In vivo ultrasound arterial recanalization of atherosclerotic total occlusions.
In vivo ultrasound arterial recanalization of atherosclerotic total occlusions.
复制标题
动脉粥样硬化完全闭塞的体内超声动脉再通。
DOI：
10.1016/s0735-1097(10)80059-2
复制
发表时间：
1990
影响因子：
24
通讯作者：
J. Forrester
中科院分区：
文献类型：
--
作者：
R. J. Siegel;T. Donmichael;M. Fishbein;J. Bookstein;L. Adler;Thomas Reinsvold;E. Decastro;J. Forrester
这项研究的目的是评估动脉内超声对动脉粥样硬化性完全闭塞的体内再通的潜力。应用超声能量为20 kHz的实芯探头，对12例手术植入的闭塞的人动脉粥样硬化异种动脉，其中9例钙化，以及12条正常犬动脉的起始部表面进行了超声能量处理。在正常犬动脉和动脉粥样硬化性闭塞的异种移植物中，血管造影没有血管痉挛、血栓形成或动脉夹层的证据。12个动脉粥样硬化性完全性动脉闭塞中有11个在没有超声能量的情况下无法通过传统的导丝或探头。经15~4nm(平均1.5±1.3min)的间歇超声能量照射后，闭塞血管通畅。超声检查后，12条血管中有8条接受了球囊血管成形术。单纯超声后血管造影残余狭窄率为62±24%，超声联合球囊成形术后为29±13%。虽然常规血管造影术没有发现动脉血栓，但高分辨率的切片确实显示了少数远端非闭塞性血栓，其大小与其他再通方法报道的相似。组织学研究显示与球囊血管成形术后相似的变化，纤维化和钙化的斑块局灶性破裂。这一发现表明，通过导管输送系统施加的超声波能量可以在体内使用，以打开完全阻塞的动脉粥样硬化血管。这些研究表明，使用超声探头创建管腔，从而允许随后的球囊扩张在临床上可能是可行的。
The purpose of this study was to assess the potential of intraarterial ultrasound for in vivo recanalization of atherosclerotic total occlusions. Ultrasound energy at a frequency of 20 kHz was applied with a prototype solid wire probe to 12 surgically implanted occluded human atherosclerotic arterial xenografts, 9 of which were calcified, as well as to the intimai surface of 12 normal canine arteries. In both the normal canine arteries and the atherosclerotic occluded xenografts, there was no angiographic evidence of vasospasm, thrombosis or arterial dissection.Eleven of the 12 atherosclerotic complete arterial occlusions were resistant to passage of a conventional guide wire or probe without ultrasound energy. However, the occlusions were recanalized after administration of 15 s to 4 nun (mean 1.5 ± 1.3 min) of intermittent ultrasound energy. After ultrasound, 8 of the 12 vessels underwent balloon angioplasty. Angiographic residual stenosis after ultrasound alone was 62 ± 24% and after combined ultrasound and balloon angioplasty, 29 ± 13%. Although routine angiography did not reveal arterial emboli, high resolution cut films did demonstrate a few distal nonocclusive thrombi of a size similar to that reported with other recanalization methods. Histologic studies demonstrated changes similar to those after balloon angioplasty, with focal cracking of the fibrotic and calcified plaque.The findings demonstrate that ultrasound energy applied through a catheter delivery system can be used in vivo to open completely obstructed atherosclerotic vessels. These studies suggest that it might be clinically feasible to use the ultrasound probe to create a lumen, allowing subsequent balloon dilation.
激光动脉再通：当前的观点。
影响因子：
24
作者：
Abela,GS
通讯作者：
Abela,GS