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1、波科外周中文导丝现在学习的是第1页，共86页PI Guide WiresOverviewPurposes of a guide wire:导丝的作用：导丝的作用：Gain access into vessels 到达目标血管Deliver devices 输送手术器械Cross lesions 穿越病变部位Used in vascular and non-vascular procedures可用于血管和非血管介入手术Used in all diagnostic and therapeutic procedures可用于所有的诊断和治疗介入手术The Backbone of every pro
2、cedure 每例介入手术均需使用每例介入手术均需使用现在学习的是第2页，共86页PI Guide WiresGeneral Features&Intended BenefitsIdeal Guide Wire FeaturesIntended BenefitSteerability/torque control操控性/扭转控制Easily directed through the body.从体外操控导丝Columnar strength纵向强度Kink resistant.抗扭曲Radiopaque显影性Good visualization.良好的可视性Frictionless润滑性Adv
3、ancement through tortuous vessels;通过迂曲的血管；smooth tracking of devices&catheters.沿导丝推送器械&导管Rail support支撑力Advancement and support of devices.推送和支撑器械Atraumatic tip无创伤的头端Reduced vessel damage.减少对血管的损伤现在学习的是第3页，共86页PI Guide Wires General Components外周介入导丝的一般结构Core Wire:Usually Stainless Steel or Nitinol导丝
4、轴芯：通常为不锈钢和镍钛诺合金Distal Tip:Working end of wire;comes in multiple shapes:straight,angled,shapeable,J远端头端：导丝的工作端；有多种形状：直型，成角型，可塑性，J型Lubricious Coating:PTFE,Silicone,or Hydrophilic光滑涂层：PTFE，硅，或亲水性Distal Tip远端Safety Ribbon安全带Core wire轴芯Coil wire螺旋金属丝Proximal End近端 现在学习的是第4页，共86页Floppy/Light Support(POBA)
5、:Starter Guide Wire松软型松软型/轻度支撑（轻度支撑（POBA）：）：StarterTM 导丝导丝Most flexible;least rail support 最佳的柔韧性；最小的支撑力Less likely to cause vessel damage 最小的血管损伤Moderate Support(Stent):Magic Torque Guide Wire中度支撑（支架）：中度支撑（支架）：Magic Torque 导丝导丝Rail support between Floppy&Extra Support 介于松软型&超硬导丝之间Added support for
6、stent delivery 为放置支架提供额外的支撑Extra Support(Stent):Amplatz Guide Wire额外支撑（支架）：额外支撑（支架）：Amplatz 导丝导丝Long rail support region,but soft tip 杆身支撑力更强，柔软的头端Designed for first generation stent delivery 设计用于放置第一代的支架PI Guide WiresCore Wire Flexibility&Support轴芯 柔韧性&支撑力现在学习的是第5页，共86页Diameters most commonly used
7、in interventions:在介入手术中最常使用的导丝直径：在介入手术中最常使用的导丝直径：.014”-Coronary and small vessel balloons -冠状动脉和小血管球囊.018”-Renal and small vessel balloons -肾动脉和小血管球囊.035”-Balloons and catheters,“workhorse”-球囊和导管，“使用最普遍”.038”-Large devices requiring extra support(rarely used)-需要额外支撑的较大器械（很少使用）Other less common diame
8、ters are.032”and.025”其他较少使用的直径：.032”和.025”Trend towards smaller diameters(.014”)趋向于小直径导丝（.014”）Common guide wire lengths:通常的导丝长度：通常的导丝长度：75cm,150cm,180cm,260cm,300cmPI Guide WiresSizing Diameters&Lengths尺寸 直径&长度现在学习的是第6页，共86页PI Guide WiresDistal Tip Configurations远端头端的类型Tip Configurations:头端类型：头端类型：
9、Straight,angled,J-Tip 直型，成角型，J型Non-hydrophilic,hydrophilic 非亲水性，亲水性Standard,floppy,stiff 标准型，松软型，硬型Tip taper 渐细的锥形头端现在学习的是第7页，共86页PI Guide WiresTypes for Gaining Initial AccessBentson Guide Wire Straight,floppy,atraumatic tipJ-Tip Guide WireAtraumatic-use when worried about the potential for vessel
