Neubaur T, Klepzig M, Heintzen M P, Richter E I, Zeitler E, Strauer B E
Medical Clinic and Policlinic B, University of Düsseldorf, Federal Republic of Germany.
Clin Cardiol. 1989 Jun;12(6):313-20. doi: 10.1002/clc.4960120606.
Percutaneous transluminal laser angioplasty has become an accepted method of treatment of peripheral arterial occlusive disease. To minimize the risk of arterial wall perforation during laser angioplasty, a novel laser catheter system was developed. In 113 obliterated postmortem human arteries the perforation rate was 0.9%. The mean degree of stenosis was reduced from 89 +/- 9% before, to 53 +/- 11% after laser irradiation. Clinical Nd:YAG laser angioplasty was performed in 19 patients suffering from peripheral arterial occlusive disease. The Fontaine stage improved in 16 patients; in no case did it deteriorate. The mean degree of stenosis was reduced by laser angioplasty from 91 +/- 12% to 31 +/- 19%. A further reduction down to 13 +/- 18% was achieved by subsequent percutaneous transluminal balloon angioplasty. The systolic Doppler ankle-arm pressure gradient was improved from 0.58 +/- 0.26 to 0.89 +/- 0.25. In 7 patients microembolisms were detectable on the final angiogram. There was no acute reocclusion and no perforation. Within a follow-up period of 12 months, four restenoses were diagnosed by digital subtraction angiography. On average, the Doppler index was 0.75 +/- 0.32.
经皮腔内激光血管成形术已成为治疗周围动脉闭塞性疾病的一种公认方法。为了将激光血管成形术期间动脉壁穿孔的风险降至最低，研发了一种新型激光导管系统。在113条死后闭塞的人体动脉中，穿孔率为0.9%。狭窄平均程度从激光照射前的89±9%降至照射后的53±11%。对19例周围动脉闭塞性疾病患者进行了临床钕钇铝石榴石激光血管成形术。16例患者的Fontaine分期得到改善；无一例病情恶化。激光血管成形术使狭窄平均程度从91±12%降至31±19%。随后的经皮腔内球囊血管成形术进一步将狭窄程度降至13±18%。收缩期多普勒踝臂压力梯度从0.58±0.26改善至0.89±0.25。7例患者在最终血管造影中可检测到微栓塞。未发生急性再闭塞和穿孔。在12个月的随访期内，通过数字减影血管造影诊断出4例再狭窄。平均而言，多普勒指数为0.75±0.32。
