Salvian A J, Morris D C, Connell D G
Department of Surgery, Vancouver General Hospital, BC.
Can J Surg. 1990 Jun;33(3):213-5.
During an initial 1-year experience with percutaneous laser-assisted balloon angioplasty at the Vancouver General Hospital, 9 of 61 patients considered suitable for intervention because of arterial occlusive disease were selected for laser treatment. The neodymium-YAG laser with a contact sapphire tip was chosen because the probes and tips are reusable, thereby reducing the cost per patient. The patients had either severe limiting claudication or pain at rest, involving the superficial femoral or popliteal artery. One of the patients had lesions in both legs, making a total of 10 lesions. In 8 of the 10 lesions, treatment initially was successful. In the other two instances, the laser perforated the arterial wall, but the patients suffered no ill effects; repair by bypass surgery was uncomplicated. Another patient had distal thrombosis at the time of angioplasty of the popliteal artery; this responded to fibrinolytic therapy and subsequent balloon angioplasty of the peroneal artery. The initial 80% success rate was reasonable, considering that all these patients would otherwise have undergone bypass surgery. One patient had recurrent stenosis 5 months after the procedure. The other seven had good results with relief of symptoms. However, follow-up has been short (mean 4.9 months), the longest being only 11 months.
在温哥华总医院开展经皮激光辅助球囊血管成形术的最初1年期间，61例因动脉闭塞性疾病被认为适合干预的患者中，有9例被选作激光治疗。之所以选择带有接触式蓝宝石尖端的钕钇铝石榴石激光，是因为探头和尖端可重复使用，从而降低了每位患者的费用。这些患者有严重的间歇性跛行或静息痛，累及股浅动脉或腘动脉。其中1例患者双腿均有病变，共计10处病变。在这10处病变中的8处，治疗最初取得成功。在另外两例中，激光穿透了动脉壁，但患者未出现不良反应；通过搭桥手术修复并不复杂。另一例患者在腘动脉血管成形术时发生远端血栓形成；这对纤溶治疗及随后的腓动脉球囊血管成形术有反应。考虑到所有这些患者否则都要接受搭桥手术，最初80%的成功率是合理的。1例患者在术后5个月出现再狭窄。其他7例症状缓解，效果良好。然而，随访时间较短（平均4.9个月），最长仅11个月。
