MECHANISM ON THROMBOSIS AND RESTENOSIS AFTER LASER ANGIOPLASTY

激光血管成形术后血栓形成和再狭窄的机制

• 批准号: 03807052
• 负责人: TOMARU Takanobu
• 金额: $ 1.15万
• 依托单位: UNIVERSITY OF TOKYO
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1991
• 资助国家: 日本
• 起止时间: 1991 至 1993
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-03807052/
• 关键词: LASER ANGIOPLASTY; BALLOON ANGIOPLASTY; THROMBOGENICITY; ANTITHROMBIN; 血管内視鏡; 血栓形成; 再狭窄; レーザー形成術; 閉〓性動脈硬化症; レ-ザ-血管形成術; バル-ン形成術; 閉塞性動脈硬化症

Thrombogenicity and proliferative effects of laser angioplasty was compared with balloon angioplasty in 8 dogs. Mean percent area stenosis by thrombus was 62 (]SY.+-[) 28 in balloon dilated, 31 (]SY.+-[) 29 in laser thermall treated and balloon dilated, 5 (]SY.+-[) 6 in laser thermal-treated, and 1 (]SY.+-[) 2 in directly lased segments at 60 minutes (P<0.0005 vs balloon). In 8 atherosclerotic rabbit iliac arteries, mean luminal diameter increased from 0.19 to 1.54 mm by laser thermal and from 0.29 to 1.84 mm by balloon (P<0.0001, repectively). However, due to thrombotic reobstruction, it decreased to 1.34 for laser and 0.45 for balloon (P<0.0001 vs immediately post) at 60 minutes later. Thus laser thermal angioplasty results less thrombogenecity than balloon angioplasty.We investigated preventive effect of laser angioplasty on restenosis in hypercholesteremic rabbits. One side of atherosclerotic iliac stenosis was dilated by balloon and the other by laser angioplasy. Following angiopl … More asty, luminal stenosis increased from 16 to 58% in balloon-dilated arteries (P<0.05), whereas, it changed from 26% to 30% in laser thermal group and from 28 to 39% in direct laser group. The results suggested that laser angioplasty may prevent restenosis after angioplasty.Thrombogenicity of pulsed laser treated arteries were evaluated in rabbits. Angioscopic mean percent obstruction with thrombus was 8.6 % with laser thermal treatment, and 41.9 % with control balloon (n=7, P<0.0001) at 1 hour after the treatment. It was 3.8 % with excimer and 51.9 % for the control balloon group (n=8, P<0.001). Angioscopic percent luminal obstruction was 1.4 with excimer, 2.6 with holmium YAG,2.5 with Nd-YAG and 49 for balloon angioplasty group (P<0.0001). The results suggested that pulse laster treatment can also reduce thrombogenicity.One side of iliac stenosis was dilated by balloon and the other artery was dilated by laser angioplasty in 18 dogs. Before angioplasty, antithrombin or heparin was infused in 10 dogs. One hour after angioplasty, mean thrombotic stenosis was 62% in balloon control, and 5% in laser thermal group. It was 8.6% in balloon with heparin, 1.2% in laser with heparin, and 0% in laser with antithrombin. The results suggested that adjunctive antithrombotic therapy to laser treatment can completely prevent thrombosis.We investigated laser thermal angioplasty in 27 patients with arteriosclerosis obliterans, and succeeded in 21 patients. With antithrombin therapy, one year patency was 82%, compare with 50% with heparin (P<0.05). Thus laser angioplasty with adjunctive antithrombin is very useful for prevention of acute reocclusion and restenosis. Less

