Corr L
Regional Cardiac Unit, Brook General Hospital, London.
BMJ. 1994 Sep 3;309(6954):579-83. doi: 10.1136/bmj.309.6954.579.
The use of percutaneous transluminal coronary angioplasty is limited by procedural complications and the serious drawback of restenosis, but some new techniques have been developed in an attempt to lower the complication rate for difficult lesions and reduce the rate of restenosis. These include devices to physically remove atheromatous plaque, such as the Simpson Coronary AtheroCath and the transluminal extraction catheter, as well as devices to ablate the plaque in situ, including the Rotablator and the excimer laser catheter. Although each device may have advantages in certain types of lesion, few data on their use have been reported in properly controlled randomised trials. The data available so far do not suggest that these devices will be safer than balloon angioplasty or that they will reduce restenosis. However, using metallic stents to support coronary arteries after balloon angioplasty seems to reduce acute complications and to lower the rate of restenosis, and the use of stents is likely to increase.
经皮腔内冠状动脉成形术的应用受到手术并发症和再狭窄这一严重缺点的限制，但已开发出一些新技术，试图降低复杂病变的并发症发生率并减少再狭窄率。这些技术包括用于物理清除动脉粥样硬化斑块的装置，如辛普森冠状动脉粥样斑块切除导管和腔内抽吸导管，以及用于原位消融斑块的装置，包括旋磨仪和准分子激光导管。尽管每种装置在某些类型的病变中可能具有优势，但在适当对照的随机试验中，关于其使用的报道数据很少。目前可得的数据并不表明这些装置比球囊血管成形术更安全，也不表明它们会降低再狭窄率。然而，在球囊血管成形术后使用金属支架来支撑冠状动脉似乎可减少急性并发症并降低再狭窄率，而且支架的使用可能会增加。
