Vallbracht C, Liermann D D, Landgraf H, Kollath J, Roth F J, Breddin H, Hartmann A, Schoop W, Kaltenbach M
Department of Cardiology, University Hospital Frankfurt, Germany.
Eur J Med. 1993 Apr;2(4):232-8.
Chronic complete occlusions still represent the major technical limitation of percutaneous transluminal angioplasty, both in peripheral and coronary vessels. The clinical use of low-speed rotational angioplasty started in 1986 for the peripheral and in 1987 for the coronary arteries, and has already become part of the clinical routine in several centres. Up to now more than 350 patients with peripheral and 250 patients with coronary occlusions have been treated in Frankfurt; a multicentre questionnaire already contains information about 1,252 patients with peripheral vessel obstructions. In peripheral occlusions the acute success rate was more than 80% if low speed rotational angioplasty was used as the first attempt; after failure of conventional techniques still more than 60% of the vessels could be recanalized successfully. In addition to occlusions of the arteries of the lower limb, indications now may include the iliac artery and the subclavian artery. In each of the patients with chronic coronary occlusions an attempt with conventional techniques had failed before. Following a learning curve, which was also influenced by a better understanding of morphological preconditions, the acute success has now reached 70%. Both in patients with peripheral and those with coronary occlusions the technique turned out to be a safe procedure. Early angiographically documented long-term results in both indications are comparable with conventional balloon techniques. It is concluded that the use of low-speed rotational angioplasty (ROTACS) can improve the results of non-operative invasive treatment, both in peripheral and in coronary arteries.
慢性完全闭塞仍然是经皮腔内血管成形术在周围血管和冠状动脉中的主要技术限制。低速旋转血管成形术于1986年开始用于周围血管，1987年开始用于冠状动脉，现已成为多个中心临床常规操作的一部分。截至目前，法兰克福已治疗了350多名周围血管闭塞患者和250多名冠状动脉闭塞患者；一份多中心调查问卷已经包含了1252名周围血管阻塞患者的信息。在周围血管闭塞中，如果首次尝试使用低速旋转血管成形术，急性成功率超过80%；在传统技术失败后，仍有超过60%的血管能够成功再通。除下肢动脉闭塞外，现在的适应证还可能包括髂动脉和锁骨下动脉。在每例慢性冠状动脉闭塞患者中，此前使用传统技术的尝试均告失败。在经历了一个学习曲线（这也受到对形态学前提条件更好理解的影响）后，现在急性成功率已达到70%。无论是周围血管闭塞患者还是冠状动脉闭塞患者，该技术都被证明是一种安全的操作方法。两种适应证早期血管造影记录的长期结果与传统球囊技术相当。得出的结论是，低速旋转血管成形术（ROTACS）的应用可以改善周围血管和冠状动脉非手术侵入性治疗的效果。
