血管内超声成像评估球囊血管成形术对股动脉的影响。

Effect of balloon angioplasty on femoral artery evaluated with intravascular ultrasound imaging.

作者信息

The S H, Gussenhoven E J, Zhong Y, Li W, van Egmond F, Pieterman H, van Urk H, Gerritsen G P, Borst C, Wilson R A

机构信息

Thoraxcenter, Rotterdam, The Netherlands.

出版信息

Circulation. 1992 Aug;86(2):483-93. doi: 10.1161/01.cir.86.2.483.

DOI:10.1161/01.cir.86.2.483

PMID:1386293

Abstract

BACKGROUND

Intravascular ultrasound was used to assess the immediate effect of balloon angioplasty on the superficial femoral artery.

METHODS AND RESULTS

In 16 consecutive patients, corresponding ultrasonic cross sections (n = 72) before and after balloon angioplasty were qualitatively and quantitatively analyzed. The qualitative data were compared with angiographic findings. Before intervention, the angiographically demonstrated obstructive lesions were confirmed by intravascular ultrasound. Ultrasound enabled discrimination between soft (n = 43) and hard (n = 29) lesions, as well as between eccentric (n = 57) and concentric (n = 15) lesions. After balloon angioplasty, the presence of a dissection assessed angiographically in 14 patients was confirmed by intravascular ultrasound. Additional morphological information provided by ultrasound included plaque rupture in 14 patients and internal lamina rupture in six patients. Quantitative ultrasound data revealed an increase in free lumen area from 9.7 +/- 4.7 to 18.3 +/- 7.0 mm2 (p less than or equal to 0.01), an increase in minimal lumen diameter from 2.8 +/- 0.7 to 3.6 +/- 1.2 mm (p less than or equal to 0.01), and an increase in media-bounded area from 21.7 +/- 5.4 to 28.3 +/- 5.8 mm2 (p less than or equal to 0.01). The lesion area for the majority of cases (n = 32) remained unchanged (13.0 +/- 4.9 mm2 versus 12.9 +/- 4.6 mm2), or the lesion disappeared partially (from 9.1 +/- 0.9 to 4.3 +/- 1.4 mm2, n = 4, p less than or equal to 0.01) or totally (from 10.1 +/- 4.2 to 0 mm2, n = 6). Stretching of the arterial wall was further evidenced by medial thinning from 0.55 +/- 0.19 to 0.34 +/- 0.11 mm (p less than or equal to 0.01).

CONCLUSIONS

Luminal enlargement by balloon dilatation is achieved primarily by overstretching the arterial wall, with the lesion volume remaining practically unchanged. Overstretching is accompanied almost always by dissection and plaque rupture and occasionally by an internal lamina rupture.

摘要

背景

采用血管内超声评估球囊血管成形术对股浅动脉的即时效果。

方法与结果

对16例连续患者球囊血管成形术前后相应的超声横截面（n = 72）进行定性和定量分析。将定性数据与血管造影结果进行比较。干预前，血管造影显示的阻塞性病变经血管内超声证实。超声能够区分软斑块（n = 43）和硬斑块（n = 29），以及偏心性病变（n = 57）和同心性病变（n = 15）。球囊血管成形术后，血管造影评估的14例患者中存在的夹层经血管内超声证实。超声提供的额外形态学信息包括14例患者的斑块破裂和6例患者的内膜破裂。定量超声数据显示，自由腔面积从9.7±4.7增加到18.3±7.0 mm²（p≤0.01），最小腔径从2.8±0.7增加到3.6±1.2 mm（p≤0.01），中膜包绕面积从21.7±5.4增加到28.3±5.8 mm²（p≤0.01）。大多数病例（n = 32）的病变面积保持不变（13.0±4.9 mm²对12.9±4.6 mm²），或病变部分消失（从9.1±0.9到4.3±1.4 mm²，n = 4，p≤0.01）或完全消失（从10.1±4.2到0 mm²，n = 6）。动脉壁的伸展进一步表现为中膜厚度从0.55±0.19变薄至0.34±0.11 mm（p≤0.01）。