Litvack F, Grundfest W S, Adler L, Hickey A E, Segalowitz J, Hestrin L B, Mohr F W, Goldenberg T, Laudenslager J S, Forrester J S
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Radiology. 1989 Aug;172(2):331-5. doi: 10.1148/radiology.172.2.2526348.
Percutaneous peripheral excimer-laser angioplasty at 308 nm was used for treatment of 30 patients with peripheral vascular disease. Twenty-eight patients underwent laser-assisted balloon angioplasty, and two patients underwent laser angioplasty alone. Acute angiographic and clinical success was achieved in 24 of 31 (77%) femoropopliteal stenoses and occlusions. Seven of nine (78%) stenoses, six of seven (86%) short (0-5 cm) occlusions, seven of eight (88%) medium-length (6-10 cm) occlusions, three of four (75%) long (11-15 cm) occlusions, and one of three (33%) extreme (greater than 15 cm) occlusions were successfully treated. Inability to treat total occlusions was in each case related to a failure to maintain coaxial position and subintimal passage of the fiber. These cases demonstrate the feasibility of safely performing percutaneous peripheral excimer-laser or excimer-laser-assisted angioplasty. The overall frequency of restenosis after a mean follow-up period of 9.1 months was 29%. The data suggest that these procedures may be useful for the treatment of peripheral vascular disease in selected patients.
采用波长308 nm的经皮外周准分子激光血管成形术治疗30例外周血管疾病患者。28例行激光辅助球囊血管成形术，2例仅行激光血管成形术。31处股腘动脉狭窄和闭塞病变中，24处（77%）获得急性血管造影和临床成功。9处狭窄中的7处（78%）、7处短段（0 - 5 cm）闭塞中的6处（86%）、8处中等长度（6 - 10 cm）闭塞中的7处（88%）、4处长段（11 - 15 cm）闭塞中的3处（75%）以及3处极长段（大于15 cm）闭塞中的1处（33%）均成功治疗。无法治疗完全闭塞病变的情况在每种情况下均与未能维持光纤的同轴位置和内膜下通过有关。这些病例证明了安全进行经皮外周准分子激光或准分子激光辅助血管成形术的可行性。平均随访9.1个月后，再狭窄的总体发生率为29%。数据表明，这些手术可能对选定患者的外周血管疾病治疗有用。
