Mahler F, Do D, Triller J
Angiologisch-gefässchirurgische Poliklinik, Medizinischen Universitätsklinik, Inselspital Bern.
Schweiz Med Wochenschr. 1991 Dec 28;121(51-52):1931-5.
Percutaneous transluminal angioplasty (PTA) by balloon catheters is the standard method in interventional angiology. It is recommended in the aorto-iliac region for arterial stenoses, and in the femoro-popliteal arteries for stenoses and short occlusions. Due to progress in technology of catheters and guide wires, a primary success rate of more than 90% is to be expected with favorable angiographic conditions. The long-term patency rate of some 90% on the aorto-iliac level exceeds that of 70-90% on the femoro-popliteal level, with the patency rate decreasing with increasing complexity of the lesions. Subacute/acute occlusions of the femoro-popliteal arteries are treated successfully in 80% by catheter-thrombolysis and/or thrombus aspiration. Several new techniques are under clinical evaluation, such as laser angioplasty, rotational catheters, atherectomy catheters and stents. Their application in clinical routine has up to now not been justified except for special situations such as obtaining biopsy material by Simpson catheter or maintenance of patency in balloon resistant lesions by stents.
通过球囊导管进行经皮腔内血管成形术(PTA)是介入血管学的标准方法。对于主动脉 - 髂动脉区域的动脉狭窄以及股 - 腘动脉的狭窄和短段闭塞,推荐使用该方法。由于导管和导丝技术的进步,在有利的血管造影条件下,预计初次成功率超过90%。主动脉 - 髂动脉水平约90%的长期通畅率超过股 - 腘动脉水平70 - 90%的通畅率,且通畅率随病变复杂性增加而降低。股 - 腘动脉的亚急性/急性闭塞通过导管溶栓和/或血栓抽吸,80%可成功治疗。几种新技术正在进行临床评估,如激光血管成形术、旋转导管、旋切导管和支架。到目前为止,除了特殊情况,如通过辛普森导管获取活检材料或通过支架维持对球囊有抵抗性病变的通畅外,它们在临床常规中的应用尚无充分依据。