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氩激光血管成形术降低血栓形成性。与球囊血管成形术的比较。

Reduction of thrombogenicity with argon laser angioplasty. Comparison with balloon angioplasty.

作者信息

Tomaru T, Uchida Y, Nakamura F, Yanagisawa-Miwa A, Fujimori Y, Gonzalez J A, Kamijo T, Sugimoto T

机构信息

Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo, Japan.

出版信息

Jpn Heart J. 1993 Jan;34(1):79-90. doi: 10.1536/ihj.34.79.

Abstract

Direct argon or thermal laser angioplasty (LA) was evaluated for thrombogenicity using angioscopy, and compared with balloon angioplasty (BA). In each of 8 dogs, 4 segments (both proximal and distal iliac arteries) were treated by laser-thermal and/or balloon angioplasty. One segment was treated by balloon angioplasty and 3 other segments were treated with either thermal LA with 7 W using a "Hot-Tip" laser probe (2.0 mm), or BA and thermal LA, or a special optical probe which emits a 3 W argon laser beam. Mean percent area stenosis by thrombus was 44 +/- 23 in balloon-dilated, 23 +/- 21 in thermally-treated and balloon-dilated, 3 +/- 3 in thermally-treated, and 1 +/- 4 in directly-lased segments at 30 min. It was 62 +/- 28 in balloon dilated, 31 +/- 29 in thermally-treated and balloon-dilated, 5 +/- 6 in thermally-treated, and 1 +/- 2 in directly-lased segments at 60 min. Balloon-inflated segments had the highest percent area stenosis which was significantly higher than that of either the direct laser or thermally-treated segments (p < 0.0005). Histology showed thermal necrosis in laser-treated sites, and wall tears in BA sites. Thus, LA can provide a less thrombogenic arterial surface than BA.

摘要

使用血管内镜评估直接氩激光或热激光血管成形术(LA)的血栓形成性,并与球囊血管成形术(BA)进行比较。在8只狗中,每只狗的4个节段(髂动脉近端和远端)接受了激光热血管成形术和/或球囊血管成形术治疗。1个节段接受球囊血管成形术治疗,其他3个节段分别使用“热尖端”激光探头(2.0毫米)以7瓦功率进行热激光血管成形术治疗,或接受球囊血管成形术和热激光血管成形术联合治疗,或使用发射3瓦氩激光束的特殊光学探头进行治疗。在30分钟时,球囊扩张节段血栓导致的平均狭窄面积百分比为44±23,热治疗联合球囊扩张节段为23±21,热治疗节段为3±3,直接激光治疗节段为1±4。在60分钟时,相应数据分别为62±28、31±29、5±6和1±2。球囊扩张节段的狭窄面积百分比最高,显著高于直接激光治疗节段或热治疗节段(p<0.0005)。组织学检查显示,激光治疗部位有热坏死,球囊血管成形术部位有血管壁撕裂。因此,与球囊血管成形术相比,激光血管成形术能提供血栓形成性较低的动脉表面。

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