Hamm C W, Kupper W, Kuck K H, Hofmann D, Bleifeld W
Department of Cardiology, University Hospital, Hamburg, West Germany.
Am J Cardiol. 1990 Dec 15;66(20):1459-63. doi: 10.1016/0002-9149(90)90534-8.
The benefit and safety of new angioplasty equipment as compared with the conventional guidewire approach was evaluated in 154 consecutive patients. with chronic, totally occluded coronary arteries. The protocol followed a stepwise design: first, conventional guidewires and low-profile balloons were used, followed by "balloon-on-the-wire" systems (Probe, Ace) or by a shaft-enforced, tip-deflecting catheter (Omniflex). In 97 patients with occlusions of 2 to 12 weeks' duration, recanalization was achieved in 51 patients (53%) with the conventional approach and in 29 patients with the new devices (balloon-on-the-wire [n = 5], Omniflex [n = 24]), thereby raising the success rate to 82%. In 57 occlusions of greater than 12 weeks' duration, the recanalization attempt was successful in 58%, mediated in 16 patients (28%) by the Omniflex catheter and in 5 patients by balloon-on-the-wire systems. There were no life-threatening complications and only 1 (0.6%) emergency bypass operation was necessary. New angioplasty devices are therefore of considerable value in the attempt to improve the results of coronary angioplasty in chronic total occlusions.
在154例患有慢性完全闭塞冠状动脉的连续患者中，评估了新型血管成形术设备与传统导丝方法相比的益处和安全性。该方案采用逐步设计：首先，使用传统导丝和低轮廓球囊，然后是“球囊导丝”系统（Probe、Ace）或轴增强、尖端偏转导管（Omniflex）。在97例闭塞持续时间为2至12周的患者中，传统方法使51例患者（53%）实现了再通，新型设备（球囊导丝[n = 5]、Omniflex[n = 24]）使29例患者实现了再通，从而将成功率提高到82%。在57例闭塞持续时间超过12周的患者中，再通尝试成功率为58%，其中16例患者（28%）由Omniflex导管介导，5例患者由球囊导丝系统介导。没有危及生命的并发症，仅需进行1例（0.6%）急诊搭桥手术。因此，新型血管成形术设备在试图改善慢性完全闭塞冠状动脉血管成形术结果方面具有相当大的价值。
