Cull D L, Feinberg R L, Wheeler J R, Snyder S O, Gregory R T, Gayle R G, Parent F N
Division of Vascular Surgery, Eastern Virginia Graduate School of Medicine, Norfolk 23510.
J Vasc Surg. 1991 Sep;14(3):332-9. doi: 10.1067/mva.1991.30867.
Favorable early results with mechanical angioplasty devices and laser-assisted balloon angioplasty have resulted in aggressive marketing and a rapid increase in the use of these devices for the treatment of femoropopliteal occlusive disease. Recent reports, however, have questioned the durability of these less invasive procedures. Since 1986 we have been involved in the clinical investigation of the Kensey dynamic angioplasty instrument and laser-assisted balloon angioplasty. One hundred two balloon angioplasty procedures assisted by the Nd:YAG laser (n = 56) and the Kensey dynamic angioplasty instrument (n = 46) were performed for the treatment of femoropopliteal occlusive lesions. Both Kensey dynamic angioplasty instrument and laser-assisted balloon angioplasty groups were similar with regard to age, operative indication, preoperative ankle-brachial index, lesion length, and distal runoff. Mean follow-up was 19 months in the Kensey dynamic angioplasty instrument group and 15 months in the laser-assisted balloon angioplasty group. Technically successful recanalization was achieved in 67% of Kensey dynamic angioplasty instrument-assisted balloon angioplasty procedures and 82% of laser-assisted balloon angioplasty procedures. Early hemodynamic and clinical improvement was obtained in 59% of Kensey dynamic angioplasty instrument-assisted balloon angioplasty procedures and 57% of laser-assisted balloon angioplasty procedures. Two-year clinical success by life-table analysis was 37% in the Kensey dynamic angioplasty instrument group and 19% in the laser-assisted balloon angioplasty group. The level of subsequent surgical revascularization was not altered in any patient by Kensey dynamic angioplasty instrument-assisted balloon angioplasty or laser-assisted balloon angioplasty.(ABSTRACT TRUNCATED AT 250 WORDS)
机械血管成形术设备和激光辅助球囊血管成形术取得的良好早期结果，促使这些设备得到大力推广，用于治疗股腘动脉闭塞性疾病的使用量迅速增加。然而，最近的报告对这些侵入性较小的手术的持久性提出了质疑。自1986年以来，我们一直参与Kensey动态血管成形术器械和激光辅助球囊血管成形术的临床研究。我们对102例采用钕钇铝石榴石激光（n = 56）和Kensey动态血管成形术器械（n = 46）辅助的球囊血管成形术进行了股腘动脉闭塞性病变的治疗。Kensey动态血管成形术器械组和激光辅助球囊血管成形术组在年龄、手术指征、术前踝肱指数、病变长度和远端血流方面相似。Kensey动态血管成形术器械组的平均随访时间为19个月，激光辅助球囊血管成形术组为15个月。在Kensey动态血管成形术器械辅助的球囊血管成形术手术中，67%实现了技术上成功的再通，在激光辅助球囊血管成形术手术中这一比例为82%。在Kensey动态血管成形术器械辅助的球囊血管成形术手术中，59%获得了早期血流动力学和临床改善，在激光辅助球囊血管成形术手术中这一比例为57%。通过生命表分析，Kensey动态血管成形术器械组的两年临床成功率为37%，激光辅助球囊血管成形术组为19%。Kensey动态血管成形术器械辅助的球囊血管成形术或激光辅助球囊血管成形术均未改变任何患者后续手术血管重建的水平。（摘要截短至250字）
