Henderson J, Chambers J, Jeddy T A, Chamberlain J, Whittingham T A
Department of Medical Physics, Newcastle General Hospital, Newcastle upon Tyne, UK.
Br J Radiol. 1994 Jun;67(798):546-51. doi: 10.1259/0007-1285-67-798-546.
Percutaneous transluminal balloon angioplasty (PTA) of superficial femoral artery lesions is associated with similar initial success rates in coronary and iliac artery angioplasty but its application is limited by a much higher incidence of restenosis. To improve understanding of the trauma caused to the vessel by balloon angioplasty and the mechanisms contributing to the subsequent processes of healing and restenosis requires serial investigations of the treated arteries in vivo. This paper describes a prospective study using colour duplex ultrasonic imaging to assess arterial changes in 51 patients with atherosclerotic disease undergoing PTA of superficial femoral artery stenoses and occlusions. Each patient was scanned prior to angioplasty and at intervals up to 6 months post-angioplasty. On each scan, measurements were made of the overall vessel and lumen diameters at each site of angioplasty. These measurements indicate that angioplasty improves vessel patency mainly by stretching of the vessel wall, with compression and/or redistribution of the atherosclerotic plaque contributing less than 25% to the improvement of lumen diameter. Serial measurements after angioplasty show complex patterns of change at the angioplasty sites indicating that several mechanisms may be contributing to the processes of vessel healing and subsequent restenosis. Possible mechanisms which could explain the measured changes in overall vessel and lumen diameters are discussed.
股浅动脉病变的经皮腔内球囊血管成形术（PTA）在冠状动脉和髂动脉血管成形术中的初始成功率相似，但其应用受到再狭窄发生率高得多的限制。为了更好地理解球囊血管成形术对血管造成的损伤以及促成随后愈合和再狭窄过程的机制，需要对体内接受治疗的动脉进行系列研究。本文描述了一项前瞻性研究，使用彩色双功超声成像评估51例患有动脉粥样硬化疾病并接受股浅动脉狭窄和闭塞PTA治疗的患者的动脉变化。在血管成形术前和血管成形术后长达6个月的间隔时间内对每位患者进行扫描。在每次扫描时，测量血管成形术每个部位的整体血管和管腔直径。这些测量结果表明，血管成形术主要通过拉伸血管壁来改善血管通畅性，动脉粥样硬化斑块的压缩和/或重新分布对管腔直径改善的贡献小于25%。血管成形术后的系列测量显示血管成形术部位有复杂的变化模式，表明几种机制可能促成血管愈合和随后的再狭窄过程。讨论了可以解释整体血管和管腔直径测量变化的可能机制。