10、perforation.无创伤 用于避免血管壁穿孔Starter Guide Wire Standard workhorseZIPwire Guide Wire Not indicated as a starter wire,but often used by physicians.现在学习的是第8页，共86页PI Guide WiresBSC ProductsThe three classifications of wires sold by Boston Scientific are:Standard Guide Wires 标准导丝标准导丝Starter Guide Wire(inclu
11、des Bentson,Newton,&Rosen shapes)Hydrophilic Guide Wires 亲水性导丝亲水性导丝ZIPwire Guide Wire(.18”,.025”,.035”,.038)Specialty Guide Wires 特殊导丝特殊导丝V-18 Control Wire Guide Wire(.018)Platinum PLUS Guide Wire(.014”,.018“,.025”)Thruway Guide Wire(.014&.018)Magic Torque Guide Wire(.035)Amplatz Super Stiff Guide W
12、ire(.035“&.038”)Meier Guide Wire(.035)现在学习的是第9页，共86页PI Guide Wires BSC Product PositioningStarter Guide WireAll routine procedures.ZIPwire Guide WireWhen a standard wire wont“go”;total occlusions.当标准导丝无法通过时；完全阻塞的病变Amplatz Super Stiff Guide WireWhen more support is needed such as filter placement and
13、 carotid catheter placement.当需要更多的支撑时，如放置血栓保护装置和颈动脉导管。Magic Torque Guide WireNegotiating difficult vessels,sizing vessels,sizing IVC filters.Meier WireAAA indicated;stiffer than Amplatz with a softer,radiopaque tip.Platinum PLUS Guide WireIVUS,small vessel(.014”&.018”).V-18 Guide WireSmall vessels(.
14、018”),tortuous anatomy,contralateral.小血管（.018”），迂曲的血管，对侧病变。Thruway Guide WireSmall vessels(.014”&.018”),renals,monorail.小血管（.014”&.018”），肾动脉，快速交换现在学习的是第10页，共86页ZIPwire Hydrophilic Guide Wires ZIPwire 亲水性导丝亲水性导丝ZIPwire Guide Wire现在学习的是第25页，共86页ZIPwire Guide Wire产品定位A family of hydrophilic guide wires
15、 designed for smooth passage through tortuous anatomy.设计用于流畅的通过迂曲的解剖结构现在学习的是第26页，共86页ZIPwire Guide Wire适应症INDICATIONS:The ZIPwire Hydrophilic Guide Wire is intended to facilitate the placement of devices during diagnostic and interventional procedures.ZIPwire 亲水性导丝用于在诊断性和治疗性介入手术中协助置入器械。现在学习的是第27页，共8
16、6页ZIPwire Guide Wire产品技术参数ZIPwire is a trademark of Boston Scientific Corporation or its affiliates.Glidewire is a trademark of Terumo Corporation.Shafts杆身杆身Standard,Stiff标准型，加硬型Tips头端头端Straight,Angled,J,Long Taper,Short Taper直型，成角型，J型，长锥型，短锥型Diameters直径直径.018”,.025”,.035”,.038”Lengths长度长度80cm,150cm
17、,180cm,260cmNote:See Guide Wires brochure or price book for all available combinations.注意：请参见相关产品彩页或手册了解所有的产品型号现在学习的是第28页，共86页ZIPwire Guide WireEnhanced Manufacturing ProcessA polymer jacket is extruded over a kink-resistant nitinol core.聚合物外壳覆盖在抗扭曲的镍钛诺合金轴芯表面聚合物外壳覆盖在抗扭曲的镍钛诺合金轴芯表面Hydrophilic coating
18、is bonded to the polymer jacket.亲水性涂层粘合在聚合物外壳上亲水性涂层粘合在聚合物外壳上Radiopaque Polyurethane Jacket 不透不透X线的聚亚安酯外壳线的聚亚安酯外壳Nitinol Core镍钛诺轴芯镍钛诺轴芯Hydrophilic Polymer Coating亲水性聚合物涂层亲水性聚合物涂层The manufacturing process enhancements treated the surface of the polyurethane jacket for consistent adhesion of the hydrop
19、hilic coating.现在学习的是第29页，共86页ZIPwire PropertiesKink-resistant抗扭曲性抗扭曲性The nitinol metal alloy core provides the strength necessary to make the ZIPwire guidewire kink-resistant.镍钛诺合金材质的导丝轴芯使ZIPwire导丝具有良好的抗扭曲性能。Steerable操控性操控性Single piece construction and atraumatic tip allow excellent steerability.一体式
