Tomaru T, Abela G S, Gonzalez J, Giacomino P, Friedl S E, Barbeau G R
2nd Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Japan.
Angiology. 1992 May;43(5):412-20. doi: 10.1177/000331979204300507.
The degree of residual stenosis by fresh thrombus after laser recanalization was compared by use of angiography and angioscopy. Fifteen NZW rabbits were used. Occlusive fresh thrombus in rabbit aorta was produced by mechanical deendothelialization and external constrictions simulating clinical situations. Argon laser angioplasty using microlens-tipped optical fiber and/or 2 mm hot-tip probe was done to recanalize thrombosed aorta in 10 animals. Two-mm hybrid probe was used in 5. Percent area stenosis (% AST) was derived by use of the mean radius method obtained by angiography of stenotic segments in two orthogonal views and/or from angioscopy. All 15 totally occluded vessels with fresh thrombus were recanalized. Four minor perforations occurred. Following argon laser angioplasty with the microlens optical fiber, percent stenosis was reduced to 53% in diameter by angiography and 66 in % AST by angioscopy, and to 48% and 55 respectively following hot-tip probe. After laser angioplasty with the hybrid probe, residual stenosis by fresh thrombus was 37% in diameter on angiography and 63 in % AST on angioscopy. Mean percent AST was 62% with angiography and 52% with angioscopy, and there was no correlation between them (r = -0.028). Angioscopy provided cross-sectional topographic views of thrombosed lumen and showed charring and shrinkage of thrombus following laser angioplasty. This study suggests that (1) continuous-wave laser angioplasty using modified optical fibers can recanalize thrombotic vascular occlusion, (2) laser angioplasty by hot-tip probe could evacuate fresh thrombus more than microlens fiber on angioscopy, and (3) angiographic % AST did not correlate with angioscopic % AST.
通过血管造影和血管内镜检查比较激光再通术后新鲜血栓形成的残余狭窄程度。使用了15只新西兰白兔。通过机械性内皮剥脱和模拟临床情况的外部压迫在兔主动脉中制造闭塞性新鲜血栓。对10只动物的血栓形成的主动脉进行再通，采用带微透镜尖端光纤的氩激光血管成形术和/或2毫米热尖端探头。5只动物使用2毫米混合探头。通过在两个正交视图中对狭窄节段进行血管造影获得的平均半径法和/或从血管内镜检查中得出狭窄面积百分比（%AST）。所有15条完全被新鲜血栓闭塞的血管均实现再通。发生了4处轻微穿孔。使用微透镜光纤进行氩激光血管成形术后，血管造影显示直径狭窄百分比降至53%，血管内镜检查显示%AST为66%；使用热尖端探头后分别降至48%和55%。使用混合探头进行激光血管成形术后，血管造影显示新鲜血栓形成的残余狭窄直径为37%，血管内镜检查显示%AST为63%。血管造影的平均%AST为62%，血管内镜检查为52%，两者之间无相关性（r = -0.028）。血管内镜检查提供了血栓形成管腔的横截面地形图，并显示了激光血管成形术后血栓的炭化和收缩。本研究表明：（1）使用改良光纤的连续波激光血管成形术可使血栓性血管闭塞再通；（2）在血管内镜检查中，热尖端探头激光血管成形术比微透镜光纤能更有效地清除新鲜血栓；（3）血管造影的%AST与血管内镜检查的%AST不相关。
