Mitty H A, Sanborn T A, Train J S, Dan S J
Department of Radiology, Mount Sinai School of Medicine, City University of New York 10029.
AJR Am J Roentgenol. 1989 Sep;153(3):617-21. doi: 10.2214/ajr.153.3.617.
The laser catheter is a nylon vascular catheter with a metal tip that has an end hole as well as side holes. The metal tip is heated by laser energy delivered through an optical fiber embedded in the catheter wall. The catheter may be advanced over a guidewire for use as an adjunct to balloon angioplasty or for use in smaller vessels as the exclusive method of recanalization. We used the catheter to treat 34 patients with 54 discrete vascular lesions in 35 extremities. Twenty patients were treated for clinically significant claudication and 14 for ischemic changes. Laser catheter-assisted balloon angioplasty was used to treat six iliac artery occlusions, two iliac artery stenoses, 10 superficial femoral artery occlusions, 12 superficial femoral stenoses, four popliteal artery occlusions, and three popliteal stenoses. Initial technical and clinical success in these patients, with follow-up periods of 3-6 months, was equivalent to the results of previous reports of laser probe-assisted balloon angioplasty. In 11 patients, 15 of 17 popliteal or tibial-peroneal lesions were treated with the laser catheter without subsequent balloon angioplasty. The treatment was successful in eight of these patients, with follow-ups for up to 6 months. Our results suggest that the laser catheter is a useful device for the treatment of vascular stenosis or occlusion when used either as an adjunct to balloon angioplasty or in smaller vessels as the exclusive method for angioplasty.
激光导管是一种带有金属尖端的尼龙血管导管，该金属尖端有一个端孔和多个侧孔。金属尖端由通过嵌入导管壁的光纤输送的激光能量加热。该导管可在导丝上推进，用作球囊血管成形术的辅助手段，或用于较小血管作为再通的唯一方法。我们使用该导管治疗了35条肢体中患有54处离散性血管病变的34例患者。20例患者因具有临床意义的间歇性跛行接受治疗，14例因缺血性改变接受治疗。激光导管辅助球囊血管成形术用于治疗6例髂动脉闭塞、2例髂动脉狭窄、10例股浅动脉闭塞、12例股浅动脉狭窄、4例腘动脉闭塞和3例腘动脉狭窄。这些患者在3至6个月的随访期内的初始技术和临床成功率与先前激光探头辅助球囊血管成形术的报告结果相当。在11例患者中，17处腘动脉或胫腓动脉病变中的15处仅用激光导管治疗，未进行后续球囊血管成形术。其中8例患者治疗成功，随访时间长达6个月。我们的结果表明，激光导管无论是作为球囊血管成形术的辅助手段，还是在较小血管中作为血管成形术的唯一方法使用，都是治疗血管狭窄或闭塞的有用设备。