20、结构和无创性头端使其具有优异的操控性。The unique alloy core and polyurethane jacket of the ZIPwire guidewire provide a true 1:1 torque response.独特的合金轴芯和聚亚安酯外壳实现了1:1扭控反应。Frictionless光滑度光滑度The hydrophilic coating makes the ZIPwire guidewire virtually frictionless when wet.The ZIPwire guidewire slides easily into place a
21、nd smoothly guides catheters.亲水性涂层在水化后变得非常光滑，易于到达病变部位和推送导管。现在学习的是第30页，共86页ZIPwire PropertiesLow Thrombogenicity(tendency to produce blood clots)低血栓性低血栓性（产生凝血块的趋势）The frictionless coating results in low potential for the formation of blood clots on the surface of the ZIPwire guidewire.光滑的亲水涂层有效减少了在导丝
22、表面形成血凝块的危险。Radiopaque显影性显影性The polyurethane is impregnated with tungsten,a radiopacifier for enhanced visibility.聚亚安酯外壳中含有钨，在X线下具有良好的可视性。Atraumatic无创性无创性The various cores result in soft,flexible tip configurations.不同的轴芯 各种类型的柔软而富有弹性的头端。现在学习的是第31页，共86页ZIPwire Guide WireFeatures&Intended BenefitsZIPwi
23、re Guide Wire FeaturesIntended BenefitsHydrophilic coating亲水性涂层亲水性涂层Facilitation of crossing of tight lesions.易于通过高度狭窄的病变Precise 1:1 torque response精确的精确的1:1扭控反应扭控反应Secure control when sub-selecting distal and angulated branch vessels.安全进入远端血管和成角较大的分支血管Highly radiopaque jacket高显影性外壳高显影性外壳Excellent v
24、isibility for accurate positioning.良好的可视性，便于准确定位Super-elastic nitinol core有良好弹性的镍钛诺轴芯有良好弹性的镍钛诺轴芯Excellent kink-resistance.优异的抗扭曲性能现在学习的是第32页，共86页ZIPwire Guide Wire临床应用领域Aortic bifurcation area腹主动脉分叉Carotids颈动脉HAM血透通路Crossing CTOs通过完全阻塞的病变Subintimal Angioplasty内膜下血管成形术现在学习的是第33页，共86页ZIPwire Guide Wir
25、eKey CompetitorsGlidewire Guide Wire(Terumo-previously sold by Boston Scientific)-Hydrophilic market leaderRoadrunner Guide Wire(Cook)AQUALiner Guide Wire(Angiodynamics)HiWire Guide Wire(Cook)HydroSteer Guide Wire(St.Jude Medical)现在学习的是第34页，共86页ZIPwire Guide WireKey TakeawaysThe ZIPwire Guide Wire i
26、s a hydrophilic guide wire designed for maneuvering through tortuous anatomy.ZIPwire 亲水性导丝设计用于通过迂曲的解剖结构。亲水性导丝设计用于通过迂曲的解剖结构。Precise 1:1 torque response 精确的1:1扭控反应 Highly radiopaque jacket 高显影性外壳 Comprehensive selection of shafts,lengths,and tips 有多种不同硬度、长度和头端类型的型号现在学习的是第35页，共86页Amplatz Super Stiff Gu
27、ide Wire Amplatz Super Stiff 超硬导丝超硬导丝现在学习的是第36页，共86页Amplatz Super Stiff Guide Wire 产品定位A stiff,secondary(non-starter)wire when strength and stability are required for catheter placement and exchange.硬度更高，具有更高的强度和稳定性，用于放置硬度更高，具有更高的强度和稳定性，用于放置和更换导管。和更换导管。现在学习的是第37页，共86页Amplatz Super Stiff Guide Wire 适
28、应症INDICATIONS:The Amplatz Super Stiff Guide Wire facilitates catheter placement and exchange during diagnostic or interventional procedures.It is not intended for use in coronary arteries.Amplatz Super Stiff超硬导丝用于在诊断性和治疗性介入手术中放置和更换导管。不适用于冠脉手术。现在学习的是第38页，共86页Amplatz Super Stiff Guide Wire 产品技术参数Tip S
