CAN IVUS MANAGE CORONARY ARTERY INTERVENTIONS

IVUS 可以进行冠状动脉干预吗

• 批准号: 6389189
• 负责人: Matthew O'Donnell
• 金额: $ 33.29万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-02-01 至 2004-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6389189
• 关键词: angiocardioultrasonography; atherosclerosis; bioimaging /biomedical imaging; biomechanics; biomedical equipment development; blood flow measurement; cardiovascular imaging /visualization; computer simulation; coronary artery; diagnosis design /evaluation; diagnostic catheterization; disease /disorder model; elasticity; histopathology; image enhancement; intraluminal angioplasty; laboratory rabbit; postmortem; restenosis; swine; ultrasonography

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.

描述（改编自申请人的摘要）：经皮介入治疗是 现在是治疗冠状动脉疾病的主要手段，其中超过一种 进行了 100 万次手术，其中包括超过 500,000 个冠状动脉支架 1999 年期间。尽管取得了这些进展，再狭窄仍然是一个主要的问题 经皮冠状动脉血运重建手术的局限性。即使在 最好的心导管检查实验室 10-20% 的治疗病变必须 进行血运重建。血管内超声（IVUS）常规用于许多 这些实验室来指导程序。虽然图像质量有所提高 稳步地，仍然只有大约 7-8% 的总手术使用该技术。 这种低比率的主要原因是 IVUS 研究可以增加可观的 时间没有显着改善结果。这将 只有当 IVUS 能够有效指导干预措施并改进 结果。该研究计划的长期目标仍然是管理近 血管内超声介入冠状动脉介入治疗的各个方面 （血管内超声）。它重点关注球囊的常见机械干预 血管成形术（PCTA）和血管内支架置入术。不过方法很一般 并可应用于其他程序，例如消融/汽化和 近距离放射治疗。根据初始资助期间的进展，现在 IVUS 似乎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 针对这些发展，我们制定了一项雄心勃勃的研究计划来解决 IVUS 如何帮助管理冠状动脉介入治疗的几乎各个方面。 用于球囊血管成形术和血管内介入的机械干预 支架置入术中，申请人假设 IVUS 可以识别机械支架 动脉病变的特性，指导和监测 PCTA 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伸， 评估干预前后的血流动力学，并确定可能性 的再狭窄。此外，还将构建综合 IVUS 交付系统 在全程超声引导下进行机械干预，包括 实时弹性和流量监控。这种导管是优化的关键 支架展开，同时最大限度地减少组织损伤和随后的再狭窄。在 此外，集成设备可以大大减少导管的数量 在典型程序中使用。