Kaltenbach M, Beyer J, Walter S, Klepzig H, Schmidts L
Cathet Cardiovasc Diagn. 1984;10(3):213-9. doi: 10.1002/ccd.1810100305.
We investigated the morphologic structure and fluid content of atherosclerotic specimens of fresh human postmortem artery segments before and after application of a pressure of 5 atmospheres simulated by a weight of 5 kg per 1 cm2. After applying pressure in nonorganized atheromata, we noticed a marked reduction in thickness while in fibrotic atheromata we observed only smaller differences in thickness. Reduction in fluid content was significantly more pronounced in nonorganized atheromatous tissue. Reduction in thickness was closely related to reduction in weight (i e, fluid content). The time of pressure application necessary to achieve the optimal result averaged 60 sec. The conclusions drawn from these experiments were incorporated into clinical application of coronary angioplasty. Prolonged balloon inflation was applied to the last 400 out of a total of 600 coronary angioplasty procedures, performed between October 1977 and October 1983. Stenoses not sufficiently responsive to balloon inflation periods of 5-10 sec were exposed to periods of 60 sec (30-120 sec). The number of "non dilatable" stenoses was 15% with the standard short pressure procedure, but only 5% with the prolonged pressure application. No serious complications related to prolonged pressure application were observed. Thus, from experimental data and clinical experience the application of longer pressure periods appears justified and beneficial.
我们研究了新鲜人类死后动脉段动脉粥样硬化标本在每平方厘米5千克重量模拟5个大气压的压力施加前后的形态结构和液体含量。在对非组织化动脉粥样硬化斑块施加压力后，我们注意到厚度显著减小，而在纤维化动脉粥样硬化斑块中，我们仅观察到厚度有较小差异。非组织化动脉粥样硬化组织中液体含量的减少明显更为显著。厚度的减小与重量（即液体含量）的减少密切相关。达到最佳效果所需的压力施加时间平均为60秒。从这些实验得出的结论被纳入冠状动脉血管成形术的临床应用中。在1977年10月至1983年10月期间进行的总共600例冠状动脉血管成形术的最后400例中，采用了延长球囊充气时间的方法。对5 - 10秒球囊充气反应不足的狭窄病变，采用60秒（30 - 120秒）的充气时间。标准短时间压力操作时“不可扩张”狭窄病变的发生率为15%，而延长压力施加时仅为5%。未观察到与延长压力施加相关的严重并发症。因此，从实验数据和临床经验来看，延长压力施加时间的应用似乎是合理且有益的。
