Hansen D D, Auth D C, Hall M, Ritchie J L
Division of Cardiology, Seattle Veterans Administration Hospital, Washington 98108.
J Am Coll Cardiol. 1988 May;11(5):1073-7. doi: 10.1016/s0735-1097(98)90067-5.
Endarterectomy was performed in vivo using a high speed rotating abrasive-tipped catheter device in 11 normal canine coronary arteries. The device is designed to remove atheromatous material from diseased arteries by the abrasive action of its rotating tip. It was operated percutaneously from a femoral approach using conventional angioplasty guiding equipment. The rotating device was advanced over a guide wire from just beyond the tip of the guide catheter into the distal vessel. Six arteries were harvested immediately after endarterectomy and five were left in place for 7 +/- 2.8 days; in the latter group, the animals were maintained on a regimen of aspirin, 325 mg/day. Angiography before and after treatment demonstrated vessel patency in all cases. Caliper-measured luminal diameters were not significantly changed after endarterectomy. Histologic examination of pressure-fixed vessels showed extensive intimal loss and 20 to 30% loss of the internal elastic lamina. Medial damage was superficial and never exceeded 40% of the total medial thickness. There were no vessel perforations. Results of histologic study of the myocardium supplied by the treated vessels were normal without evidence of distal embolization or infarction. It is concluded that a high speed rotating abrasive device can be safely operated percutaneously in normal coronary arteries and results in minimal vessel damage and continued patency at 7 +/- 2.8 days.
使用高速旋转的带磨头导管装置，在11只正常犬的冠状动脉内进行了体内动脉内膜切除术。该装置旨在通过其旋转尖端的磨蚀作用，从病变动脉中清除粥样物质。使用传统的血管成形术引导设备，经皮从股动脉途径进行操作。将旋转装置通过导丝从导引导管尖端稍远处推进到远端血管中。动脉内膜切除术后立即采集6条动脉，另外5条保留原位7±2.8天；在后一组中，动物维持服用325毫克/天的阿司匹林治疗方案。治疗前后的血管造影显示所有病例血管均通畅。动脉内膜切除术后，卡尺测量的管腔直径无明显变化。对经压力固定的血管进行组织学检查，显示内膜广泛缺失，内弹力层缺失20%至30%。中层损伤较浅，从未超过中层总厚度的40%。没有血管穿孔。对治疗血管供血的心肌进行组织学研究的结果正常，没有远端栓塞或梗死的证据。结论是，高速旋转磨蚀装置可在正常冠状动脉内安全地经皮操作，导致血管损伤最小，并在7±2.8天时保持通畅。
