Little T, Rosenberg J, Seides S, Lee B, Lindsay J, Pichard A D
Department of Cardiology, Washington Hospital Center, Washington, DC.
Cathet Cardiovasc Diagn. 1990 Oct;21(2):124-7. doi: 10.1002/ccd.1810210216.
Coronary angioplasty (PTCA) of total coronary occlusion is limited by the inability of guidewires and conventional dilating catheters to cross all such lesions. A new technique was therefore prospectively evaluated for PTCA of these lesions using the ultra-low-profile Probe "balloon on a wire" device. An intracoronary Probing Catheter was used to facilitate crossing the stenosis with a guidewire and then to deliver a Probe into the obstruction for balloon dilatation. This technique was utilized in 64 consecutive patients with "absolute" coronary occlusions demonstrating no angiographically detectable antegrade coronary flow. Successful dilatation was achieved in 47 (73%). Among 33 occlusions of less than 3 mo duration 31 (94%) were successfully dilated whereas only 16 of 31 more chronic occlusions were dilated (P less than .01). Chronic occlusions with a tapered morphology and those located more than 1 cm from a branch point were more frequently dilatable. There were no serious complications including no vessel perforations with this technique. The Probing Catheter technique offers a safe and effective method for the dilatation of recent coronary occlusions by using balloon on a wire technology.
冠状动脉完全闭塞的经皮冠状动脉腔内血管成形术（PTCA）受到导丝和传统扩张导管无法穿过所有此类病变的限制。因此，前瞻性地评估了一种使用超小型“导线球囊”装置对这些病变进行PTCA的新技术。冠状动脉内探测导管用于协助导丝穿过狭窄，然后将探测导管送入阻塞部位进行球囊扩张。该技术应用于64例连续的“绝对”冠状动脉闭塞患者，这些患者血管造影显示无冠状动脉前向血流。47例（73%）成功扩张。在33例病程小于3个月的闭塞病变中，31例（94%）成功扩张，而31例病程更长的慢性闭塞病变中仅16例成功扩张（P<0.01）。形态呈锥形且距分支点超过1 cm的慢性闭塞病变更易扩张。该技术无严重并发症，包括无血管穿孔。探测导管技术通过使用导线球囊技术为近期冠状动脉闭塞的扩张提供了一种安全有效的方法。
