s**********8
发帖数: 25265 | 1 来自主题: MedicalDevice版 - stent http://en.wikipedia.org/wiki/Stent
Stent
From Wikipedia, the free encyclopedia
For people named Stent, see Stent (surname).
Stent
Intervention
MeSH
D015607
In the technical vocabulary of medicine, a stent is an artificial 'tube'
inserted into a natural passage/conduit in the body to prevent, or
counteract, a disease-induced, localized flow constriction. The term may
also refer to a tube used to temporarily hold such a natural conduit open to
allow access for surgery.
Contents
[hide] 1 Etymology
... 阅读全帖 |
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w********e
发帖数: 275 | 2 国内一亲戚得了心脏病，还挺年轻的，刚40岁。需要做心脏支架手术。国内这个STENT
要上万，就问我可否在这里买的到。 我在网上找了一圈，也找不到这方面的信息。可
能是医疗用品，政府管理比较严格吧。
若是不卖给个人的话，他说他认识在国内一家比较大的医疗器械公司工作的人，可以帮
着进口。不知这里的朋友有这方面信息的话，请不吝指教。多谢！ |
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h****s
发帖数: 16779 | 3 这个东西美国的比中国更贵，1万美元都不一定行。
STENT |
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A*****8
发帖数: 8590 | 5 Report Information:
Publication date: 11/07/2012
Number of Pages: 145
Report Details:
In 2011, the medical device market worldwide was worth $309bn, with high
single-digit growth from the year before . Despite being a vast and mature
market, there are number of sectors likely to experience fast growth during
the next 10 years. Much of this growth is linked to the prevalence of a
number of diseases worldwide, as well as an aging population. The rise in
neurological disorders will drive both the d... 阅读全帖 |
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b*********2
发帖数: 534 | 6 妈妈下周一心脏造影手术，有可能当场就做支架。我想知道Bare Metel Stent（普通金
属支架
）和 Drug Coated Stent （药物涂层支架）各有什么好坏。
护士说术后如果装了支架，要吃一种非常贵的药防止小血栓堵住支架，没保险的话，大
概药费3-5百一个月。普通金属支架要吃3个月， 药物涂层支架至少要吃一年。所以她
现在给我们建议用普通金属支架
网上查了Harvard Medical School 研究说
Stents are tiny wire cages that can fit inside an artery. They were invented
to prop open heart arteries after angioplasty cleared them of clogs. The
first stents were made of bare metal. The drug-coated versions release
medication to stop restenosis, a regrowth of cells that can creat... 阅读全帖 |
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a*i
发帖数: 1652 | 7 http://247wallst.com/2011/07/18/the-eleven-most-implanted-medic
11. Implantable Cardioverter Defibrillators
> Number of procedures: 133,262
> Total annual expenditure: $5.5 billion
> Average cost per procedure: $40,000
> Major manufacturer: Medtronic (40%), St. Jude Medical, and Boston
Scientific
Cardiac arrhythmia, or improper electric signaling in the heart, occurs in
millions of people a year. While the vast majority are benign, a select few
— usually in patients with a history of heart attac... 阅读全帖 |
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s**********8
发帖数: 25265 | 8 http://en.wikipedia.org/wiki/Balloon_angioplasty
Angioplasty
From Wikipedia, the free encyclopedia (Redirected from Balloon angioplasty)
Jump to: navigation, search
Angioplasty
Intervention
Balloon angioplasty.
ICD-9-CM 00.6, 36.0 39.50
MeSH D017130
Angioplasty is the technique of mechanically widening a narrowed or
obstructed blood vessel, typically as a result of atherosclerosis. An empty
and collapsed balloon on a guide wire, known as a balloon catheter, is
passed into the narrowed locations... 阅读全帖 |
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c********e
发帖数: 496 | 9 I heard many stories like this, three stents for coronary heart disease.
by pass/CABG is indicated in the treatment of multiple lesions (including 3)
.
the most I've heard is 7, imagine 7 stents in one heart, with one year re-
stenosis rate for one stent is 10-20% (3% for rapamycin eluting stent), what
's the total.
totally a disaster. |
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y***c
发帖数: 48 | 10 俺现在研究支架，但是engineering方面的人。合作的有很多大牛级的医生。也看过动
物实验。
楼上有位说的是biodegradable的，不作数，镁啊之类的。别听他的，哈哈。
我的意见仅供参考。也没看你们的仔细情况。不知道为啥你的医生会建议bare stent，
我听到的都是bare metal stent 容易restenosis, 现在都流行drug eluting stents.