29、hape头端形状头端形状Tip Length头端长度头端长度(cm)Diameters(in)直径直径Lengths(cm)长度长度3mm J3mmJ型3.035,.038145,180,260Straight直型6.018,.035,.03875,145,180,260Short Tip短头端1,3.5.035,.038150,180,260Note:See Guide Wire brochure or price book for all available combinations.注意：请参见相关产品彩页或手册了解所有的产品型号现在学习的是第39页，共86页Amplatz Super
30、Stiff Guide WireFeatures&Intended BenefitsAmplatz Super Stiff FeaturesIntended BenefitsStiff core硬的轴芯硬的轴芯Added strength for easier access and better stability during catheter placement and exchange.强度更高，进入更方便，在放置和更换导管时具有更佳的稳定性。Atraumatic tip&gradual distal core taper无创性头端无创性头端&渐细的远端轴芯渐细的远端轴芯Safety d
31、uring advancement.在推进导丝时具有良好的安全性Teflon coating特氟隆涂层特氟隆涂层Smooth entry and catheter tracking.进入血管和推送导管更加流畅现在学习的是第40页，共86页Amplatz Super Stiff Guide Wire临床应用领域Aortic bifurcation area主动脉分叉Carotid/aortic arch area颈动脉/主动脉弓现在学习的是第41页，共86页Amplatz Super Stiff Guide WireKey Competitors“Amplatz”is a standard wi
32、re name sold by other companies including Cook and Cordis.Others competing wires include:Wholey HI-TORQUE(Covidien)HI-TORQUE Supra Core(Abbott Vascular)现在学习的是第42页，共86页Amplatz Super Stiff Guide WireKey TakeawaysVery supportive wire 具有高支撑力For secondary use(not for gaining initial access)第二根导丝（不作为进入导丝）
33、Strong enough to get through tight lesions,yet tip is soft enough for reduced trauma during advancement.具有足够的强度通过狭窄病变，同时柔软的头端可避免在推进导丝时损伤血管。现在学习的是第43页，共86页Amplatz Super Stiff GuidewireSuper stiff wire body with an atraumatic tip for catheter placement and exchange in uroradiology,biliary drainage,abs
34、cess drainage and vascular procedures.具有良好硬度的杆身和无创性头端，可用于在泌尿系统、胆道引流、脓肿引流具有良好硬度的杆身和无创性头端，可用于在泌尿系统、胆道引流、脓肿引流和血管介入手术中放置和更换导管。和血管介入手术中放置和更换导管。PTFE Coating helps to reduce friction and allows for easy catheter passage PTFE涂层减少了摩擦力，便于推进导管。涂层减少了摩擦力，便于推进导管。在具有出色的硬度、强度、稳定性的同时柔软在具有出色的硬度、强度、稳定性的同时柔软的无创伤头端有良好的安
35、全性的无创伤头端有良好的安全性现在学习的是第44页，共86页V-18 Control Wire Guide Wire V-18 可控导丝可控导丝现在学习的是第72页，共86页V-18 Control Wire Guide Wire产品定位.018”hydrophilic performance with excellent torque control and rail support for distal,peripheral access and contralateral approaches.带有亲水涂层的带有亲水涂层的.018”导丝，具有出色的扭控性和支导丝，具有出色的扭控性和支撑力
36、，可用于远端的外周血管和对侧性病变。撑力，可用于远端的外周血管和对侧性病变。现在学习的是第73页，共86页V-18 Control Wire Guide Wire 适应症.0353CM50CMGLIDEX180/260CMINDICATIONS The V-18 Control Wire Guide Wire is available in 110,150,200 and 300 cm lengths.The wire can be torqued to facilitate the selective placement of diagnostic or therapeutic cathet
37、ers.This device is intended for peripheral use only.A torque device(pin vise)is included with each wire to facilitate directional manipulation of the guide wire.V-18 可控导丝有110，150，200和300cm四种长度。导丝可以扭转以有选择的放置诊断或治疗导管。该产品只供用于外周血管。每根导丝都附有一个扭转装置以控制导丝的前进方向。The 110cm V-18 Control Wire Guide Wire is intended
38、 for general intravascular use including the placement of PTA balloon catheters requiring an 0.018”guide wire in hemodialysis AV access procedures.110cm长的V-18 可控导丝可用于在血透通路等普通血管介入手术中放置兼容0.018”导丝的PTA球囊扩张导管。The 150,200 and 300 cm V-18 Control Wire Guide Wires are intended for general intravascular use.
