions of balloon angioplasty and endovascular stenting, the applicants hypothesize that IVUS can identify the mechanical properties of arterial lesions, guide and monitor both PCTA and stent deployment to minimize tissue injury while insuring full stent extensions, assess flow dynamics pre- and post-interventions, and determine the likelihood of restenosis. In addition, an integrated IVUS delivery will be constructed to perform mechanical interventions under full ultrasound guidance, including real-time elasticity and flow monitoring. Such a catheter is key to optimizing stent deployment while minimizing tissue injury and subsequent restenosis. In addition, an integrated device can dramatically reduce the number of catheters employed during a typical procedure.