医生喜欢cipher的，但Jnj撤出市场了。我自己看到的stents觉得nitinol弹性超好。不
过听医生的吧，护士不靠谱。 |
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l*h
发帖数: 4124 | 11 you should ask more questions:
1. the reason to stent? vs. aggressive medical treatment.
2. which artery to stent?
3. what type of stent are they going to use?
stenting after stroke is controversial and multiple recent reports show the
vast majority of patients don't benefit from it. |
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s**********8
发帖数: 25265 | 12 i believe all companies have their own product line. Those are highly
specialized application and all major palyers should have manufacture
capability to the finest detail.
polymer stent is selling for the concept. it will take time to fully
penetrate into mature market. in coutries where ppl will buy concept
easily, it may sell well.
nitinol self-expand stent still have its applications for lower leg and
carotid. polymer stent can not replace this since stent can get fractured
easily.
)... 阅读全帖 |
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s**********8
发帖数: 25265 | 13 i believe all companies have their own product line. Those are highly
specialized application and all major palyers should have manufacture
capability to the finest detail.
polymer stent is selling for the concept. it will take time to fully
penetrate into mature market. in coutries where ppl will buy concept
easily, it may sell well.
nitinol self-expand stent still have its applications for lower leg and
carotid. polymer stent can not replace this since stent can get fractured
easily.
)... 阅读全帖 |
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y******a
发帖数: 590 | 14 教授，你的这个回复害人啊，玩笑有点开过了
A++，我觉得你应该禁止教授回复医疗咨询的帖子，至少也要在回帖上注明他不是医生。
楼主，你爸爸这个情况，如果放的是drug eluting stent，aspirin and plavix need
to be on board for at least one year, if they are stopped, there is a higher
risk for acute in-stent thrombosis, comparing to bare metal stent. It can
be life threatening. If it was a bare metal stent, your father needs to
take them for at least a month. Afterward, depending on whether there is
any contraindication, he can continue these two drugs, or only taking ASA. |
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D******k
发帖数: 335 | 15 http://urology.wustl.edu/en/Patient-Care/Kidney-Stones/Surgery-for-Kidney-Stones
根据Washington Univ 医学院的建议：
1.首选shockwave，用冲击波体外碎石，这个最简单，省事，不用动刀，折腾少，对病
人最好。
请仔细读那一段中shockwave的局限性。看起来病人不适合shockwave，因为他的结石
种类和吃blood-thinning药.
2.Ureteroscopy and laser lithotripsy
就是从小弟弟那里伸一根内窥镜进去到输尿管把石头取出来，然后放一根导管stent
在里面10天左右，防止搽伤的伤口粘连。这个也不切开，但是stent在里面会一直导致
流血和不适，直到取出了stent人才能感觉好。这个也有局限性，只能取中小尺寸的石
头。
3.Percutaneous Nephrolithotomy (PCNL)
从背那里开口一直切，把肾脏切开，把石头取出来。这个对于特别大的2cm的石头，
或者特别多的小石头，老美推荐用切。里面也会留一个临时性的导管... 阅读全帖 |
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f******I
发帖数: 769 | 16
assume 冠脉搭桥 is CABG, and 支架 is PCI/coronary stenting,
by history CABG was the treatment till cardiology invented cardiac cath/
stenting, that pretty much took majority cases(income as well) away from CT
surgeons, so you see less and less CT surgeons nowadays,
medically speaking, if you have 3 vessels disease or you have left main
disease, or 2 vessels disease with heart failure then CABG is the best
option, otherwise they like to do PCI with stenting, as it's much quicker
hospitalization and re |
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f******I
发帖数: 769 | 17
left heart cath is the gold standard test of choice as far as diagnosing
coronary disease, stress test could have either false positive or negative
results, not very sure about CT scan, it might have less contrast comparing
to heart cath but you can't perform any intervention when you just do CT
scan,
depends on which cardiologist you talk to,
generally speaking, when you put in a stent, it's a foreign body and there
is significant risk of in-stent re-stenosis, so for bare metal stent you
need |
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h***f
发帖数: 162 | 18 Nobody in the US will do an official second opinion without seeing a patient
. That is like asking someone to fix your car without bringing it into the
shop.
