Siegel R J, Cumberland D C, Myler R K, DonMichael T A
Cedars-Sinai Medical Center, Los Angeles, California.
Lancet. 1989 Sep 30;2(8666):772-4. doi: 10.1016/s0140-6736(89)90832-5.
Percutaneous catheter-delivered ultrasound energy for arterial recanalisation was applied in eight patients with peripheral vascular disease. Four patients had severe claudication with total occlusion and four high-grade stenosis in a superficial femoral or popliteal artery. A prototype ultrasound probe, with a frequency of 20 kHz and a power output of 20-35 W/cm2, was ensheathed in a 7F catheter and advanced to the occlusions under angiographic guidance. Three of four complete occlusions were recanalised in 120s or less, leaving a residual stenosis of mean (SD) diameter 54 (5)%. Ultrasound energy reduced the diameter of the isolated stenoses from 77 (14)% to 37 (21)%. All lesions were further treated with balloon angioplasty, resulting in a mean residual stenosis of 20 (9)%. There was no evidence of arterial emboli, dissection, spasm, or perforation. The major limitations of this ultrasound system are ease of steering and flexibility. Percutaneous catheter-delivered ultrasound energy appears promising for safe and effective use in atherosclerotic peripheral vessels to reduce arterial stenoses and recanalise complete arterial obstructions.
对8例外周血管疾病患者应用经皮导管输送超声能量进行动脉再通。4例患者有严重间歇性跛行且伴有完全闭塞，4例患者在股浅动脉或腘动脉有高度狭窄。一个频率为20千赫、功率输出为20 - 35瓦/平方厘米的超声探头原型被包裹在一根7F导管中，并在血管造影引导下推进至闭塞部位。4例完全闭塞中有3例在120秒或更短时间内实现再通，残余狭窄平均（标准差）直径为54（5）%。超声能量使孤立狭窄的直径从77（14）%减小至37（21）%。所有病变均进一步接受球囊血管成形术治疗，平均残余狭窄为20（9）%。未发现动脉栓塞、夹层、痉挛或穿孔的证据。该超声系统的主要局限性在于操控的便利性和灵活性。经皮导管输送超声能量在用于动脉粥样硬化外周血管以减少动脉狭窄和使完全性动脉阻塞再通方面似乎很有前景，可安全有效地使用。
