Gonschior P, Höfling B, Backa D, Bauriedel G, von Pölnitz A
Medizinische Klinik I, Klinikum Grosshadern, Universität München.
Dtsch Med Wochenschr. 1991 Nov 2;116(44):1657-63. doi: 10.1055/s-2008-1063800.
130 arteriosclerotic lesions--10 in the iliac, 109 in the superficial femoral, 10 in the popliteal and 1 in the anterior tibial artery--were treated by percutaneous atherectomy in 80 patients (62 men and 18 women: mean age 65 +/- 10 years). 23 of the lesions were concentric, 65 eccentric stenoses, while 42 were fully occlusive. 32 patients were in stage IIb (after Fontaine), 24 in stage IIa and 12 each in stage III or IV. Most of the stenoses were not suitable for conventional balloon dilatation because of their primary morphology. A good early angiographic result (residual stenosis less than 50%) was achieved in 94% of lesions. Mean stenosis degree was reduced from 85 +/- 12% to 12 +/- 10% (occlusions from 100% to 9 +/- 9%). The Doppler index increased from 0.6 +/- 0.18 to 0.85 +/- 0.15 (P less than 0.01). Follow-up angiography after 6 months in 104 lesions demonstrated an average stenosis degree of 33 +/- 25% (occlusions 44 +/- 28%). 26 of the 104 re-studied lesions fulfilled the criterion for re-stenosis (greater than 50%): six concentric ones and five eccentric ones, as well as 15 occlusions. These findings indicate that peripheral atherectomy can be employed with good short and long-term results even in morphologically unfavourable, markedly eccentric or calcified lesions and occlusions.
130处动脉硬化性病变——髂动脉10处、股浅动脉109处、腘动脉10处、胫前动脉1处——在80例患者（62例男性和18例女性，平均年龄65±10岁）中接受了经皮斑块旋切术治疗。其中23处病变为同心性，65处为偏心性狭窄，42处为完全闭塞。32例患者处于Fontaine分期IIb期，24例处于IIa期，12例处于III期或IV期。由于其初始形态，大多数狭窄不适合常规球囊扩张。94%的病变在早期血管造影中取得了良好结果（残余狭窄小于50%）。平均狭窄程度从85±12%降至12±10%（闭塞病变从100%降至9±9%）。多普勒指数从0.6±0.18升至0.85±0.15（P<0.01）。104处病变在6个月后进行的随访血管造影显示平均狭窄程度为33±25%（闭塞病变为44±28%）。在重新研究的104处病变中，有26处符合再狭窄标准（大于50%）：6处同心性病变、5处偏心性病变以及15处闭塞病变。这些结果表明，即使对于形态不佳、明显偏心或钙化的病变及闭塞病变，外周斑块旋切术也能取得良好的短期和长期效果。