Your father needs coronary angiography, which is a low risk but nonetheless
invasive procedure. If he needs stenting he will need anticoagulation
medications for life to maintain patency of the stent.
If your father comes to the United States without insurance, how much he
will pay depends on the institution, but almost certainly the costs ... 阅读全帖 |
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s********p
发帖数: 1319 | 19 2010 美国心脏病协会（AHA）Scientific Sections Nov. 13-17 在Chicago进行。
与会期间，因为我自己有其他任务,蜻蜓点水，这次听的是临床方面而不是基础方面的
报道,根据Daily News, 主要述评此次年会的临床的主要热点和焦点话题：一个深刻的
危机，二个Highlights和四个Hot Topics。
一个仍然非常深刻的全球范围内的危机：
开幕式上，以神经病学家身份担任AHA现任主席的Ralph L. Sacco强调：全球范围内的
心血管疾病危机正在日益威胁着我们心脏和脑的健康。AHA 2020年的冲击目标：“改善
全美20%的心血管健康和减少20%的卒中死亡病例”将是抗击这一危机的关键。AHA定义
的“理想的心血管健康”状态，既可控的因素和健康的行为，“Life’s Simple 7 （
可控的因素：理想的胆固醇、血压和血糖水平；健康的行为：不吸烟、适当的体重、规
律的运动和健康的饮食）”，是完成这一目标的现实的、可行的、有力的武器。然而，
从Sacco领导的、始于1990年的、以3,200人为观察对象的“北曼哈顿研究（Northern
M... 阅读全帖 |
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g****i
发帖数: 2269 | 20 昨天又Float了
现在每周3天里有一天需要float，也没有额外的differential。
昨天还好，去了cardiology的floor，全tele的。主要是从cath lab来的病人：PTCA，
stents,和EP(electrophysiology) LAB的病人：new pacemaker or update。还有等待
CABG或其他开胸手术的病人，还有一些慢性病人比如CHF。由于医院要高效利用床位，
有时有med-surg的病人。
运气比较好，那里的RN跟我们科里的一样热心，其中一个总是跑过来问问我怎么样，是
否需要帮忙。secretary也很nice。
这个科的特点：病人轮转快，如果病人没有放stents，当天shealth拔出来后bedrest几
个小时就可以回家了，有stents的需要过夜。当然这个只是average而言，有
complication的就需要多呆了。早上我去的时候只有3个病人，吓我一跳，以为搞错了
，其中一个还是要去做CABG的，在我接到report前OR就call了。这样因为我没有report
，夜班RN就必须pre-op：给on call的药， |
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b***p
发帖数: 1398 | 21 Thanks a lot.
for niti-based stents, does ABT or BSX have their own manufacturing
facilities (like laser patterning; shape-setting, surface finish treatment)?
or they simply outsource those steps to companies like NDC, Memry, but they
keep drug-coating & packaging in house.
by the way, is polymer-based stent (bio-absorbable) getting hot?
If so, how long do you see NiTi-based stents will be phased out of the
market? |
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b***p
发帖数: 1398 | 22 Thanks a lot.
for niti-based stents, does ABT or BSX have their own manufacturing
facilities (like laser patterning; shape-setting, surface finish treatment)?
or they simply outsource those steps to companies like NDC, Memry, but they
keep drug-coating & packaging in house.
by the way, is polymer-based stent (bio-absorbable) getting hot?
