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[氩激光与准分子激光血管成形术治疗股动脉和腘动脉病变患者的比较:1年后的临床及血管造影结果]

[Comparison between argon and excimer laser angioplasty in patients with lesions of the femoral and popliteal arteries: clinical and angiography results after 1 year].

作者信息

Wilhelm C, Schömig A, Brachmann J, Amendt K, Sieben J, Weiss T, Diehm C, Kübler W

机构信息

Abteilung Innere Medizin III, Medizinischen Universitätsklinik Heidelberg.

出版信息

Vasa. 1993;22(2):169-77.

PMID:8322505
Abstract

The aim of this study was to compare acute and long term results of thermic argon laser versus athermic XeCl-excimer laser for recanalization of femoropopliteal lesions in 43 patients with peripheral vascular disease stage IIb to IV according to Fontaine. The argon laser system was applied in 29 lesions (9 stenoses, 20 occlusions up to 31 cm length) and an excimer laser was used in 28 lesions (10 stenoses, 18 occlusions up to 30 cm length). In all cases balloon dilatation followed laser recanalization to achieve a sufficient primary result (< 25% stenosis rate). Primary success was obtained in 86% with both laser systems. After 1 year 62.5 of the recanalized vessels with excimer laser and 56% with argon laser were still patent. Neither acute nor long term results showed significant differences between both laser systems. Compared to the argon laser, the procedure with the excimer laser was of shorter duration which may be advantageous under routine conditions. After one year, combining the results of both systems, the reocclusion rates of stenoses amounted to 22%, the reocclusion rates of short distance occlusions to 35% and that of long occlusions more than 10 cm length to 71%. With regard to the high reocclusion rate after reopening of long occlusions the laser systems seem to be of advantage, compared to balloon angioplasty mainly in critical stenosis and short occlusions which cannot be passed with the guide-wire.

摘要

本研究的目的是比较热氩激光与非热XeCl准分子激光对43例根据Fontaine分级为IIb至IV期的外周血管疾病患者股腘病变再通的急性和长期结果。氩激光系统应用于29处病变(9处狭窄,20处闭塞,长度达31厘米),准分子激光应用于28处病变(10处狭窄,18处闭塞,长度达30厘米)。在所有病例中,激光再通后进行球囊扩张以获得足够的初步结果(狭窄率<25%)。两种激光系统的初步成功率均为86%。1年后,准分子激光再通的血管中有62.5%仍保持通畅,氩激光再通的血管中有56%仍保持通畅。两种激光系统在急性和长期结果方面均未显示出显著差异。与氩激光相比,准分子激光手术时间更短,这在常规条件下可能具有优势。1年后,综合两种系统的结果,狭窄的再闭塞率为22%,短距离闭塞的再闭塞率为35%,长度超过10厘米的长闭塞的再闭塞率为71%。鉴于长闭塞再通后的再闭塞率较高,与球囊血管成形术相比,激光系统似乎在主要是临界狭窄和导丝无法通过的短闭塞方面具有优势。

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