Veith F J, Bakal C W, Cynamon J A, Gupta S K, Keeley J, Greenberg M, Mennigus M A, Ascer E, Dietzek A M, Wengerter K R
Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, New York, NY.
J Cardiovasc Surg (Torino). 1990 Jul-Aug;31(4):413-5.
A dual laser system capable of distinguishing atherosclerotic plaque from components of normal arterial wall was used to deliver laser energy to cut a channel through occluded vessels. This system was used to facilitate balloon angioplasty of short (3-17 cm) total occlusions of the superficial femoral or popliteal arteries in 17 patients. In 10 patients the occluding lesion was traversed by the laser wire and patency was effectively restored by balloon angioplasty. Satisfactory luminal patency has persisted for 2 to 12 months (mean 6 months) in 9 cases; the lesion in the tenth patient restenosed at 3 months. The laser procedure was unsuccessful in all 3 cases with occlusions over 10 cm and in 4 others. There were no clinically important complications. This experience suggests that most patients who presently require interventional treatment can be managed by standard angioplasty methods and/or require a bypass operation. The "Smart" laser is safe and effective short-term in facilitating angioplasty in some patients in whom standard angioplasty techniques are not feasible. The implications of these findings are discussed.
一种能够区分动脉粥样硬化斑块与正常动脉壁成分的双激光系统被用于输送激光能量，以在闭塞血管中切割出一条通道。该系统用于辅助对17例患者的股浅动脉或腘动脉3至17厘米长的完全闭塞病变进行球囊血管成形术。10例患者的闭塞病变被激光导丝穿过，球囊血管成形术有效地恢复了血管通畅。9例患者的管腔通畅情况令人满意，持续了2至12个月（平均6个月）；第10例患者的病变在3个月时再狭窄。在所有3例闭塞长度超过10厘米的病例以及另外4例病例中，激光手术均未成功。没有出现具有临床重要意义的并发症。该经验表明，目前大多数需要介入治疗的患者可以通过标准血管成形术方法进行治疗和/或需要进行搭桥手术。“智能”激光在一些标准血管成形术技术不可行的患者中，短期内安全有效地辅助血管成形术。本文讨论了这些发现的意义。
