Talley J D, Joseph A, Killeavy E S, Garratt K N, Hodes Z I, Linnemeier T J, Yussman Z A, Brier M E, Kupersmith J
Section of Interventional Cardiology, School of Medicine, University of Louisville, KY 40292.
Cathet Cardiovasc Diagn. 1991 Apr;22(4):310-6. doi: 10.1002/ccd.1810220411.
Coronary angioplasty is increasingly used as an attempt to revascularize patients with severe coronary artery disease. To determine the efficacy of such treatment, a new fixed wire angioplasty catheter was evaluated by a multicenter group in a non-randomized fashion in 50 patients, average 58 +/- 11 years (+/- 1 SD), 58% men. Forty-four percent had a prior revascularization procedure (28% angioplasty, 16% coronary bypass surgery), 38% had a prior Q-wave myocardial infarction, 43% had grade 4 angina, and 60% multiple vessel disease. Angioplasty was attempted in 63 lesions which were located in a mid to distal location in 69%, with a proximal tortuosity score of 1.8 (2 = 45-60 degrees entrance angle), and lesion angulation of 1.4 (1 = 45 degrees lesion bend). In 88%, the device was the primary catheter used and in 6%, it was chosen when another system failed. The balloon was able to successfully cross 94% of all lesions attempted. Six lesions were crossed and dilated but significant residual stenoses remained. There were no significant device malfunctions, or angiographic or clinical complications. This feasibility evaluation of this new fixed wire system yielded excellent angiographic results. Although not a comparative study, this analysis suggests that this new generation of angioplasty catheter may improve the safety and efficacy of complex coronary angioplasty.
冠状动脉血管成形术越来越多地被用于尝试为患有严重冠状动脉疾病的患者进行血管重建。为了确定这种治疗方法的疗效，一个多中心研究小组对一种新型固定导丝血管成形术导管进行了非随机评估，研究对象为50例患者，平均年龄58±11岁（±1标准差），男性占58%。44%的患者曾接受过血管重建手术（28%为血管成形术，16%为冠状动脉搭桥手术），38%的患者曾发生过Q波心肌梗死，43%的患者有4级心绞痛，60%的患者有多支血管病变。对63处病变尝试进行血管成形术，其中69%位于血管中远端，近端迂曲评分为1.8（2=45-60度入口角），病变成角为1.4（1=45度病变弯曲）。88%的情况下，该装置是主要使用的导管，6%的情况是在另一个系统失败时选择使用该装置。球囊能够成功穿过所有尝试病变的94%。6处病变被穿过并扩张，但仍有明显的残余狭窄。没有明显的装置故障，也没有血管造影或临床并发症。对这种新型固定导丝系统的可行性评估取得了优异的血管造影结果。尽管这不是一项对比研究，但该分析表明，新一代血管成形术导管可能会提高复杂冠状动脉血管成形术的安全性和疗效。
