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经皮准分子激光冠状动脉成形术:动物模型及台湾地区首例人体经验

Percutaneous excimer laser coronary angioplasty: animal models and the first human experience in Taiwan.

作者信息

Chen J S, Hwang C L, Kwan P S, Kao M C, Chen Y T

机构信息

Department of Medicine, Taichung Veterans General Hospital, Taiwan, R.O.C.

出版信息

Zhonghua Yi Xue Za Zhi (Taipei). 1994 Jan;53(1):1-6.

PMID:8173994
Abstract

BACKGROUND

Clinical studies with excimer laser coronary angioplasty (ELCA) have been published in USA and Germany for lesions too difficult for use of routine balloon angioplasty. The purpose of the study was to evaluate the safety and short-term effects of excimer laser radiation applied to canine coronary angioplasty, and to report the first experience with percutaneous coronary excimer laser angioplasty and adjunctive percutaneous transluminal coronary angioplasty (PTCA) in a human subject on Taiwan.

METHODS

Twelve canine subjects were studied. An excimer laser (Technolas Inc. Max-10), 20 Hz, 35 mJ/mm2, and 60 ns pulse was used.

RESULTS

There were no perforations, with minimal dissection on the arterial intimal layer after using the bare-tip (crude single fiber-optic) fiber laser. The human subject showed partially successful recanalization after ELCA, with no residual stenosis after adjunctive PTCA for an occluded left anterior descending (LAD) artery (proximal lesion). A 0.014-in guide wire was used. There were no complications except for premature ventricular contractions during the procedure.

CONCLUSIONS

The percutaneous excimer laser angioplasty is an effective and safe tool for treating coronary artery disease.

摘要

背景

在美国和德国已发表了关于准分子激光冠状动脉成形术(ELCA)治疗常规球囊血管成形术难以处理的病变的临床研究。本研究的目的是评估准分子激光辐射应用于犬冠状动脉成形术的安全性和短期效果,并报告台湾地区首例经皮冠状动脉准分子激光血管成形术及辅助经皮腔内冠状动脉成形术(PTCA)治疗人体患者的经验。

方法

对12只犬进行研究。使用一台准分子激光(Technolas公司Max-10型),频率20Hz,能量密度35mJ/mm²,脉冲宽度60ns。

结果

使用裸头(单根粗光纤)光纤激光后未出现穿孔,动脉内膜层仅有轻微剥离。该人体患者在ELCA术后部分再通成功,辅助PTCA治疗闭塞的左前降支(LAD)动脉近端病变后无残余狭窄。使用了一根0.014英寸的导丝。术中除室性早搏外无其他并发症。

结论

经皮准分子激光血管成形术是治疗冠状动脉疾病的一种有效且安全的工具。

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