Busch U, Erbel R, Clas W, Pfeiffer U, Meyer J, Blümel G, Blömer H
Z Kardiol. 1985 Aug;74(8):435-9.
We evaluated the modified Grüntzig coronary angioplasty catheter, which allows for continuous antegrade coronary perfusion during balloon occlusion without the use of an external pump. During in vitro tests the flow rates for effective pressure differences between aorta and distal coronary vessel in the range between 25 and 100 mm Hg were determined. During in vivo tests in 10 dogs the effect of balloon occlusion with continuous perfusion (OM) was compared with conventional occlusion without perfusion (OC). The occlusion tolerance time (OTZ) as determined by the appearance of unequivocal signs of ischemia in the ECG, was 486 +/- 77 s for OM versus 256 +/- 82 s for OC with a relative, individual increase of 191 +/- 54% (p less than 0.01, data are given +/- SEM). Observed ST-elevation was less with OM than with OC (0.22 +/- 0.05 versus 0.33 +/- 0.06, p less than 0.05). Occlusion related pressure difference between aorta and occluded coronary vessel was less with OM than with OC (31 +/- 8 mm Hg versus 40 +/- 10 mm Hg, p = 0.05). In selected cases such a prolongation of the intracoronary balloon occlusion time may represent a distinct advantage.
我们评估了改良的Grüntzig冠状动脉血管成形术导管，该导管在球囊闭塞期间无需使用外部泵即可实现冠状动脉持续顺行灌注。在体外测试中，测定了主动脉与冠状动脉远端血管之间有效压差在25至100 mmHg范围内时的流速。在对10只狗进行的体内测试中，比较了持续灌注球囊闭塞（OM）与无灌注传统闭塞（OC）的效果。通过心电图中明确的缺血迹象确定的闭塞耐受时间（OTZ），OM为486±77秒，OC为256±82秒，个体相对增加191±54%（p<0.01，数据以±SEM给出）。观察到的ST段抬高OM比OC少（0.22±0.05对0.33±0.06，p<0.05）。主动脉与闭塞冠状动脉血管之间的闭塞相关压差OM比OC小（31±8 mmHg对40±10 mmHg，p = 0.05）。在某些情况下，这种冠状动脉内球囊闭塞时间的延长可能具有明显优势。
