Chin A K, Kinney T B, Rurik G W, Shoor P M, Fogarty T J
Surgery. 1984 Feb;95(2):196-201.
We report a quantitative determination of the relative contribution of various factors leading to arterial lumen enlargement during transluminal angioplasty. Mechanical tests were conducted on both normal and atherosclerotic artery necropsy specimens. In the range of dilating pressures tested (0 to 3.4 atm or 0 to 50 lb/in2), content extrusion of fluid from the plaque accounted for 6% to 12% of the overall lumen area increase, while compaction of the plaque accounted for only 1% to 1.5%. Most of the increase (86.8% to 93%) was due to plaque and arterial wall disruption. The mechanism of disruption involved shearing of the plaque from the underlying artery at relatively low dilating pressures, followed by longitudinal tearing in the arterial wall at higher pressures. Diseased arteries were observed to dilate significantly more than nondiseased arteries at dilating pressures greater than or equal to 1.36 atm or 20 lb/in2 (P less than 0.05). In the range of stenoses tested (10% to 50% based on diameter reduction), the mean dilating pressure required to increase the lumen cross-sectional area by 50% was approximately 1.5 atm or 22 lb/in2. Based on these studies, we conclude that balloon dilatation results arise mainly from plaque and arterial wall disruption.
我们报告了一项关于经皮腔内血管成形术期间导致动脉管腔扩大的各种因素相对贡献的定量测定。对正常和动脉粥样硬化动脉尸检标本进行了力学测试。在所测试的扩张压力范围内（0至3.4个大气压或0至50磅/平方英寸），斑块中流体的内容物挤出占管腔总面积增加的6%至12%，而斑块的压实仅占1%至1.5%。大部分增加（86.8%至93%）是由于斑块和动脉壁破坏。破坏机制包括在相对较低的扩张压力下斑块从下层动脉的剪切，随后在较高压力下动脉壁的纵向撕裂。在扩张压力大于或等于1.36个大气压或20磅/平方英寸时，观察到病变动脉比非病变动脉扩张明显更多（P小于0.05）。在所测试的狭窄范围内（基于直径减小为10%至50%），将管腔横截面积增加50%所需的平均扩张压力约为1.5个大气压或22磅/平方英寸。基于这些研究，我们得出结论，球囊扩张的结果主要源于斑块和动脉壁破坏。