If so, how long do you see NiTi-based stents will be phased out of the
market? |
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A*******s
发帖数: 9638 | 23 我觉得你首先得明确你究竟喜欢什么？ 喜欢动手可以做的科多了去了，不是你选择专
业的主要依据。
cardiology和radiology都可以做carotid stenting， 你知道他们的区别吗？前者的病
人是他们自己的，后者需要其他医生给refer。 所以目前很少听说有radiology做
carotid stenting，这就是细节决定结果。
喜欢跟病人直接打交道就做cardiology，反之radiology比较适合你。 至于打不打架这
种事就超出你考虑到范围了。 如果在Private practice，作为radiologist你恐怕一辈
子都做不上carotid stenting，但在kaiser这样的机构，你恐怕会忙不过来。 |
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T*R
发帖数: 36302 | 24 我帮助医生获得过无数consent，都是这么写的，angiogram with possible stent
placement。没有任何一个医生会在做angiogram前告诉病人需要stent。 |
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T*R
发帖数: 36302 | 25 我帮助医生获得过无数consent，都是这么写的，angiogram with possible stent
placement。没有任何一个医生会在做angiogram前告诉病人需要stent。 |
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l***d
发帖数: 1798 | 26 FOR IMMEDIATE RELEASE
National Academy of Engineering Elects 66 Members and 10 Foreign Associates
WASHINGTON — The National Academy of Engineering (NAE) has elected 66 new m
embers and 10 foreign associates, announced NAE President Charles M. Vest to
day. This brings the total U.S. membership to 2,254 and the number of forei
gn associates to 206.
Election to the National Academy of Engineering is among the highest profess
ional distinctions accorded to an engineer. Academy membership honors th... 阅读全帖 |
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c********e
发帖数: 496 | 27 爸爸有冠心病，最近觉得胸闷，很不舒服，现在有点考虑去做支架。我们家在一个地级
市，他们说有一个大夫挺好的，可又有点不放心，想去上海做。
1.冠心病如何确诊的，是运动平板吗？
2.事实上之家并不是一劳永逸的事情，支架后的再狭窄一直是一个比较严重的问题，即
使有eluting stent之后。
3.瑞金和中山相对好一点。一般来讲如果是常见的，非疑难的病例，有一年的培训就可
以做得不错了，但是如果是很特殊的病例，比如：左主干的（cabg可能更好一点，但是
stent也能做），这个就最好去北京或者上海了。
这个手术在地级市做可以吗？depends
另外今天爸爸去做了心电图，说缺氧量其实不大，他很怕做造影，总说做了造影
就一定要做支架了，是这样吗？不能先做造影再决定嘛？另外造影是不是肯定是创伤性
的?要切开装管子进去的？我不在他们身边，帮不上忙很是着急，麻烦大家给我点建议
，太感谢了！！！
1.造影后不一定要做支架，不过不做支架，做造影的意义也不是那么大，有点矛盾哈？
2. 手术本身不大， |
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c********e
发帖数: 496 | 28 restenosis is always a big problem for stent implantation, CEA is preferred,
but if it is not available, and the patient is suffering from TIA or high
risk/intendency to stroke, then stent is indicated. |
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h******l
发帖数: 112 | 29 Do you check the "courage stent study"
Please google it. If your mother is in "stable condition", stent is not
the best choice. Also, if you check the on-line discussion form. the
medicine is needed for whole life, not first 3 months or 1 year.
invented |
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I****a
发帖数: 407 | 30 Strategy 1:
Let it be and consider stent or radiation when obstruction symptoms arise.
Strategy 2:
Radiation now and let it be then consider stent if obstruction symptoms
arise. |
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f****o
发帖数: 2770 | 31 The biodegradable Igaki-Tamai stent is used in nine European Union countries
and Turkey — but not in the United States — to treat peripheral artery
disease (PAD), the disorder which results from fatty deposits that narrow
leg arteries. However, no countries have approved the Igaki-Tamai stent for
treating clogged heart arteries.
有谁了解这项新技术
http://www.webmd.com/heart-disease/news/20120416/are-biodegrada |
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d******6
发帖数: 276 | 33 HI blehum
I'd like review MS for JAPS.
