Sanborn T A, Greenfield A J, Guben J K, Menzoian J O, LoGerfo F W
J Vasc Surg. 1987 Jan;5(1):83-90.
In this study, the safety and efficacy of percutaneous laser thermal angioplasty as an adjunct to balloon angioplasty were investigated in 13 patients with severe peripheral vascular disease. By means of a novel fiberoptic laser delivery system (Laserprobe) in which argon laser energy is converted to heat in a metallic tip at the end of the fiberoptic fiber, improvement in the angiographic luminal diameter was noted in 14 of 15 femoropopliteal vessels (93%) by delivering 8 to 13 watts of continuous argon laser energy as the Laserprobe was advanced through the lesion. Initial clinical success (indicated by relief of symptoms and increase in Doppler index) for the combined laser and balloon angioplasty procedures was obtained in 12 of 15 vessels (80%), with inadequate balloon dilatation being the limiting factor in three patients. No significant complications of vessel perforation, dissection, pain, spasm, or embolization of debris occurred. Of the 12 patients who had procedures with initial angiographic and clinical success, 10 (83%) were asymptomatic in the initial follow-up period of 1 to 9 months (mean 6 months). Thus, laser thermal angioplasty with a Laserprobe is a safe and effective adjunct to peripheral balloon angioplasty. This technique has the potential to increase the initial success rate of angioplasty for lesions that are difficult or impossible to treat by conventional means. By removing most of the obstructing lesion, this technique may also reduce recurrent stenosis.
在本研究中，对13例严重外周血管疾病患者进行了经皮激光热血管成形术作为球囊血管成形术辅助手段的安全性和有效性研究。借助一种新型光纤激光传输系统（Laserprobe），其中氩激光能量在光纤末端的金属尖端转化为热量，当Laserprobe通过病变部位推进时，输送8至13瓦连续氩激光能量，15条股腘血管中有14条（93%）的血管造影管腔直径得到改善。激光和球囊血管成形术联合操作的初始临床成功（以症状缓解和多普勒指数增加为指标）在15条血管中有12条（80%）获得，3例患者中球囊扩张不足是限制因素。未发生血管穿孔、夹层、疼痛、痉挛或碎片栓塞等明显并发症。在12例初始血管造影和临床成功的患者中，10例（83%）在1至9个月（平均6个月）的初始随访期内无症状。因此，使用Laserprobe的激光热血管成形术是外周球囊血管成形术的一种安全有效的辅助手段。该技术有可能提高对传统方法难以或无法治疗的病变进行血管成形术的初始成功率。通过去除大部分阻塞性病变，该技术还可能减少再狭窄。
