Kinney T B, Fan M, Chin A K, Finn J C, Hayden W G, Fogarty T J
AJR Am J Roentgenol. 1985 Jan;144(1):115-22. doi: 10.2214/ajr.144.1.115.
The inability to successfully position angioplasty catheters and the occurrence of complications during angioplasty procedures can, in part, be related to the shear forces generated during catheter introduction. Shear forces are the axial contact forces that the catheter system exerts on the inner arterial surfaces during advancement. The shear forces exerted by three different catheter designs (coaxial dilator, coaxial balloon, and linear extrusion) were measured in normal and atherosclerotic arteries; in modeled stenoses of variable severity, length, and compliance; and in modeled vessel angulations. The results with modeled vessels show that the linear extrusion catheter reduces the level of shear forces, particularly in narrow, long, noncompliant stenoses and in tortuous vessels. The stenotic artery results also show that the linear extrusion catheter minimizes these forces in tight lesions. The relative differences in forces are explained by the mechanism of action for each catheter. The reported occurrences of technical difficulties, complications, and long-term patency rates are then interpreted on the basis of the relative differences in measured shear forces. The results of this study combined with preliminary clinical data indicate that linear extrusion should facilitate placement and reduce associated complications.
血管成形术导管无法成功定位以及血管成形术过程中出现并发症，部分原因可能与导管插入过程中产生的剪切力有关。剪切力是导管系统在推进过程中作用于动脉内表面的轴向接触力。在正常动脉和动脉粥样硬化动脉中，在不同严重程度、长度和顺应性的模拟狭窄病变中，以及在模拟血管成角情况下，测量了三种不同导管设计（同轴扩张器、同轴球囊和线性挤压式）所施加的剪切力。模拟血管的结果表明，线性挤压式导管可降低剪切力水平，尤其是在狭窄、长段、非顺应性狭窄病变以及迂曲血管中。狭窄动脉的结果还表明，线性挤压式导管可使紧密病变中的这些力降至最低。每种导管的作用机制解释了力的相对差异。然后根据测量的剪切力的相对差异，对所报告的技术困难、并发症及长期通畅率进行解释。本研究结果与初步临床数据相结合表明，线性挤压式导管应有助于放置并减少相关并发症。
