Field C K, Matsumoto T, Kerstein M D
Department of Surgery, Hahnemann University School of Medicine, Philadelphia, PA 19102-1192, USA.
J Diabetes Complications. 1995 Jul-Sep;9(3):186-9. doi: 10.1016/1056-8727(94)00038-p.
Laser-assisted balloon angioplasty (LABA), has potential as a treatment modality for re-establishing flow in occluded arterial segments. The objective of this retrospective review is to summarize the results of LABA of totally occluded superficial femoral arteries in 33 limbs among 32 diabetic patients. Indications for vascular intervention in this population included disabling claudication in 15 (45.6%), rest pain in 9 (27.2%), and tissue loss in 9 (27.2%) limbs. The review of preoperative arteriograms allowed for the division of limbs into three groups by occlusion length as follows; less than 5 cm, between 5 and 10 cm, and greater than 10 cm. Overall initial success rate was 21 of 33 (63.6%). Nine of ten (90%) occlusions less than 5 cm in length; six of nine (66.7%) occlusions between 5 and 10 cm in length; and six of 14 (42.9%) lesions greater than 10 cm in length were initially successfully recanalized. Overall cumulative patency rate at 1 year was 22.5%. For occlusion lengths less than 5 cm, cumulative patency rates at 1 year and 2 years were 66.4% and 33.2%, respectively. All lesions greater than 5 cm that were initially recanalized, uniformly re-occluded by 1 year. The number of complications (vessel perforation or dissection) increased as lesion length increased. The theoretic advantages of laser energy's ability to recanalize occlusive lesions are lost when coupled with the balloon angioplasty technique, especially in diabetics. Laser-assisted balloon angioplasty in its present form should be considered an investigational tool requiring further technologic refinements and controlled clinical trials.
激光辅助球囊血管成形术（LABA）有潜力成为一种用于恢复闭塞动脉段血流的治疗方式。本回顾性研究的目的是总结32例糖尿病患者33条肢体的完全闭塞股浅动脉LABA治疗结果。该人群血管介入的指征包括15条肢体（45.6%）的致残性间歇性跛行、9条肢体（27.2%）的静息痛以及9条肢体（27.2%）的组织缺损。术前动脉造影检查结果可将肢体按闭塞长度分为三组，分别为：小于5厘米、5至10厘米以及大于10厘米。总体初始成功率为33例中的21例（63.6%）。长度小于5厘米的闭塞病变中，10例中有9例（90%）；长度在5至10厘米之间的闭塞病变中，9例中有6例（66.7%）；长度大于10厘米的病变中，14例中有6例（42.9%）最初成功再通。1年时的总体累积通畅率为22.5%。对于长度小于5厘米的闭塞病变，1年和2年时的累积通畅率分别为66.4%和33.2%。所有最初成功再通且长度大于5厘米的病变，到1年时均再次闭塞。并发症（血管穿孔或夹层）的数量随着病变长度增加而增多。激光能量再通闭塞病变的理论优势与球囊血管成形术技术结合后丧失，尤其是在糖尿病患者中。目前形式的激光辅助球囊血管成形术应被视为一种需要进一步技术改进和对照临床试验的研究工具。
