Kaltenbach M
Z Kardiol. 1984 Nov;73(11):669-73.
A new technique for steerable balloon dilatation is described. In contrast to the usual procedure the stenosis is first crossed by a long wire only. To minimize injuries to the vessel wall the wire is equipped with a thickened ball-shaped tip. After the stenosis has been crossed and the wire tip sufficiently advanced the balloon catheter is inserted over the long wire. If necessary the balloon catheter can be removed and another inserted without repeat crossing. If an occlusion is caused by the process of dilatation a perfusion catheter can be advanced distal to the occlusion. Perfusion can be performed with the aid of a simple syringe-tap system because the cross sectional area of this catheter is much larger than a single lumen of the double-lumen balloon catheter. This procedure even allows the dilatation of branching stenoses through the same guiding catheter whereas for the usually performed "kissing balloon" technique two guiding catheters are required. Preliminary experience with 80 patients has shown that crossing of stenoses is facilitated by the new technique because steering of the guide wire and display by contrast medium injections are unhindered. If required the balloon catheter can be changed for another one without difficulty. In the case of an occlusion the lesion can be crossed again without any risk and repeat dilatation or coronary perfusion can be performed.
本文描述了一种用于可控球囊扩张的新技术。与常规操作不同，狭窄部位首先仅通过一根长导丝穿过。为了将对血管壁的损伤降至最低，导丝配备了一个加厚的球形尖端。在穿过狭窄部位且导丝尖端充分推进后，将球囊导管沿长导丝插入。如有必要，可移除球囊导管并插入另一根，而无需再次穿过。如果扩张过程导致闭塞，可将灌注导管推进至闭塞部位的远端。由于该导管的横截面积远大于双腔球囊导管的单个腔，因此可借助简单的注射器 - 三通系统进行灌注。该操作甚至允许通过同一根引导导管对分支狭窄进行扩张，而对于通常实施的“对吻球囊”技术，则需要两根引导导管。对80例患者的初步经验表明，新技术便于穿过狭窄部位，因为导丝的操控和通过注射造影剂进行显示不受阻碍。如有需要，可轻松更换球囊导管。在出现闭塞的情况下，可再次穿过病变部位且无任何风险，并可进行重复扩张或冠状动脉灌注。
