Tomaru T, Uchida Y, Nakamura F, Yanagisawa-Miwa A, Kamijo T, Sugimoto T
Second Department of Internal Medicine, University of Tokyo, Japan.
J Interv Cardiol. 1993 Mar;6(1):41-50. doi: 10.1111/j.1540-8183.1993.tb00440.x.
The vasoreactivity and thrombogenicity of laser-thermal angioplasty were examined and compared with those of balloon angioplasty in an atherosclerotic rabbit iliac artery. Eight rabbits underwent laser-thermal angioplasty with a 1.7-mm hot-tip probe activated at 7 W with a probe temperature of 126 +/- 19 degrees C in one iliac artery. The other iliac artery was treated with balloon angioplasty using a 2.0-mm balloon. Angiographic luminal diameter increased from 0.19 +/- 0.15 to 1.54 +/- 0.35 mm by laser and from 0.29 +/- 0.22 to 1.84 +/- 0.20 mm by balloon (P less than 0.0001, respectively). However, it decreased to 1.34 +/- 0.42 for laser and 0.45 +/- 0.39 for balloon 60 minutes later (P less than 0.0001 vs immediately post). Both iliac arteries were visualized using angioscopy, which revealed thrombotic obstruction of 91% stenosis in the ballooned artery and 8% stenosis in the lased artery. Vasoreactivity of treated vessels was also investigated. Segments 3-mm long were obtained from either treated artery or control artery and examined for noradrenaline (10 -7 M) contraction. The segments were then mounted isometrically with 1 g tension in Krebs-bicarbonate buffer. Developed tension was 0.13 +/- 0.21 g for laser thermal and 2.33 +/- 0.4 g for its control (P less than 0.0001), and 0.15 +/- 0.16 g for balloon dilatation and 2.12 +/- 0.43 g for its control (P less than 0.0001). Neither acetylcholine at 10 -6 M or papaverine at 10 -4 M induced relaxation of treated segments. Histology showed slight thermal injury at thermally-treated sites without thrombus, and intimal and medial dissection with thrombus formation at balloon dilated site.
(1) neither a laser-thermal recanalized or a balloon dilated obstructed artery is vasoreactive to constrictive or relaxant agents; and (2) laser-thermal angioplasty results in less thrombogenicity than balloon angioplasty under moderate probe temperature.
在动脉粥样硬化兔髂动脉中，检测并比较了激光热血管成形术与球囊血管成形术的血管反应性和血栓形成性。8只兔子在一侧髂动脉接受了激光热血管成形术，使用1.7毫米热尖端探头，功率7瓦，探头温度为126±19℃。另一侧髂动脉用2.0毫米球囊进行球囊血管成形术治疗。激光治疗后血管造影管腔直径从0.19±0.15毫米增加到1.54±0.35毫米，球囊治疗后从0.29±0.22毫米增加到1.84±0.20毫米（P均小于0.0001）。然而，60分钟后激光组降至1.34±0.42毫米，球囊组降至0.45±0.39毫米（与治疗后即刻相比P均小于0.0001）。对双侧髂动脉进行血管内镜检查，发现球囊扩张动脉有91%狭窄的血栓阻塞，激光治疗动脉有8%狭窄的血栓阻塞。还研究了治疗血管的血管反应性。从治疗动脉或对照动脉获取3毫米长的节段，检测去甲肾上腺素（10-7M）收缩情况。然后将节段在Krebs-碳酸氢盐缓冲液中以1克张力等长安装。激光热治疗节段的张力发展为0.13±0.21克，其对照为2.33±0.4克（P小于0.0001），球囊扩张节段为0.15±0.16克，其对照为2.12±0.43克（P小于0.0001）。10-6M的乙酰胆碱或10-4M的罂粟碱均未引起治疗节段的舒张。组织学检查显示，热治疗部位有轻微热损伤，无血栓形成，球囊扩张部位有内膜和中膜剥离并伴有血栓形成。
（1）激光热再通或球囊扩张的阻塞动脉对收缩剂或舒张剂均无血管反应性；（2）在适度探头温度下，激光热血管成形术比球囊血管成形术的血栓形成性更低。
