Fischell T A, Fischell R E, White R I, Chapolini R
Cardiology Division, Stanford University Medical Center, CA 94305.
Cathet Cardiovasc Diagn. 1990 Dec;21(4):287-91. doi: 10.1002/ccd.1810210418.
In order to evaluate the feasibility of performing definitive atheromatous plaque removal using a novel retrograde cutting (Pullback) atherectomy catheter, pullback atherectomy was performed in 13 severely diseased cadaveric superficial femoral arteries. All experiments were performed using cadaver tissue either mounted in a perfusion/mounting chamber (n = 10) or left in situ (n = 3). In general, a single cut was made with each of three sequentially larger atherectomy catheters (2.5 mm, 3.0 mm, and then 3.5 mm devices). The results were evaluated by angiography and by light microscopy. Nine of the 13 experiments were performed in totally occluded vessels. The mean pre-atherectomy stenosis (all specimens) was 95 +/- 3%, with a final mean postatherectomy stenosis of 21 +/- 5%. There was one vessel performation. We conclude from these preclinical studies that retrograde atherectomy with the Pullback Atherectomy Catheter is a feasible means of performing definitive atherectomy. Despite the promising potential of retrograde atherectomy, little can be said with certainty about the clinical utility of such a device at this early stage.
为了评估使用新型逆行切割（回撤式）斑块旋切导管进行确定性动脉粥样硬化斑块清除的可行性，在13条严重病变的尸体股浅动脉中进行了回撤式斑块旋切术。所有实验均使用安装在灌注/固定腔室中的尸体组织（n = 10）或原位组织（n = 3）。一般来说，依次使用三种尺寸逐渐增大的斑块旋切导管（2.5毫米、3.0毫米，然后是3.5毫米装置）各进行一次切割。通过血管造影和光学显微镜对结果进行评估。13项实验中有9项在完全闭塞的血管中进行。术前平均狭窄率（所有标本）为95±3%，术后最终平均狭窄率为21±5%。发生了1次血管穿孔。我们从这些临床前研究得出结论，使用回撤式斑块旋切导管进行逆行斑块旋切术是进行确定性斑块旋切术的一种可行方法。尽管逆行斑块旋切术具有潜在的前景，但在这个早期阶段，关于这种装置的临床实用性几乎无法确定。