pls see the following information. Many thanks
Ⅰ: PERSONAL INFORMATION
Name: Xiaoyi XU
Telephone Number: +1-(650)391-5991
E-mail Address: d******[email protected];
x**[email protected]
Address: Stanford University, School of Medicine
3801 Miranda Ave, Palo Alto, CA, 94304, US
Ⅱ: EDUCATION EXPERIENCE
YEAR INSTITUTION DEGREES /
2003.09-2006.06 Changchun Institute of Applie... 阅读全帖 |
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d******6
发帖数: 276 | 34 我是做高分子化学药物控释，包括前药这个方向的，求审稿推荐。多谢
Ⅰ: PERSONAL INFORMATION
Name: Xiaoyi XU
Telephone Number: +1-(650)391-5991
E-mail Address: x**[email protected]
Address: Jilin University
Stanford University, School of
Medicine
3801 Miranda Ave, Palo Alto, CA, 94304, US
Ⅱ: EDUCATION EXPERIENCE
YEAR INSTITUTION DEGREES /
2003.09-2006.06 Changchun Institute of Applied Chemistry, Ph... 阅读全帖 |
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T*R
发帖数: 36302 | 35 类似的，你住BXXXXXXX，选EDWARD医院也很正常的。但是轻易不要叫AMBULANCE，即使
可以报销。因为AMBULANCE是就近原则，肯定先把你送到BXXXXXX医院去了。
BXXXXXXX医院是个新医院，现在好点了。两年前我在那上班的时候见过很烂的一件事：
那是他们的CATHLAB可以做ANGIOGRAM，但是不能按STENT。
有一个病人手术后突发心梗，心电图已经很明显SHOW心梗了。医生说送CATHLAB。妈的
，插管进去，CONFIRM了心梗，但是因为他们没经认证，不能放STENT，只好把伤口缝合
，然后紧急送HINSDALE医院。因为BXXXXX医院和HISNDALE医院是一个系统的，即使他们
离EDWARD医院只有5分钟，离那30分钟，也是送那不送EDWARD。
这一带，TRAUMA CENTER是GOOD SAM医院，另外HISNDALE和GOOD SAM都可以做开胸心脏
搭桥手术，但是EDWARD医院做不了（至少一两年前还做不了，虽然他们自称HEART
HOSPITAL）。 |
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i*****s
发帖数: 15215 | 36 LONDON (Reuters) - Britain's Prince Philip, the 90-year-old husband of Queen
Elizabeth, had heart surgery to ease a blocked artery on Friday after being
rushed to hospital with chest pains as he prepared to celebrate Christmas
with the royal family.
Britain's longest-serving royal consort, known for his outspoken and
sometimes brusque manner, needed an operation to fit a small tube known as a
stent that keeps the blood vessel open.
Philip had been preparing to spend Christmas with other members ... 阅读全帖 |
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i*****s
发帖数: 15215 | 37 Prince Philip has 'good night' after heart surgery
Prince Philip "had a good night" in hospital after heart surgery and family
members will visit him Saturday, Buckingham Palace said.
The Queen's 90-year-old husband had a successful operation on Friday for a
blocked coronary artery, after being taken to hospital by helicopter from
the queen's Sandringham estate, where the royal family is celebrating
Christmas.
"The Duke of Edinburgh had a good night. There will be some members of the
family visi... 阅读全帖 |
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K***a
发帖数: 3614 | 38 我学过一点点这方面东西，感觉是很偏基理的研究。基本的就是用流体力学的方法研究
体内循环的传质传热。比如什么样的流体环境更容易导致Clot，进而引起心机梗塞.或
者弄个stent在血管内会引起什么样的流体变化之类的.这个毕业去做stent也行，不过
感觉可能公司更需要做材料的.
Laboratory |
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j******n
发帖数: 941 | 39 纯属罗列（一升一降）：
1.Abbott (NYSE: ABT) today announced that the XIENCE Xpedition((TM))
Everolimus Eluting Coronary Stent System received U.S. Food and Drug
Administration (FDA) approval and is launching immediately in the United
States, providing physicians with a next-generation technology with the
largest size matrix in the U.S. market. XIENCE Xpedition features a new
stent delivery system designed to optimize deliverability, particularly in
challenging coronary anatomies. Current: 32.94 +0.89 (2.78... 阅读全帖 |
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q***l
发帖数: 177 | 40 National Academy of Engineering Elects 66 Members and 10 Foreign Associates
WASHINGTON — The National Academy of Engineering (NAE) has elected 66 new
members and 10 foreign associates, announced NAE President Charles M. Vest
today. This brings the total U.S. membership to 2,254 and the number of
foreign associates to 206.
Election to the National Academy of Engineering is among the highest
professional distinctions accorded to an engineer. Academy membership
honors those who have made outstand... 阅读全帖 |
|
g******6
发帖数: 782 | 41 http://www.nae.edu/56154.aspx
National Academy of Engineering Elects 66 Members and 10 Foreign Associates
WASHINGTON — The National Academy of Engineering (NAE) has elected 66 new
members and 10 foreign associates, announced NAE President Charles M. Vest
today. This brings the total U.S. membership to 2,254 and the number of
foreign associates to 206.
