Stanley Gregory A, Winscott John G
Division of Vascular and Endovascular Surgery, Department of Surgery, University of Mississippi Medical Center, Jackson, MS, USA
Division of Cardiology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
J Endovasc Ther. 2016 Aug;23(4):648-52. doi: 10.1177/1526602816644914. Epub 2016 Apr 25.
To describe the use of a low-pressure balloon inflation (LPBI) technique to delineate intraluminal plaque and guide directional atherectomy in order to maximize lumen gain and achieve procedure success.
The technique is illustrated in a 77-year-old man with claudication who underwent superficial femoral artery revascularization using a HawkOne directional atherectomy catheter. A standard angioplasty balloon was inflated to 1 to 2 atm during live fluoroscopy to create a 3-dimensional "lumenogram" of the target lesion. Directional atherectomy was performed only where plaque impinged on the balloon at a specific fluoroscopic orientation. The results of the LPBI technique were corroborated with multimodality diagnostic imaging, including digital subtraction angiography, intravascular ultrasound, and intra-arterial pressure measurements.
With the LPBI technique, directional atherectomy can routinely achieve <10% residual stenosis, as illustrated in this case, thereby broadly supporting a no-stent approach to lower extremity endovascular revascularization.
描述使用低压球囊扩张（LPBI）技术描绘腔内斑块并指导定向旋切术，以最大程度地增加管腔增益并实现手术成功。
该技术在一名77岁患有间歇性跛行的男性患者中进行了演示，该患者使用HawkOne定向旋切导管进行了股浅动脉血运重建。在实时荧光透视检查期间，将标准血管成形术球囊充气至1至2个大气压，以创建目标病变的三维“管腔造影图”。仅在斑块在特定荧光透视方向上撞击球囊的部位进行定向旋切术。LPBI技术的结果通过包括数字减影血管造影、血管内超声和动脉内压力测量在内的多模态诊断成像得到了证实。
如本病例所示，采用LPBI技术，定向旋切术通常可实现<10%的残余狭窄，从而广泛支持在下肢血管腔内血运重建中采用无支架方法。
