Dorros G, Lewin R F, Mathiak L
St. Luke's Medical Center, Department of Cardiology, Milwaukee.
Cathet Cardiovasc Diagn. 1988;14(4):286-8. doi: 10.1002/ccd.1810140413.
Coronary angioplasty is unsuccessful in less than 3-5% of cases because the balloon catheter fails to follow a guidewire that has traversed a lesion. Between June 1986 and August 1987, 31 lesions were unable to be crossed with at least two standard angioplasty catheters. Finally, a 2.0-mm-diameter Hartzler LPS (ACS) was utilized and successfully crossed and dilated 16 out of 31 lesions (52%). In the remaining 15 lesions, the Probe (USCI) 2.0 mm diameter x 1.5 cm long balloon wire was able to cross the lesions in 13 (82%) and successfully dilated 12. In one case, lesion rigidity prevented the balloon from expanding at 14 atm. A right coronary artery lesion was attempted in 11 cases, and a left anterior descending and circumflex artery lesion in two patients each. No complications were encountered. In seven out of 12 successful Probe cases, a larger balloon catheter was used to further dilate the artery. This new balloon wire has increased our success rate in severe stenoses and in tortuous vessels with severe distal lesions, in which presently available angioplasty equipment has failed.
冠状动脉血管成形术在不到3% - 5%的病例中不成功，原因是球囊导管无法沿着穿过病变的导丝行进。在1986年6月至1987年8月期间，至少两根标准血管成形术导管无法穿过31处病变。最后，使用了一根直径2.0毫米的哈茨勒LPS（美国心血管系统公司），成功穿过并扩张了31处病变中的16处（52%）。在其余15处病变中，直径2.0毫米×1.5厘米长的美国科学工业公司的探针球囊导丝能够穿过13处病变（82%），并成功扩张了12处。在1例中，病变的硬度阻止球囊在14个大气压下扩张。尝试对11例右冠状动脉病变进行治疗，对2例患者的左前降支和回旋支动脉病变进行治疗。未遇到并发症。在12例成功使用探针的病例中，7例使用了更大的球囊导管进一步扩张动脉。这种新型球囊导丝提高了我们在严重狭窄以及伴有严重远端病变的迂曲血管中的成功率，而目前现有的血管成形术设备在这些病变中均告失败。
