Yoshida M, Okada M, Tsuji Y, Nakamura K
Department of Surgery, Kobe University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1991 Aug;92(8):1016-26.
To evaluate the safety and efficacy of recanalization of the occlusive arterial diseases by Argon laser, we investigated the effects of the laser irradiation using bare-ended probe (BEP) and metal-tip probe (MTP) on human cadaveric aorta and canine femoral arteries with thrombotic occlusion. In case of the BEP, the incidence of perforation of the arterial wall was high as compared with the MTP. However, laser angioplasty with angioscopic guidance could reduce the perforation rate, and made it possible to observe the new channel recanalized by laser. In case of the MTP, it was confirmed that the smaller MTP showed higher tip temperature and was more effective on plaques under the same laser energy. Optimal laser energy for single ablation was from 15J to 25J in case of 2.0mm tip and from 30J to 40J in case of 2.5mm tip. Application of the MTP equipped with thermal feedback control system could avoid the excessive thermal damage in comparison with the conventional MTP. It was considered that optimal temperature of the MTP equipped with thermal feedback control system ranged between 200 degrees C and 300 degrees C. It was concluded that laser angioplasty would be a useful treatment for the occlusive diseases of the peripheral arteries.
为评估氩激光再通闭塞性动脉疾病的安全性和有效性,我们研究了使用裸端探头(BEP)和金属头探头(MTP)对人尸体主动脉和血栓闭塞性犬股动脉进行激光照射的效果。在使用BEP的情况下,与MTP相比,动脉壁穿孔的发生率较高。然而,在血管镜引导下的激光血管成形术可以降低穿孔率,并能够观察到激光再通形成的新通道。在使用MTP的情况下,证实较小的MTP显示出更高的尖端温度,并且在相同激光能量下对斑块的作用更有效。对于2.0mm尖端的情况,单次消融的最佳激光能量为15J至25J,对于2.5mm尖端的情况为30J至40J。与传统MTP相比,配备热反馈控制系统的MTP的应用可以避免过度的热损伤。据认为,配备热反馈控制系统的MTP的最佳温度范围在200摄氏度至300摄氏度之间。得出的结论是,激光血管成形术将是治疗外周动脉闭塞性疾病的一种有用方法。