Strikwerda S, Koolen J J, de Feyter P J, Sprangers R L, Tijssen J G, Serruys P W
Department of Cardiology, University Hospital Dijkzigt, Erasmus University, Rotterdam, The Netherlands.
Am Heart J. 1993 Mar;125(3):838-47. doi: 10.1016/0002-8703(93)90179-d.
The immediate outcome of ELCA by XeCl excimer laser radiation is described in 53 patients who were selected to undergo ELCA from December 1990 to September 1991 in two centers that are currently performing ELCA in the Netherlands. Immediate success rates on the basis of visual assessment of the angiogram were as follows. Laser success (> 20% reduction of diameter stenosis after ELCA alone) was observed in 77% of patients, procedural success (< 50% residual stenosis after ELCA with or without adjunctive balloon dilatation [PTCA]) in 91%, and clinical success (procedural success without clinical complications) in 83% of patients. Quantitative coronary angiography by automated contour detection was performed in 31 patients who underwent ELCA in the Thoraxcenter. The minimal luminal diameter (mean +/- SD) of the treated coronary segments increased from 0.77 +/- 0.41 mm to 1.24 +/- 0.25 mm after ELCA and further to 1.67 +/- 0.29 mm after adjunctive PTCA in 25 patients. The present experience is put in perspective of results initially reported by other centers and compared with data from multicenter registries of ELCA. Finally, a short description is given of the design of a prospective, randomized trial of ELCA versus conventional PTCA (AMRO trial).
1990年12月至1991年9月期间，荷兰两家目前开展准分子激光冠状动脉斑块切除术（ELCA）的中心，对53例选择接受ELCA治疗的患者，描述了XeCl准分子激光辐射进行ELCA的即刻结果。基于血管造影视觉评估的即刻成功率如下。激光成功率（仅ELCA后直径狭窄降低>20%）在77%的患者中观察到，手术成功率（ELCA联合或不联合辅助球囊扩张术[PTCA]后残余狭窄<50%）在91%的患者中观察到，临床成功率（手术成功且无临床并发症）在83%的患者中观察到。在胸科中心接受ELCA的31例患者中，通过自动轮廓检测进行了定量冠状动脉造影。在25例患者中，接受治疗的冠状动脉节段的最小管腔直径（平均值±标准差）在ELCA后从0.77±0.41mm增加到1.24±0.25mm，在辅助PTCA后进一步增加到1.67±0.29mm。将目前的经验与其他中心最初报告的结果进行对比，并与ELCA多中心注册数据进行比较。最后，简要描述了一项ELCA与传统PTCA对比的前瞻性随机试验（AMRO试验）的设计。
