AbuRahma A F, Robinson P A, Kennard W, Boland J P
Department of Surgery, West Virginia University Health Sciences Center/Charleston Area Medical Center.
J Vasc Surg. 1990 Nov;12(5):566-72.
Laser-assisted thermal balloon angioplasty was performed in 48 arteries (iliac, superficial femoral, and popliteal). Indications for surgery were limb salvage (25%), rest pain (38%), and claudication (38%). Patients were categorized into three groups: lesions less than 5 cm, greater than 5 to 10 cm, or greater than 10 cm in length. Demographic characteristics, risk factors, and outcome measures were compared by use of Fisher's exact test and Student's t test. The time for vascular patency failure was compared by use of a standard Kaplan-Meier survival analysis for the three groups. Initial failure to recanalize was noted in 14% in lesions less than 5 cm, 40% in lesions greater than 5 to 10 cm, and 73% in lesions greater than 10 cm. The overall success rate was 38%, with a mean follow up of 1 year. The less than 5 cm lesion group had a significantly higher rate of overall success (59%, p = 0.005) than the other two groups combined. The greater than 10 cm lesion group did significantly worse (9%) than the other two groups combined (p = 0.028). Patients in the less than 5 cm group had significantly longer patency than the other two groups (p less than 0.01). Iliac lesions had a higher overall success rate (73%) than superficial femoral and popliteal artery lesions (35%) (p = 0.038). In conclusion, the widespread application of laser-assisted thermal balloon angioplasty cannot be justified without further long-term clinical and laboratory investigation. Conversely, the potential of this technique should not be dismissed out of hand. Proper patient selection, length and nature of the lesion to be treated, and the appropriate forms, doses, and method of delivery of laser energy, remain to be defined.
对48条动脉（髂动脉、股浅动脉和腘动脉）进行了激光辅助热球囊血管成形术。手术指征为保肢（25%）、静息痛（38%）和间歇性跛行（38%）。患者被分为三组：病变长度小于5厘米、大于5至10厘米或大于10厘米。使用Fisher精确检验和学生t检验比较人口统计学特征、危险因素和结果指标。通过对三组进行标准的Kaplan-Meier生存分析来比较血管通畅失败的时间。在病变长度小于5厘米的患者中，初始再通失败率为14%；在病变长度大于5至10厘米的患者中，为40%；在病变长度大于10厘米的患者中，为73%。总体成功率为38%，平均随访1年。病变长度小于5厘米的组总体成功率（59%，p = 0.005）显著高于其他两组之和。病变长度大于10厘米的组（9%）比其他两组之和显著更差（p = 0.028）。病变长度小于5厘米组的通畅时间显著长于其他两组（p小于0.01）。髂动脉病变的总体成功率（73%）高于股浅动脉和腘动脉病变（35%）（p = 0.038）。总之，在没有进一步长期临床和实验室研究的情况下，激光辅助热球囊血管成形术的广泛应用是不合理的。相反，不应轻易否定这项技术的潜力。合适的患者选择、待治疗病变的长度和性质，以及激光能量的合适形式、剂量和输送方法，仍有待确定。
