CAN IVUS MANAGE CORONARY ARTERY INTERVENTIONS

描述（改编自申请人摘要）：经皮介入是 现在，管理冠状动脉疾病的主要手段， 进行了100万例手术，包括50多万个冠状动脉支架， 在1999年。尽管有这些进展，再狭窄仍然是一个主要的问题， 经皮冠状动脉血运重建术的局限性。即使在 最好的心导管实验室10- 20%的治疗病变必须 进行血管重建血管内超声（IVUS）通常用于许多 这些实验室来指导程序。虽然图像质量有所改善 目前，只有大约7%-8%的手术采用了这项技术。 发生率低的主要原因是IVUS研究可以增加明显的 手术时间没有显著改善结果。这将 只有当IVUS可以有效地指导干预， 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各个方面 （IVUS）。重点介绍球囊的常见机械干预 血管成形术（PCTA）和血管内支架植入术。然而，这些方法是通用的 并且可以应用于其它过程，例如消融/汽化， 近距离放射治疗根据最初供资期间的进展情况， 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。给定 这些发展，一个雄心勃勃的研究计划已经制定，以解决 IVUS如何帮助管理冠状动脉介入治疗的几乎所有方面。 对于球囊血管成形术和血管内 对于支架植入术，申请人假设IVUS可以识别机械 动脉病变的性质，引导和监测PCTA和支架 展开以最小化组织损伤，同时确保支架完全延伸， 评估干预前后的血流动力学，并确定 再狭窄。此外，还将构建一个集成的IVUS输送系统， 在完全超声引导下进行机械干预，包括 实时弹性和流量监控。这种导管是优化 同时最大限度地减少组织损伤和随后的再狭窄。在 此外，集成设备可以显著减少导管的数量， 在一个典型的过程中。

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.