Stent pharmaco actif dans le rest nose intra stent
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Stent pharmaco actif dans le resténose intra stent. Symposium Biotronik High tech 2012 A. Tirouvanziam Nantes. Epidémiologie. Traitement RIS BMS. Traitement RIS BMS. Traitement RIS BMS. Traitement RIS BMS. Mécanismes RIS DES. Sous expansion. Type RIS % DES.

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Stent pharmaco actif dans le resténose intra stent

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Stent pharmaco actif dans le resténose intra stent

Symposium Biotronik

High tech 2012

A. Tirouvanziam Nantes


Epidémiologie


Traitement RIS BMS


Traitement RIS BMS


Traitement RIS BMS


Traitement RIS BMS


Mécanismes RIS DES


Sous expansion


Type RIS % DES


Traitement RIS DES :DES vs POBA / Cut / VBT


RIS SES


Études randomisées


Interet switch DES ?

Milan Experience

  • Does implanting a different type of DES have a benefit?

    • SES for PES ISR

    • PES for SES ISR

Non-focal ISR

Focal ISR


DEB / RIS DES ?


RIS BMS

DES>POBA (VBT)

SES>PES

DEB>POBA

DEB>DES?

En pratique


En pratique proposition

  • RIS DES (LIMUS) / analyse mecanisme (IVUS) : focale ++

  • Type de resténosemeca potentiel traitement

  • Focale sous expansion POBA (NC)

    fracture DES, POBA

    allergie,HNI DES,DEB

  • Focale/ Edgegeo miss DES id (overlap)

    progressionplaque DES

    dissection DES

    (PES=SES ,pas interet switch)

  • Diffuse in stentres. drogue,allergie DES (+/-switch),DEB

    ( TLR ++> RIS BMS )

  • Diffuse proliferativeres.drogue, allergie DES(+/- switch ),DEB,PAC

  • Etudes en attente (ISAR DESIRE 3),etudes DES G2/G3,evolution guidelines remboursement DEB


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