Hansen D D, Auth D C, Vracko R, Ritchie J L
Division of Cardiology, Seattle Veterans Administration Hospital, WA 98108.
Am Heart J. 1988 Jan;115(1 Pt 1):160-5. doi: 10.1016/0002-8703(88)90532-7.
PTCA is not technically possible in many patients with symptoms of coronary artery disease. In addition, atheroma is not physically removed by PTCA, and restenosis of the treated vessel is common. We have tested a new, rotating, abrasive-tipped angioplasty device in vivo in 13 atherosclerotic rabbit iliac vessels. Atherosclerosis was generated in rabbit iliac vessels by a 2% cholesterol diet combined with balloon endothelial injury for 10 weeks. The diseased vessels were then treated with the rotational atherectomy device. Before treatment, contrast angiograms demonstrated that initial percent diameter stenosis was 81% +/- 9%. After atherectomy, there was significant improvement, with residual 38% +/- 22% narrowing (p less than 0.001). One perforation resulted from distal guidewire manipulation, and one vessel was occluded by the device. Histologic examination demonstrated loss of portions of the diseased intima in all cases. Particles were produced for analysis in vitro by operating the atherectomy device in atherosclerotic rabbit aortas perfused with saline solution. Ninety-eight percent of the particles produced by the device were less than 10 micron in diameter. We conclude that this new rotational device can remove atheromatous material from diseased arteries in rabbits. Such a device may complement other angioplasty techniques and lead to wider application of catheter-based therapeutic interventions.
对于许多有冠状动脉疾病症状的患者来说，经皮冠状动脉腔内血管成形术（PTCA）在技术上是不可行的。此外，PTCA并不能实际去除动脉粥样硬化斑块，而且治疗后的血管再狭窄很常见。我们在13只患有动脉粥样硬化的兔髂血管中对一种新型的、带有旋转磨头的血管成形术装置进行了体内测试。通过给予2%胆固醇饮食并结合球囊内皮损伤10周，在兔髂血管中诱发动脉粥样硬化。然后用旋磨术装置对病变血管进行治疗。治疗前，造影血管造影显示初始直径狭窄百分比为81%±9%。旋磨术后，有显著改善，残余狭窄为38%±22%（p<0.001）。1例穿孔是由远端导丝操作引起的，1根血管被该装置阻塞。组织学检查显示所有病例中病变内膜的部分均有缺失。通过在灌注生理盐水的动脉粥样硬化兔主动脉中操作旋磨术装置，制备颗粒用于体外分析。该装置产生的颗粒98%直径小于10微米。我们得出结论，这种新型旋转装置可以从兔的病变动脉中去除动脉粥样硬化物质。这样一种装置可能补充其他血管成形术技术，并导致基于导管的治疗干预得到更广泛的应用。
