钬激光辅助冠状动脉成形术的有效性。钬激光冠状动脉注册研究。

Effectiveness of holmium laser-assisted coronary angioplasty. The Holmium Laser Coronary Registry.

作者信息

de Marchena E J, Mallon S M, Knopf W D, Parr K, Moses J W, Murphy-Chutorian D, Myerburg R J

机构信息

Department of Medicine, University of Miami/Jackson Memorial Medical Center, Florida.

出版信息

Am J Cardiol. 1994 Jan 15;73(2):117-21. doi: 10.1016/0002-9149(94)90200-3.

DOI:10.1016/0002-9149(94)90200-3

PMID:8296731

Abstract

The efficacy of holmium laser-assisted angioplasty was studied in 365 narrowings in 331 consecutive patients with coronary artery disease. Clinical indications for study were unstable angina pectoris in 140 patients (42%), stable angina in 136 patients (41%), postmyocardial infarction angina in 35 patients (10.5%), silent myocardial ischemia in 11 patients (3%), acute myocardial infarction in 1 patient (0.3%) and undefined in 8 patients (2%). Coronary morphology characteristics by Multivessel Angioplasty Prognosis Study group criteria were type A in 12.6%, type B1 in 34.2%, type B2 in 27.4% and type C in 25.4%. The laser successfully crossed the total length of the narrowing in 85.2%. Procedural success was 94.2%. Laser alone reduced mean percent luminal narrowing from 88 +/- 11% to 57 +/- 22%. Subsequent balloon angioplasty further reduced the mean luminal narrowing to 23 +/- 18%. Major complication rate was 2.7% (death 0.3%, Q-wave myocardial infarction 0.5%, and emergent bypass surgery 2.7%). Six-month angiographic restenosis (> 50% stenosis) rate was 44%.

摘要

对331例连续性冠心病患者的365处血管狭窄进行了钬激光辅助血管成形术疗效研究。研究的临床指征为：不稳定型心绞痛140例（42%），稳定型心绞痛136例（41%），心肌梗死后心绞痛35例（10.5%），无症状性心肌缺血11例（3%），急性心肌梗死1例（0.3%），未明确类型8例（2%）。根据多支血管成形术预后研究组标准，冠状动脉形态特征为：A型占12.6%，B1型占34.2%，B2型占27.4%，C型占25.4%。激光成功穿过狭窄全长的比例为85.2%。手术成功率为94.2%。单纯激光治疗使平均管腔狭窄百分比从88±11%降至57±22%。随后的球囊血管成形术进一步将平均管腔狭窄降至23±18%。主要并发症发生率为2.7%（死亡0.3%，Q波心肌梗死0.5%，急诊搭桥手术2.7%）。6个月时血管造影再狭窄（狭窄>50%）率为44%。