Büchler J R, Armelin E, Pimentel Filho W A, Neves Filho M F, Mussi M W, Pinheiro L F, Zomer Filho O
Hospital Beneficência Portuguesa, São Paulo.
Arq Bras Cardiol. 1991 Aug;57(2):115-20.
To describe a new alternative technique for treating coronary artery disease: the coronary atherectomy with the transluminal endarterectomy-extraction catheter.
Four patients, 1 female and 3 males age 46 to 65 years (mean 53 +/- 8.5 years), were submitted to coronary atherectomy with the transluminal endarterectomy-extraction catheter. One patient presenting stable angina, one presenting recent angina, one with residual stenosis after acute myocardial infarction treated with intravenous streptokinase and one with two episodes of syncope and ECG alterations. The treated arteries were: left anterior descending in 3 patients and left circumflex in one. Two lesion were concentric and two were segmentary and eccentric.
The coronary artery stenosis ranged from 80 to 95% (mean of 90 +/- 7.1%) before the atherectomy and from 20-50% (mean of 32.5 +/- 12.6%) after the atherectomy. Except the first patient, the other 3 were discharged in less than 48 hours after the atherectomy. None presented chest pain during the procedure and in three of them were no recordings of dissection or coronary artery perforation. In one patient the treated artery presented total occlusion (thrombus) 15 minutes after the procedure, but was immediate and successfully reopened with balloon angioplasty.
Coronary atherectomy with the "transluminal endarterectomy-extraction catheter" has shown to be a safe and feasible procedure and to bring satisfactory immediate results.
描述一种治疗冠状动脉疾病的新的替代技术：经腔内膜切除术-抽吸导管冠状动脉斑块旋切术。
4例患者，1例女性，3例男性，年龄46至65岁（平均53±8.5岁），接受了经腔内膜切除术-抽吸导管冠状动脉斑块旋切术。1例表现为稳定型心绞痛，1例表现为近期心绞痛，1例在静脉注射链激酶治疗急性心肌梗死后有残余狭窄，1例有两次晕厥发作及心电图改变。所治疗的动脉为：3例患者为左前降支，1例为左旋支。2处病变为同心性，2处为节段性且偏心。
冠状动脉狭窄在斑块旋切术前为80%至95%（平均90±7.1%），术后为20%至50%（平均32.5±12.6%）。除第1例患者外，其他3例在斑块旋切术后不到48小时出院。术中无一例出现胸痛，其中3例未记录到夹层或冠状动脉穿孔。1例患者在术后15分钟所治疗的动脉出现完全闭塞（血栓形成），但立即通过球囊血管成形术成功再通。
“经腔内膜切除术-抽吸导管”冠状动脉斑块旋切术已被证明是一种安全可行的手术，能带来令人满意的即刻效果。
