Korogi Y, Hirai T, Sakamoto Y, Harada M, Yamamoto H, Hamatake S, Ikushima I, Takahashi M
Department of Radiology, Kumamoto University School of Medic.
Nihon Igaku Hoshasen Gakkai Zasshi. 1994 Jul 25;54(8):743-50.
We studied the preliminary results of atherectomy of atherosclerotic lesions involving the lower extremities in 10 patients. Fifteen arterial stenotic lesions, five iliac, eight superficial femoral, one popliteal, and one anterior tibial, were treated. Five lesions were re-stenoses after balloon angioplasty, while the remaining lesions were previously untreated primary stenoses. For atherectomy, over-the-wire atherectomy catheters ranging in size from 7 to 10-F were used. Balloon angioplasty was also performed in cases 3, 6 and 9. Atherectomy was considered a success in all patients based on angiographic and clinical criteria. Complications occurred in three patients: intimal dissection, distal embolism and arterial spasm. In the patients with distal embolism, a surgical approach was required to remove the embolus. The internal elastic lamina or media was resected in 10 lesions on the histopathologic specimens. Although further assessment of complications and long-term results is required, these results suggest that atherectomy is useful for treating occlusive peripheral vascular disease.
我们研究了10例累及下肢的动脉粥样硬化病变旋切术的初步结果。共治疗了15处动脉狭窄病变，其中5处为髂动脉病变，8处为股浅动脉病变，1处为腘动脉病变，1处为胫前动脉病变。5处病变为球囊血管成形术后再狭窄，其余病变为未经治疗的原发性狭窄。旋切术使用了外径7至10F的导丝引导旋切导管。病例3、6和9还进行了球囊血管成形术。根据血管造影和临床标准，所有患者的旋切术均被视为成功。3例患者出现并发症：内膜剥离、远端栓塞和动脉痉挛。对于发生远端栓塞的患者，需要采用手术方法清除栓子。组织病理学标本显示，10处病变切除了内弹力层或中膜。尽管需要对并发症和长期结果进行进一步评估，但这些结果表明，旋切术对治疗闭塞性周围血管疾病是有用的。
