Ritchie J L, Hansen D D, Intlekofer M J, Hall M, Auth D C
Department of Medicine, University of Washington, School of Medicine, Seattle.
Z Kardiol. 1987;76 Suppl 6:59-65.
We have developed and tested a rotational, mechanical approach to arterial plaque removal (PTRA or Percutaneous Transluminal Rotational Atherectomy). An elliptical burr is rotated by a helical driveshaft at 150,000 rpm. The tip of the burr is embedded with small diamond chips, 30 micron in diameter. Plaque is thus abraded and particles of 2-5 micron in diameter are released downstream. Preliminary studies in a rabbit model of iliac atherosclerosis showed a reduction in percent diameter stenosis from more than 80% to less than 40%. Perforations are the current principal complication, occurring in 2 of the 13 rabbit arteries. A second rotational catheter system has been developed for removal of fresh thrombus (PRT-Percutaneous Rotational Thrombectomy). Low speed rotation (5000 rpm) of a non-cutting catheter promotes the selective winding of fibrin with subsequent lysis of thrombus. This was effective in 20 out of 21 total thrombotic occlusions in a canine model of fresh clot, with a single perforation early in the experiment.
我们已研发并测试了一种用于去除动脉斑块的旋转式机械方法（PTRA或经皮腔内旋切术）。一个椭圆形磨头由一根螺旋驱动轴以每分钟150,000转的速度旋转。磨头尖端镶嵌有直径为30微米的小钻石颗粒。斑块因此被磨蚀，直径为2至5微米的颗粒被释放到下游。在兔髂动脉粥样硬化模型中的初步研究显示，直径狭窄百分比从超过80%降至不到40%。穿孔是目前的主要并发症，在13条兔动脉中有2条出现。已研发出第二种旋转导管系统用于清除新鲜血栓（PRT - 经皮旋转血栓切除术）。非切割导管的低速旋转（每分钟5000转）促进纤维蛋白的选择性缠绕，随后血栓溶解。在新鲜血栓犬模型的21处总血栓性闭塞中，有20处有效，在实验早期出现了1次穿孔。
