Tjomsland O, Almdahl S M, Saatvedt K, Nordstrand K, Aaberge L
Feiringklinikken.
Tidsskr Nor Laegeforen. 1999 Oct 10;119(24):3597-601.
Transmyocardial laser treatment is currently being evaluated as a treatment modality for patients with severe coronary artery disease unsuitable for conventional revascularization with percutaneous transluminal coronary angioplasty or coronary artery bypass grafting. The original hypothesis was that laser-made channels could contribute to myocardial perfusion by conducting blood from the left ventricular cavity into the ischemic myocardium. Results from clinical trials suggest that transmyocardial laser treatment leads to a significant decrease in physician-assessed angina scores and improvement of quality of life. There are, however, conflicting data regarding the effect of myocardial perfusion, and the mechanisms responsible for the observed clinical effect remain unclear. It has been suggested that the angina relief is caused by destruction of myocardial peripheral nerve-endings and improved perfusion through induction of angiogenesis and collateral recruitment. A review of transmyocardial laser treatment with emphasis on experimental and clinical results, based on a thoroughly performed search on Medline of English language publications up until May 1999, is presented.
目前正在评估经心肌激光治疗作为一种治疗方式，用于那些患有严重冠状动脉疾病、不适合采用经皮冠状动脉腔内血管成形术或冠状动脉旁路移植术进行传统血运重建的患者。最初的假设是，激光制造的通道可通过将左心室腔的血液导入缺血心肌来促进心肌灌注。临床试验结果表明，经心肌激光治疗可使医生评估的心绞痛评分显著降低，并改善生活质量。然而，关于心肌灌注效果的数据存在矛盾，且导致所观察到的临床效果的机制仍不清楚。有人提出，心绞痛缓解是由于心肌外周神经末梢的破坏以及通过诱导血管生成和侧支循环募集而改善了灌注。本文基于对截至1999年5月的英文医学文献数据库（Medline）进行全面检索，对经心肌激光治疗进行综述，重点阐述实验和临床结果。
