Yock P G, Fitzgerald P J, Sudhir K, Linker D T, White W, Ports A
Department of Medicine, University of California, San Francisco.
Int J Card Imaging. 1991;6(3-4):179-89. doi: 10.1007/BF01797850.
Intravascular ultrasound imaging provides a direct view of atherosclerotic disease, generating in vivo information about the depth and mechanical characteristics of plaque at any point in the vessel wall. For this reason, ultrasound has significant potential to serve as a guidance modality for catheter-based techniques designed to remove or ablate plaque. Although the current generation mechanical atherectomy, laser ablation and ultrasound pulverization techniques all have some specificity for attacking plaque as opposed to normal vessel wall, it appears that in practice all of these devices will continue to carry a risk of traumatizing or even perforating arteries. In addition, it seems highly likely that aggressive 'debulking' of plaque will require some type of guidance beyond angiography - a role which ultrasound is theoretically well suited to play. The purpose of this review is to consider the theoretical and practical applications of ultrasound imaging as a guide to catheter-based plaque removal and ablation techniques. Specific uses will be discussed with respect to both directional and coaxial therapeutic devices.
血管内超声成像可直接观察动脉粥样硬化疾病，生成血管壁任何部位斑块深度及力学特征的体内信息。因此，超声作为旨在去除或消融斑块的基于导管技术的引导方式具有巨大潜力。尽管当前一代的机械旋切术、激光消融术和超声粉碎技术在攻击斑块而非正常血管壁方面都具有一定特异性，但在实际应用中，所有这些设备似乎仍存在损伤甚至穿透动脉的风险。此外，积极的斑块“减容”很可能需要血管造影之外的某种引导——超声理论上非常适合扮演这一角色。本综述的目的是探讨超声成像作为基于导管的斑块去除和消融技术引导的理论及实际应用。将针对定向和同轴治疗设备讨论其具体用途。
