Litvack F, Eigler N L, Margolis J R, Grundfest W S, Rothbaum D, Linnemeier T, Hestrin L B, Tsoi D, Cook S L, Krauthamer D
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048.
Am J Cardiol. 1990 Nov 1;66(15):1027-32. doi: 10.1016/0002-9149(90)90499-q.
To determine the efficacy of percutaneous excimer laser coronary angioplasty as an adjunct or alternative to conventional balloon angioplasty, 55 patients were studied in a multicenter trial. These patients underwent the procedure using a modification of conventional balloon angioplasty technique. A first-generation, 1.6-mm diameter catheter constructed of 12 individual silica fibers concentrically arranged around a guidewire lumen was used. Catheter tip energy density varied from 35 to 50 mJ/mm2. The mean number of pulses delivered at 20 Hz was 1,272 +/- 1,345. Acute success was defined as a greater than or equal to 20% increase in stenotic diameter and a lumen of greater than or equal to 1 mm in diameter after laser treatment. Acute success was achieved in 46 of 55 (84%) patients. Adjunctive balloon angioplasty was performed on 41 patients (75%). The percent diameter stenosis as determined by quantitative angiography decreased from a baseline of 83 +/- 14 to 49 +/- 11% after laser treatment and to 38 +/- 12% in patients undergoing adjunctive balloon angioplasty. The mean minimal stenotic diameter increased from a baseline of 0.5 +/- 0.4 to 1.6 +/- 0.5 mm after laser treatment and to 2.1 +/- 0.5 mm after balloon angioplasty. There were no deaths and no vascular perforations. One patient (1.8%) required emergency coronary bypass surgery. These data suggest that excimer laser energy delivered percutaneously by specially constructed catheters can safely ablate atheroma and reduce coronary stenoses.
为了确定经皮准分子激光冠状动脉成形术作为传统球囊血管成形术的辅助手段或替代方法的疗效，在一项多中心试验中对55例患者进行了研究。这些患者采用改良的传统球囊血管成形术技术进行该手术。使用了第一代直径1.6毫米的导管，该导管由围绕导丝腔同心排列的12根单独的石英纤维构成。导管尖端能量密度在35至50 mJ/mm²之间变化。以20 Hz频率发射的平均脉冲数为1272±1345。急性成功定义为激光治疗后狭窄直径增加大于或等于20%且管腔直径大于或等于1毫米。55例患者中有46例（84%）取得了急性成功。41例患者（75%）接受了辅助球囊血管成形术。定量血管造影确定的直径狭窄百分比从基线时的83±14%在激光治疗后降至49±11%，在接受辅助球囊血管成形术的患者中降至38±12%。平均最小狭窄直径从基线时的0.5±0.4毫米在激光治疗后增加到1.6±0.5毫米，在球囊血管成形术后增加到2.1±0.5毫米。没有死亡病例，也没有血管穿孔情况。1例患者（1.8%）需要紧急冠状动脉搭桥手术。这些数据表明，通过特制导管经皮输送的准分子激光能量能够安全地消融动脉粥样硬化斑块并减轻冠状动脉狭窄。
