Ahn S S, Auth D, Marcus D R, Moore W S
University of California, Los Angeles Center for the Health Sciences 90024-1749.
J Vasc Surg. 1988 Feb;7(2):292-300. doi: 10.1067/mva.1988.avs0070292.
A new high-speed rotary atherectomy device, inserted over a guide wire and directed with an angioscope, offers the potential of restoring patency of outflow vessels by "boring out" the atheromatous lesion of the orifices of runoff vessels. The device was tested on 68 cadaver arteries with atheromatous lesions involving the superficial femoral, popliteal, and tibial arteries. This was performed with either free segments or in situ with the device placed through a popliteal arteriotomy. The gross results of rotary atherectomy were assessed by angioscopy, angiography, or both. The luminal surfaces were studied with scanning electron microscopy and transverse sections of vessels were studied with light microscopy. The pulverized atheroma, in colloidal suspension, was analyzed for particle size by Coulter counter. The effect of a colloidal suspension of atheromatous particles on distal capillary circulation was measured in animal experiments. Obstructive lesions were successfully removed in 36 of 37 stenotic arteries (97%) and 18 of 31 completely occluded arteries (58%), an overall efficacy of 54 of 68 (79%). In successfully atherectomized arteries, angioscopy and angiography demonstrated a widely patent, smooth, polished surface. Light microscopy demonstrated removal of the diseased intima with maintenance of the outer media and adventitia. The pulverized atheroma particles were generally smaller than red blood cells and injection of the colloidal atheroma into canine femoral arteries failed to produce local tissue injury. We conclude that in the human cadaver this atherectomy device effectively enlarges and recanalizes obstructed superficial femoral, popliteal, and tibial arteries.(ABSTRACT TRUNCATED AT 250 WORDS)
一种新型高速旋切血管成形术装置，通过导丝插入并借助血管镜引导，有望通过“钻除”流出血管开口处的动脉粥样硬化病变来恢复流出血管的通畅。该装置在68条患有涉及股浅动脉、腘动脉和胫动脉的动脉粥样硬化病变的尸体动脉上进行了测试。测试在游离节段上进行，或通过腘动脉切开术将装置原位放置进行。旋切血管成形术的大体结果通过血管镜、血管造影或两者进行评估。用扫描电子显微镜研究管腔表面，用光镜研究血管横切面。用库尔特计数器分析胶体悬浮液中粉碎的动脉粥样硬化斑块的粒径。在动物实验中测量了动脉粥样硬化颗粒的胶体悬浮液对远端毛细血管循环的影响。37条狭窄动脉中的36条（97%）和31条完全闭塞动脉中的18条（58%）的阻塞性病变被成功清除，68条中的54条（79%）总体有效。在成功进行旋切血管成形术的动脉中，血管镜和血管造影显示管腔广泛通畅、表面光滑。光镜显示病变内膜被清除，外膜和中膜得以保留。粉碎的动脉粥样硬化斑块颗粒通常小于红细胞，将胶体动脉粥样硬化斑块注入犬股动脉未造成局部组织损伤。我们得出结论，在人体尸体中，这种旋切血管成形术装置能有效扩大并重新开通阻塞的股浅动脉、腘动脉和胫动脉。（摘要截短至250字）
