Do DD, Triller J, Baumgartner I, Freiburghaus AU, Mahler F
Division of Angiology, Department of Medicine, Inselspital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland.
J Invasive Cardiol. 1998 Nov;10(9):578-582.
To prospectively determine the safety, feasibility and efficacy of a new atherectomy device. Methods. Seventy patients with 93 symptomatic femoro-popliteal lesions underwent percutaneous atherectomy with Redha-cut, a metallic, flexible catheter. The device works on pull-back with two umbrella-like blades and enables cutting, retaining and removing of material. Quantitative analysis of the angiograms was performed. RESULTS: Obtaining of atherectomized samples was successful in all cases. The mean atherectomy time was 5 +/- 2 minutes. The stenoses were reduced from 74 +/- 2.3% before to 26 +/- 2% after atherectomy (p < 0.001). Subsequent PTA, which was performed to optimize the results, further decreased the degree of stenosis to 17% (p > 0.5). No perforations, acute closure or early re-thrombosis occurred. Cumulative patency rates according to the findings of non-invasiveive examinations were 83% at 6 months and 66% at 12 months. Conclusions. The Redha-cut device is a simple, safe and efficacious tool for biopsy sampling and atherectomy. Further studies randomizing patients either to balloon or atherectomy are planned to compare this technique with others in regard to long-term patency.
前瞻性地确定一种新型旋切装置的安全性、可行性和有效性。方法。70例患有93处有症状的股腘病变的患者接受了使用Redha-cut(一种金属柔性导管)进行的经皮旋切术。该装置通过两个伞状刀片在回撤时工作,能够切割、保留和移除物质。对血管造影进行了定量分析。结果:所有病例均成功获取旋切样本。平均旋切时间为5±2分钟。狭窄程度从旋切术前的74±2.3%降至术后的26±2%(p<0.001)。为优化结果而进行的后续经皮腔内血管成形术(PTA)进一步将狭窄程度降至17%(p>0.5)。未发生穿孔、急性闭塞或早期再血栓形成。根据非侵入性检查结果,6个月时的累积通畅率为83%,12个月时为66%。结论。Redha-cut装置是一种用于活检采样和旋切术的简单、安全且有效的工具。计划进行进一步的研究,将患者随机分为接受球囊治疗或旋切术组,以在长期通畅性方面将该技术与其他技术进行比较。