Ben-Dor Itsik, Maluenda Gabriel, Pichard Augusto D, Satler Lowell F, Gallino Robert, Lindsay Joseph, Waksman Ron
Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK.
Cardiovasc Revasc Med. 2011 Jan-Feb;12(1):69.e1-8. doi: 10.1016/j.carrev.2010.06.008. Epub 2010 Oct 20.
Excimer laser coronary atherectomy (ELCA) has been used for coronary intervention for more than 20 years. Advances in delivery systems for laser energy using the xenon-chlorine pulsed laser catheter deliver higher energy density with lower heat production. The Spectranetics CVX-300 (Spectranetics, Colorado Springs, CO, USA) excimer laser catheter system has been used for the treatment of complex coronary lesions. We report our experience with the use of this advanced system for stenoses for which were unsuitable for standard percutaneous coronary intervention; for example, balloon-resistant lesions, chronic total occlusions, and for underexpanded stents in calcified lesions. ELCA may also be valuable for thrombus-containing lesion. We find ELCA to be indispensable in the catheterization laboratory for specific complex or calcified lesions. Its role should be explored in a large randomized trial of thrombus containing lesions and saphenous vein grafts.
准分子激光冠状动脉斑块旋切术（ELCA）已用于冠状动脉介入治疗20多年。使用氙氯脉冲激光导管的激光能量输送系统的进展能够以较低的热量产生输送更高的能量密度。Spectranetics CVX - 300（美国科罗拉多州斯普林斯市的Spectranetics公司）准分子激光导管系统已用于治疗复杂冠状动脉病变。我们报告了使用这种先进系统治疗不适合标准经皮冠状动脉介入治疗的狭窄病变的经验，例如，球囊扩张抵抗性病变、慢性完全闭塞病变以及钙化病变中扩张不足的支架。ELCA对于含血栓病变可能也有价值。我们发现ELCA在导管室对于特定的复杂或钙化病变是不可或缺的。其在含血栓病变和大隐静脉移植血管的大型随机试验中的作用应予以探索。
