Sanborn T A, Faxon D P, Kellett M A, Ryan T J
J Am Coll Cardiol. 1986 Dec;8(6):1437-40. doi: 10.1016/s0735-1097(86)80320-5.
Percutaneous coronary laser thermal angioplasty was successfully performed before conventional balloon angioplasty in a 55 year old white man with a 90% left anterior descending artery stenotic lesion and angina at rest (Canadian Heart Association class IV). The lesion was reduced to 50% residual stenosis using a 1.7 mm laser-heated metallic capped fiber and two pulses of 8 W of argon laser energy, each delivered for 5 seconds. With subsequent balloon angioplasty, the lesion was further decreased to 10% residual stenosis. The entire procedure was well tolerated without chest pain or burning, vessel perforation or spasm, thrombus formation or embolization of debris. The patient was free of pain at 1 month follow-up. This case demonstrates the feasibility of safely performing percutaneous coronary laser thermal angioplasty. Additional studies are indicated to determine the clinical role and potential benefits of coronary laser thermal angioplasty in relation to the established procedures of bypass surgery and conventional balloon angioplasty.
在一名55岁的白人男性患者中，其左前降支动脉存在90%的狭窄病变且有静息性心绞痛（加拿大心脏协会IV级），在进行传统球囊血管成形术之前成功实施了经皮冠状动脉激光热血管成形术。使用1.7毫米激光加热金属帽光纤及两脉冲8瓦氩激光能量（每次发射5秒），将病变减少至50%的残余狭窄。随后进行球囊血管成形术，病变进一步降至10%的残余狭窄。整个过程耐受性良好，无胸痛或烧灼感、血管穿孔或痉挛、血栓形成或碎片栓塞。患者在1个月随访时无疼痛。该病例证明了安全进行经皮冠状动脉激光热血管成形术的可行性。需要进行更多研究以确定冠状动脉激光热血管成形术相对于既定的搭桥手术和传统球囊血管成形术的临床作用和潜在益处。
