Anderson H V, Leimgruber P P, Roubin G S, Nelson D L, Gruentzig A R
Am Heart J. 1985 Oct;110(4):720-6. doi: 10.1016/0002-8703(85)90448-x.
Perfusion of the coronary artery distal to an occluding angioplasty balloon was performed in 34 patients undergoing coronary angioplasty (PTCA). A randomized crossover study was employed using two exogenous substances as perfusates: lactated Ringer's solution (LR) and a fluorocarbon emulsion (FL), Fluosol-DA 20%. Both substances are electrolyte solutions, but the FL will dissolve more oxygen than the LR. During two attempted coronary artery occlusions of 90 seconds each, we perfused through the central lumen (guidewire channel) of the PTCA catheter at 60 ml/min. With FL perfusion the mean time to onset of angina after occlusion was delayed (41 +/- 21 vs 33 +/- 16 seconds, mean +/- SD; p less than 0.05), the mean duration of angina was shortened (77 +/- 58 vs 92 +/- 70 seconds, p less than 0.05), and the rise in the ST segment of the ECG was reduced (0.15 +/- 0.24 vs 0.2 +/- 0.23 mV, p less than 0.001) when compared to LR perfusion. Balloon occlusion time was able to be extended with FL perfusion (71 +/- 22 vs 59 +/- 22 seconds p less than 0.001). These results indicate that perfusion of the distal coronary artery is possible during PTCA and can reduce ischemia during a prolonged balloon occlusion time.
对34例行冠状动脉成形术（PTCA）的患者进行了闭塞性血管成形术球囊远端冠状动脉的灌注。采用随机交叉研究，使用两种外源性物质作为灌注液：乳酸林格液（LR）和氟碳乳剂（FL），即20%的全氟三丙胺。两种物质均为电解质溶液，但FL比LR能溶解更多的氧。在两次每次持续90秒的冠状动脉闭塞尝试过程中，我们以60 ml/min的速度通过PTCA导管的中央腔（导丝通道）进行灌注。与LR灌注相比，使用FL灌注时，闭塞后心绞痛发作的平均时间延迟（41±21秒对33±16秒，平均值±标准差；p<0.05），心绞痛的平均持续时间缩短（77±58秒对92±70秒，p<0.05），心电图ST段的上升幅度减小（0.15±0.24 mV对0.2±0.23 mV，p<0.001）。使用FL灌注时球囊闭塞时间能够延长（71±22秒对59±22秒，p<0.001）。这些结果表明，在PTCA期间对冠状动脉远端进行灌注是可行的，并且可以在延长的球囊闭塞时间内减少局部缺血。