Election to the National Academy of Engineering is among the highest
professional distinctions accorded to an engineer. Academy membership
honor... 阅读全帖 |
|
m***n
发帖数: 266 | 42 一个老贴子的新思维.
Drug-eluting Stent上的polymer matrix (as drug reservior) 怎样固定在金属
stent 上? Spin coating or sth else? |
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k*e
发帖数: 238 | 43 是stent的模拟？怎么叫“这个形状可不可行?"
google "stent FEA simulation" online and see if there is any website helpful? |
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a*********d
发帖数: 2763 | 44 这些都是很reasonable的要求阿，心脏科的病人，那些都很relevant的，不只是stent
，什么stent,drug eluting的还是bare metal的，装在哪个branch上，当时还有没有别
的branch disease但是没有放支架的，如果有，大概狭窄到什么程度，这些都是应该知
道得，这样病人再次进来，你看到心电图的变化就知道是不是和那次没有放支架的狭窄
血管有关。
这些都是care about education得人才会要求，他自己也有这个水平比你问得好，看得
好，所以你才能学东西。
主治医生查房几分钟，病史也不再问了，note也不看，大家嘻嘻哈哈开开心心，这样的
主治医生我也有过，但是短暂的住院三年，有多少个月可以浪费。毕业以后就是on
your own了。
另外我不知道你是什么training level，但是我觉得被主治医生说，如果是真得自己没有做好，不爽的感觉应该是自愧，是要争取下次做得更好，而不是觉得没有面子或者感觉受伤。我想他说这些的时候是把你当作学生，把自己多年的经验一点点交给你，这些医生经历过的教训，就是通过这样的途径给你，希望你以后不要犯他们 |
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c******k
发帖数: 237 | 45 In US, 4-6 weeks plavix for metal stent, 1 yr for drug elute stent.
Now we know how much profit the pharmaceutical company has made from plavix.
Does anyone know when the generic one is available? I heard earlier this
year that the generic one would be available by November but I haven't seen
it yet. |
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J*********4
发帖数: 1274 | 46 今年的新Intern马上要开始最艰苦的头三月了。为了给大家鼓劲和提供survival tips，
经Dr. Againstwind (逆风而行)同意，把她以前的精彩帖子重新分段贴下. 谢谢！BTW,
Dr. Againstwind is the winner of the best resident in her program at her
graduation.
Intern汇报病史小tips
被花厘鼠抓去参加了几次skype case presentation，想想自己当年一match上就回国腐
败得昏天黑地，呵呵，大家的起跑线已经高了很多，有点感触，跟大家分享一下。
1。汇报病史的顺序：第一句话主诉，然后现病史，然后PMH/PSH/SH/FH/ALL/MEDS/ROS,
条理要分明。现病史第一句话通常是 this is a 63 year old male with history of
DM-2, HTN, CAD presented with .... 然后把故事加入细节。
2。汇报的重点：
如果CAD病人是胸痛/SOB等主诉，那么一定要知道的病史包括：有没有MI, 什么时... 阅读全帖 |
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s**********8
发帖数: 25265 | 47 seems this friend need carotid stenting and SFA stenting |
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b***p
发帖数: 1398 | 48
Xience vs Promus, which one is better or more popular?
by the way, is drug-eluting stent more popular than bare-metal stent in the
market?
thanks |
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b***p
发帖数: 1398 | 49
Xience vs Promus, which one is better or more popular?
by the way, is drug-eluting stent more popular than bare-metal stent in the
market?
thanks |
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g*2
发帖数: 658 | 50 刚刚把堆积了几个星期的nejm翻看了一下，居然在11月底的那期case discussion就是
讲得这个病
http://www.nejm.org/doi/full/10.1056/NEJMcpc1103565
Case 36-2011 — A 93-Year-Old Woman with Shortness of Breath and Chest Pain
Presentation of Case
Dr. Pooja Agrawal (Emergency Medicine): A 93-year-old woman was seen in the
emergency department at this hospital because of chest pain and shortness of
breath.
The patient had been in her usual state of health, with hypertension and
chronic renal insufficiency, until the morning of admission, wh... 阅读全帖 |
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