Yamashita K, Satake S, Ohira H, Ohtomo K
Cardiovascular Department, Yokohama Red Cross Hospital, Japan.
J Am Coll Cardiol. 1994 Feb;23(2):336-40. doi: 10.1016/0735-1097(94)90416-2.
The purpose of this study was to evaluate the effects of thermal balloon percutaneous transluminal coronary angioplasty using radiofrequency energy in the treatment of patients with failed coronary angioplasty and complex lesions. In addition, we evaluated restenosis after radiofrequency thermal balloon applications.
The efficacy of coronary angioplasty is limited by the relatively low success rate in complex lesions and the high frequency of restenosis. Few reports have studied the combined effects of pressure and laser thermal energy. This study describes a new device for coronary angioplasty using radiofrequency thermal energy.
Thirty-two patients with failed conventional coronary angioplasty or complex lesions were treated with radiofrequency thermal balloon coronary angioplasty. Radiofrequency energy was delivered up to 11 times in exposures ranging from 30 to 60 s in duration. This combined effect allowed the vascular wall to be heated to temperatures ranging from 60 to 70 degrees C. Follow-up coronary angiography was performed, on average, 6 months after the procedure.
Successful radiofrequency coronary angioplasty was achieved in 28 (82%) of 34 lesions. There was one abrupt coronary artery occlusion (3%) and no death, perforation or dissection. Angiographic restenosis occurred in 14 (56%) of 25 lesions.
In patients with failed coronary angioplasty and difficult complex lesions, radiofrequency coronary angioplasty could potentially improve angioplasty success rates and may have important implications for bailout cases with abrupt occlusion. However, restenosis remains a significant problem.
本研究旨在评估使用射频能量的热球囊经皮腔内冠状动脉成形术对冠状动脉成形术失败及复杂病变患者的治疗效果。此外，我们还评估了射频热球囊应用后的再狭窄情况。
冠状动脉成形术的疗效受到复杂病变相对较低的成功率和较高的再狭窄发生率的限制。很少有报告研究压力和激光热能的联合作用。本研究描述了一种使用射频热能的新型冠状动脉成形术设备。
32例传统冠状动脉成形术失败或有复杂病变的患者接受了射频热球囊冠状动脉成形术治疗。射频能量在30至60秒的持续时间内最多输送11次。这种联合作用使血管壁温度升高到60至70摄氏度。术后平均6个月进行冠状动脉造影随访。
34处病变中有28处（82%）成功进行了射频冠状动脉成形术。发生1例冠状动脉急性闭塞（3%），无死亡、穿孔或夹层。25处病变中有14处（56%）发生造影再狭窄。
对于冠状动脉成形术失败及有困难复杂病变的患者，射频冠状动脉成形术可能提高成形术成功率，对急性闭塞的补救病例可能具有重要意义。然而，再狭窄仍然是一个重大问题。