39、150，200和300cm长V-18可控导丝可用于普通血管介入手术。现在学习的是第74页，共86页V-18 Control Wire Guide Wire 产品技术参数Tip Shape头端形状头端形状Diameters(in)直径直径Lengths(cm)长度长度Taper Length(cm)头锥长度头锥长度Shapeable可塑形.018110,150,200,3008Shapeable可塑形.018150,200,30012现在学习的是第75页，共86页V-18 Control Wire Guide Wire Features&Intended BenefitsV-18 Control
40、 Wire Guide Wire FeaturesIntended BenefitsSCITANIUM stainless steel alloy coreSCITANIUM不锈钢合金轴芯不锈钢合金轴芯Superb torque control and rail support for maneuverability and catheter tracking.出色的扭转控制和支撑力，具有良好的操控性，便于推送导管。ICE hydrophilic coating on distal 8cm&12cm在远端在远端8cm&12cm有有ICE 亲水亲水性涂层性涂层Excellent trackabi
41、lity and crossability(less time and effort)优异的跟踪性和通过性（更高效，缩短手术时间）Shapeable,atraumatic tip可塑形的无创性头端可塑形的无创性头端Flexibility for facilitating accurate placement.良好的柔顺性，放置准确。现在学习的是第76页，共86页V-18 Control Wire Guide Wire 临床应用领域GLIDEXSFA股浅动脉BTK膝下血管HAM血透通路现在学习的是第77页，共86页V-18 Control Wire Guide Wire Key Competit
42、ors.0353CM50CMGLIDEX180/260CM SV.018“Guidewire(Cordis)HI-TORQUE SteelCore 18 Guide Wire(Abbott Vascular)Roadrunner PC Wire Guides(Cook)现在学习的是第78页，共86页V-18 Control Wire Guide Wire Key TakeawaysSmall diameter(.018”)good for LE&small vessel balloons 小直径小直径（.018”）-尤其适用于下肢和小血管球囊Shapeable,hydrophilic tip
43、good for highly stenosed vessels 带亲水性涂层的可塑形头端带亲水性涂层的可塑形头端 便于通过严重狭窄的血管Excellent torque&rail support 优异的扭控性优异的扭控性&支撑性支撑性现在学习的是第79页，共86页V-18 Control Wire0.018 hydrophilic performance with excellent torque control for distal peripheral access and controlateral approaches.直径0.018“，有亲水性涂层，出色的扭转控制，尤适用于远端外周
44、血管和对侧病变。Scitanium不锈钢合金轴芯具有良好的扭转控制和操控性；ICETM亲水性涂层；柔软的2cm可塑形头端。现在学习的是第80页，共86页Thruway Guide Wire现在学习的是第81页，共86页Thruway Guide Wire 产品定位50CMOffers precision,strength and deliverability with a broad.014”&.018”matrix designed to meet any requirement,particularly acutely angled vessels.多种规格的多种规格的.014”&.018
45、”导丝，具有良好的精导丝，具有良好的精确性、强度和输送性，可满足临床的各种需求，确性、强度和输送性，可满足临床的各种需求，尤适合于成角较大的血管。尤适合于成角较大的血管。现在学习的是第82页，共86页Thruway Guide Wire 适应症50CMIndications:The Thruway Guide Wire facilitates placement of a catheter during diagnostic or interventional peripheral intravascular procedures,including but not limited to re
46、nal intervention.The wire can be torqued to facilitate navigation through the vasculature.Thruway导丝用于帮助在诊断性和治疗性外周血管介入手术中放置导管，包括但不仅限于肾脏介入手术。该导丝可以旋转以顺利通过血管系统。现在学习的是第83页，共86页Thruway Guide Wire 产品技术参数50CMDiameter直径直径(in)Tip Shape头端形状头端形状Tip Taper(cm)头锥长度头锥长度Length(cm)长度长度.014”Straight,J直型，J型5,7,10130,19
47、0,300.018”Straight,J直型，J型2.5,3,7130,190,300Note:See guide wire brochure or price book for available combinations.注意：请参见导丝的产品彩页或手册以获得产品型号信息。Teflon涂层涂层硅涂层硅涂层显影性头端显影性头端现在学习的是第84页，共86页Thruway Guide Wire Features&Intended Benefits50CMThruway FeaturesIntended BenefitsDistal radiopaque markers&tip(.014”onl
48、y)远端有放射显影标记远端有放射显影标记&头端头端（仅限于（仅限于.014”直径的导丝直径的导丝）Aid in wire positioning,lesion measurement and device sizing.便于导丝定位，测量病变长度和选择合适的器械。Proximal markers(90&100 cm)近端标记（近端标记（90&100 cm）Determine wire position relative to sheath tip.帮助确定导丝和血管鞘头端的相对位置。Precise 1:1 torque response精确的精确的1:1扭控反应扭控反应Secure control when sub-selecting distal and angulated branch vessels.安全进入远端血管和成交较大的分支血管现在学习的是第85页，共86页Thruway Guide Wire 临床应用领域SFA股浅动脉BTK膝下血管Renals肾动脉现在学习的是第86页，共86页