Vallbracht C, Liermann D, Prignitz I, Beinborn W, Landgraf H, Paasch C, Roth F J, Kollath J, Schoop W, Bamberg W
Department of Cardiology, University Hospital Frankfurt, Federal Republic of Germany.
Am J Cardiol. 1988 Nov 1;62(13):935-40. doi: 10.1016/0002-9149(88)90896-x.
After experimental investigation using postmortem human arteries, 19 patients with chronic peripheral artery occlusions were treated with a new angioplasty technique between December 1986 and October 1987. In 17 patients the superficial femoral artery and in 2 patients the popliteal artery were completely occluded. The length of the occlusions ranged between 5 and 25 cm (mean 11). The duration--estimated according to patients' history--was 5 to 48 months (mean 17). In 5 patients, durations of up to 30 months had been documented by angiography. A flexible, blunt, motor-driven rotating catheter was introduced through an 8 or 9Fr sheath and rotational angioplasty was performed at low speeds (up to 200 rpm). In 11 of 14 patients in whom this new technique was used as the primary intervention, the occlusions could be successfully reopened. In 2 patients after failure of conventional techniques the rotating catheter could not bypass the preexisting dissections in the same intervention. In 2 of 3 further patients after failure of conventional techniques the occlusions could be successfully reopened in a second intervention after several weeks. In none of the 19 patients did a perforation occur. It is concluded that with the new technique chronic peripheral artery occlusions can be reopened with a high success rate and without the danger of arterial wall perforation. The method can also be used in patients in whom conventional techniques have failed.
在使用人体尸检动脉进行实验研究后，1986年12月至1987年10月期间，19例慢性外周动脉闭塞患者接受了一种新的血管成形术治疗。17例患者股浅动脉完全闭塞，2例患者腘动脉完全闭塞。闭塞长度在5至25厘米之间（平均11厘米）。根据患者病史估计的病程为5至48个月（平均17个月）。5例患者的病程长达30个月，血管造影已记录在案。通过8或9Fr鞘管插入一根灵活、钝头、电动旋转导管，并以低速（最高200转/分钟）进行旋转血管成形术。在14例将该新技术作为主要干预手段的患者中，11例患者的闭塞病变得以成功再通。2例患者在传统技术失败后，旋转导管在同一干预过程中无法绕过先前存在的夹层。另外3例传统技术失败的患者中，2例在数周后的第二次干预中闭塞病变成功再通。19例患者均未发生穿孔。结论是，采用新技术，慢性外周动脉闭塞能够以高成功率再通，且无动脉壁穿孔风险。该方法也可用于传统技术失败的患者。
