www.bostonscientific.jp/kakushin EduCAS Report 人工心臓を用いたFilterWire EZ 捕捉性能の映像化 早稲田大学 理工学術院総合機械工学科 先端生命医科学センター TWIns 梅津 光生 先生
TWIns 1 Fig.1Boston ScientificFilterWire EZ in vitro debrisfilterwire EZ debris FilterWire EZ 6mm Ni-Ti aside view ø110µm 2 Fig.2 FilterWire EZ FilterWire EZ FASTCAM-1024PCIPhotoron bfront view c30 View Fig.1FilterWire EZ Movie1 Fig.3 330L/min530L/min 120/80Hg Movie1 Simulator HumanInternal carotid artery Fig.3 High speed camera Debri Test section Flow probe Pressure Transducer Compliance tube Pneumatic driver Pulsatile Pump High speed camera Cerebral circulation Systemic circulation Resistance Resistance Protection device Fig.2 Air compliance µm mesh Reservoir
TWIns 3 3.1 FilterWire EZ FilterWire EZ Movie23 ø5.0mm 3.2 FilterWire EZ Fig.4 FilterWire EZ 37 FilterWire EZ ø3.0mm4.0mm5.0mm 6.0mm Fig.5 FilterWire EZ Movie2FilterWire EZ ø5.0mm Movie3FilterWire EZ ø5.0mm Fig.4 a b a b iø6.0mm iiiø4.0mm a b a b iiø5.0mm ivø3.0mm Fig.5ø6.05.04.03.0mmFilterWire EZ
TWIns 3.3DebrisFilterWire EZ debrisfilterwire EZ 3.3.1 debris debristable1 16 Fig.6debris 3 debris Major axis particle size (microns) particle size debris Number particles Fig.6Distribution of size major axis and number of embolic particles debris idebris DebrisFig.7 1.051.07 PVAPVA PVA iidebris debris 6.020.10mg 7 5mg 10mg 711 debris15mg iiidebris debris 289.1512µm 1 debris PVA200300µm 700800µm PVA PVA5mg200 300µmstandard700800µmlarge Fig.7Photograph of polyvinyl alcohol particles Table1Debris µm µm µm 1.08 5043.5 290 Annalisa A, et al, Cerebral Protection During Carotid Artery Stenting Collection and Histopathologic Analysis of Embolized Debris. Strok33, 456-461, 2002 56 2652 250 M. Henry, M. Amor, et al: Carotid Stenting With Cerebral Protection: First Clinical Experience Using the PercuSurge GuardWire System, Journal of Endovascular Surgery: Vol.6, No.4, pp. 321-331 31 1430 285 S. Macdonald, G. Venables, et al: Safety and efficacy of the MedNova NeuroShield filter, Journal of Vascular Surgery, Vol. 35, Issue 5, pp. 966-972, 2002 3.5 5262 203 P. Whitlow, P. Lylyk, et al: Carotid Artery Stenting Protected With an Emboli Containment System, Stroke33, pp,1308-1314, 2002
TWIns 3.3.2 37 FilterWire EZ µm µm PVA 300.1mg ø3.0mm4.0mm5.0mm 6.0mmdebrisN=3 3.3.3 1 Movie4debrisMovie5 FilterWire EZ Movie45 debris210mg 2 i Fig.8 debris200-300µm ø4.0mmø5.0mm% ø6.0mm99debris ø3.0mm92% iidebris ø3.0mmdebris Fig.9debris 90% PVA0.1mg0.1mg Capturerate % Capturerate % 95 90 85 0 95 90 85 0 Movie4Debrisø4.0mm Movie5FilterWire EZ ø4.0mm 92 ø3.0 ø4.0 ø5.0 ø6.0 92 Standard ø200-300µm Diameter mm Fig.8 Diameter mm 97 Large ø700-800µm Fig.9Debris 99 aø3.0mm bø6.0mm Fig.10Debris5mg, 700-800µm
TWIns 4 4.1 Fig.8FilterWire EZ ø4.0mmø5.0mm ø6.0mm99debris ø6.0mmø4.05.0mm1 FilterWire EZ 5.87mm6.13mmø6.0mm FilterWire EZ Ni-Ti ø5.0mm15 ø6.0mmdebris debris ø3.0mm Fig.10a 2 21 ø3.0mm 2FilterWire EZ Fig.11 4.2Debris Fig.9ø3.0mmdebris debris FilterWire EZ Flow rate % 80 50 40 20 14 Standardø200-300µm 50 aside view Bfront view Fig.11Photographs of FilterWire EZ clearance installed in the 3.0mm tube 30 53 94 Largeø700-800µm 96 97 98 4.3Debris No-flowSlow-flow FilterWire EZ debris debris Fig.12 0 ø3.0mm ø4.0mm ø5.0mm ø6.0mm Fig.12FilterWire EZ
TWIns 5 FilterWire EZ debris in-vitro FilterWire EZ ø4.0 5.0mmdebris ø3.0mm debrisø5.0mm 1Annalisa A, et al: Cerebral Protection During Carotid Artery Stenting Collection and Histopathologic Analysis of Embolized Debris. Strok33, 456-461, 2002 2M. Henry, M. Amor, et al: Carotid Stenting With Cerebral Protection: First Clinical Experience Using the PercuSurge GuardWire System, Journal of Endovascular Surgery: Vol.6, No.4, pp. 321 331 3S. Macdonald, G. Venables, et al: Safety and efficacy of the MedNova NeuroShield filter, Journal of Vascular Surgery, Vol. 35, Issue 5, pp. 966-972, 2002 4P. Whitlow, P. Lylyk, et al: Carotid Artery Stenting Protected With an Emboli Containment System, Stroke33, pp,1308-1314, 2002 5T. Ohki, G. Roubin, et al: Efficacy of a filter device in the prevention of embolic events during carotid angioplasty and stenting: An ex vivo analysis, Journal of Vascular Surgery, Vol.30, Issue 6, pp.1034-1044 6~Carotid Artery StentingCAS~, pp:162, 2008 7M. Stefan, T. Jahnke, et al: In Vitro Comparison of Four Cerebral Protection Filters for Preventing Human Plaque Embolization During Carotid Interventions, Journal of endovascular therapy, Vol. 9, Issue 6, pp.793, 2002 8G. Siewiorek, M. Wholey, et al: In Vitro Performance Assessment of Distal Protection Devices for Carotid Artery Stenting, Effect of Physiological Anatomy on Vascular Resistance, Journal of endovascular therapy, 4, Issue 5,pp.712-724, 2007 9E. Finol, G. Siewiorek, et al: Wall Apposition Assessment and Performance Comparison of Distal Protection Filters International, Journal of Endovascular Therapy, Vol. 15, Issue 2, pp. 177185, 2008 10B. Order, C. Glass, et al: Comparison of 4 Cerebral Protection Filters for Carotid Angioplasty, An In Vitro Experiment Focusing on Carotid Anatomy, Journal of endovascular therapy. 1, Issue 2, pp. 211-218, 2004 11B. Reimers, N. Corvaja, et al: Cerebral Protection With Filter Devices During Carotid Artery Stenting, Circulation, vol.104, pp.12-15, 2001 www.bostonscientific.jp/kakushin EZ 22200BZX00139000 2010 Boston Scientific Corporation or its affiliates. All rights reserved. FilterWire EZ Boston Scientific Corporation www.bostonscientific.jp 782500W PSST20702-0337