在 8 只狗身上比较了激光血管成形术与球囊血管成形术的血栓形成和增殖作用。球囊扩张中血栓造成的平均面积狭窄百分比为 62 (]SY.+-[) 28，激光热处理和球囊扩张中为 31 (]SY.+-[) 29，激光热处理中为 5 (]SY.+-[) 6，60 分钟时直接激光切割段中为 1 (]SY.+-[) 2（与球囊相比，P<0.0005）。在8条动脉粥样硬化兔髂动脉中，激光热治疗使平均管腔直径从0.19毫米增加到1.54毫米，球囊治疗使平均管腔直径从0.29毫米增加到1.84毫米（分别P<0.0001）。然而，由于血栓再梗阻，60 分钟后，激光的该值降至 1.34，球囊的值降至 0.45（P<0.0001 与术后立即相比）。因此，激光热血管成形术比球囊血管成形术产生更少的血栓形成。我们研究了激光血管成形术对高胆固醇血症兔再狭窄的预防作用。动脉粥样硬化性髂骨狭窄一侧采用球囊扩张，另一侧采用激光血管成形术。血管扩张术后，球囊扩张动脉的管腔狭窄从16%增加到58%（P<0.05），而激光热组从26%增加到30%，直接激光组从28%增加到39%。结果表明，激光血管成形术可以预防血管成形术后的再狭窄。在兔子身上评估了脉冲激光治疗的动脉的血栓形成性。治疗后 1 小时，血管镜下血栓阻塞的平均百分比在激光热治疗中为 8.6%，在对照球囊治疗中为 41.9%（n=7，P<0.0001）。准分子球囊组为 3.8%，对照球囊组为 51.9%（n=8，P<0.001）。准分子血管镜管腔阻塞百分比为1.4，钬YAG组为2.6，Nd-YAG组为2.5，球囊血管成形术组为49（P<0.0001）。结果表明，脉冲持续治疗也可以减少血栓形成。对18只狗的一侧髂动脉狭窄进行球囊扩张，另一侧动脉进行激光血管成形术扩张。在血管成形术之前，给 10 只狗注射了抗凝血酶或肝素。血管成形术后一小时，球囊对照组的平均血栓狭窄率为 62%，激光热组为 5%。肝素球囊为 8.6%，肝素激光为 1.2%，抗凝血酶激光为 0%。结果表明，激光治疗的辅助抗血栓治疗可以完全预防血栓形成。我们对27名闭塞性动脉硬化患者进行了激光热血管成形术，其中21名患者取得了成功。抗凝血酶治疗一年的通畅率为 82%，而肝素治疗的一年通畅率为 50%（P<0.05）。因此，辅助抗凝血酶的激光血管成形术对于预防急性再闭塞和再狭窄非常有用。较少的

项目成果

東丸貴信: "Reduction of Vasoreactivity and Thrombogenicity with Laser-Thermal Angioplasty : Comparison with Balloon Angioplasty" Journal of Interventional Cardiology. 6. 41-50 (1993)

Takanobu Higashimaru：“激光热血管成形术减少血管反应性和血栓形成：与球囊血管成形术的比较”介入心脏病学杂志 6. 41-50 (1993)。

Tomaru T,Uchida Y,Nakamura F,Miwa A,Kamijo T,Sugimoto T: "Reduction of vasoreactivity and thrombogenecity with laser thermal angioplasty ; comparison with balloon angioplasty" Jornal of Interventional Cardiology. 5. 301-308 (1992)

Tomaru T、Uchida Y、Nakamura F、Miwa A、Kamijo T、Sugimoto T：“激光热血管成形术减少血管反应性和血栓形成；与球囊血管成形术的比较”介入心脏病学杂志。

T.Tomaru: "Reduction of thrombogenecity with argon laser angioplasty:Comparison with balloon angioplasty" Angiology.

T.Tomaru：“用氩激光血管成形术减少血栓形成：与球囊血管成形术的比较”血管学。

東丸貴信: "Reduction of Thrombogenicity with Argon Laser Angioplasty" Japanese Heart Journal. 34. 79-90 (1993)

Takanobu Higashimaru：“用氩激光血管成形术减少血栓形成”，日本心脏杂志 34. 79-90 (1993)。

Tomaru T,Uchida Y,Nakamura F,et al: "Reduction of vasoreactivity and thrombogenecity with laser thermal angioplasty ; comparison with balloon angioplasty" Journal of Interventional Cardiology. 6. 41-50 (1993)

Tomaru T、Uchida Y、Nakamura F 等人：“激光热血管成形术减少血管反应性和血栓形成；与球囊血管成形术的比较”介入心脏病学杂志。