Marzilli M
Istituto di Fisiologia Clinica del CNR, Università degli Studi, Pisa.
Cardiologia. 1994 Dec;39(12 Suppl 1):59-63.
Although balloon angioplasty represented a significant advance in the treatment of coronary artery disease, this procedure is limited by acute occlusion and late restenosis. Among the new devices proposed to overcome the limitations of balloon catheters, Simpson's atherocath has the unique property of removing the atherosclerotic plaques from the coronary wall. Size and stiffness of the terminal portion limit the use of the atherocath to the proximal, non tortuous portion of coronary vessels more than 2.5 mm in size. Studies comparing atherectomy with balloon angioplasty have demonstrated a greater acute luminal gain with atherectomy but have failed to prove a clinical advantage from this better initial results. Atherectomy however is a rapidly evolving technology: better devices and more aggressive dilating strategies could significantly modify the conclusions of the earlier studies. In the meantime atherectomy is providing a unique opportunity to study vascular wall pathology.
尽管球囊血管成形术在冠状动脉疾病的治疗方面取得了重大进展，但该手术受到急性闭塞和后期再狭窄的限制。在为克服球囊导管局限性而提出的新装置中，辛普森动脉粥样硬化斑块切除导管具有从冠状动脉壁去除动脉粥样硬化斑块的独特特性。末端部分的尺寸和硬度限制了动脉粥样硬化斑块切除导管仅能用于直径超过2.5毫米的冠状动脉近端、无弯曲的部分。比较斑块切除术和球囊血管成形术的研究表明，斑块切除术能带来更大的急性管腔增益，但未能证明这种更好的初始结果具有临床优势。然而，斑块切除术是一项快速发展的技术：更好的装置和更积极的扩张策略可能会显著改变早期研究的结论。与此同时，斑块切除术为研究血管壁病理学提供了独特的机会。
