Arlart I P, Gerlach A, Grass H G
Radiologisches Institut, Katharinenhospital Stuttgart, FRG.
Cardiovasc Intervent Radiol. 1991 Jul-Aug;14(4):233-7. doi: 10.1007/BF02578468.
Laser-assisted balloon angioplasty (LA) using a Nd-YAG laser with a sapphire tip probe was performed in 40 selected patients with complete chronic femoropopliteal occlusions (SFA n = 30, PA n = 10), in whom the lesion was resistant to conventional guidewire/catheter traversal. Overall technical success rate was 77.5% (31/40). Technical failure occurred in nine cases due to calcifications (n = 2), imminent perforation (n = 5), or complete perforation (n = 4). In 1 case a Simpson atherectomy was done following LA. In addition, 3 cases of peripheral embolizations were managed successfully by selective fibrinolysis and thrombus aspiration. Follow-up studies up to 14 months demonstrated a clinical improvement in 87% (27/31). Early reocclusion rate was 4/31; after 2-14 months, reocclusion rate was 7/31. Our results demonstrate that LA may be recommended for chronic occlusions resistant to conventional guidewire or catheter traversal in spite of a relatively high rate of technical failure and complications, and recurrence.
对40例选定的患有慢性股腘动脉完全闭塞的患者（股浅动脉闭塞30例，腘动脉闭塞10例）进行了使用带蓝宝石尖端探头的Nd-YAG激光的激光辅助球囊血管成形术（LA），这些患者的病变对传统导丝/导管通过具有抵抗性。总体技术成功率为77.5%（31/40）。9例出现技术失败，原因是钙化（2例）、即将穿孔（5例）或完全穿孔（4例）。1例在LA术后进行了Simpson旋切术。此外，3例周围栓塞通过选择性纤维蛋白溶解和血栓抽吸成功处理。长达14个月的随访研究显示87%（27/31）的患者临床症状改善。早期再闭塞率为4/31；2至14个月后，再闭塞率为7/31。我们的结果表明，尽管技术失败、并发症和复发率相对较高，但对于对传统导丝或导管通过具有抵抗性的慢性闭塞，LA仍可推荐使用。
