ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00829.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00830.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

This study was performed to assess the ablational properties of 1.4‐, 1.7‐, and 2.0‐mm wire‐guided multiple fiber catheters coupled to a XeCl excimer laser. Samples of postmortem human aorta were irradiated in blood at fluences of 40, 50, and 60 mJ/mm2. Our results indicate that: 1) an increase in the active irradiation coverage results in an increase in the ablation efficiency; 2) the ablation efficiency is not fluence related using the 1.4‐ or 1.7‐mm multiple fiber catheter but efficiency is fluence dependent using the 2.0‐mm multiple fiber catheter; 3) the depth of tissue ablated with a multiple fiber catheter depends primarily upon the proportion of the active irradiation coverage at the catheter tip: 4) the 2.0‐mm multiple fiber catheter induces craters surrounded by a larger zone of tissue damage than that observed with the 1.4‐ or 1.7mm multiple fiber catheter; and 5) the 2.0‐mm multiple fiber catheter should be used cautiously for laser angioplasty because of its high penetration and its risk of arterial wall damage. (J Interven Card

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00831.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Laser angioplasty has now been successfully performed on over 2,000 patients worldwide. Two systems (Advanced Interventional Systems, and Spectranetics, Corp.) have now received initial approval from the Food and Drug Administration. As with all new interventional techniques designed as an alternative to balloon angioplasty, there are a variety of instrument related issues that merit consideration in terms of patient selection as well as operator technique. While the ultimate role of laser angioplasty in the percutaneous revascularization of coronary artery disease remains to be established with certainty, laser angioplasty is, in fact, being currently used on a widespread basis as an alternative or an adjunct to balloon angioplasty in a large number of centers worldwide.1–5Industry projections suggest that the use of this technique will increase further over the next decade. Accordingly, the purpose of this article is to discuss specific issues regarding instrumentation, native anatomical considerations, operator technique, and complications that relate specifically to the applied use of this technology as it is currently being used. (J Interven Cardiol 1992; 5:275–

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00832.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Alternatives to balloon angioplasty, which has a restenosis rate of 25%–68%, are being sought for patients at high risk for restenosis. The mid‐infrared holmium laser may have properties more advantageous for coronary angioplasty than the ultraviolet excimer laser. The Coronary HaloCath (Trimedyne, Inc.) has a diverging lens that allows the beam diameter to approximate the catheter tip diameter, increasing the size of the channel that can be created by laser ablation. This unique ability may make it more efficacious in treating arteriosclerotic disease. This device was used to treat: I) a chronic total occlusion, creating a recanalized diameter larger than the catheter diameter; and 2) an ostial right coronary stenosis, which opened more readily than would have been expected with balloon angioplasty. The Coronary HaloCath may prove useful in difficult‐to‐treat coronary lesions. (J Interven Cardiol 1992; 5:

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00833.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The feasibility of an Nd: YAG laser system with automatic control of hot‐tip probe temperature was examined in 15 segments (14.7 ± 6 cm in length) of iliofemoral arteries from 13 patients. The hot‐tip temperature to be attained and the upper limit temperature at which lasing was to be stopped were preset. A catheter with a 1.8‐mm hot‐tip probe was introduced into the obstructed segment and angioplasty (lasing time 5–10 sec) was performed under angioscopic guidance. Recanalization was observed in all segments without obvious complications. No thermal effects below 50°C, coagulation at 100°C, carbonization at 200°C, or sticking of the hot‐tip to the luminal surface at 300°C or over, were observed by angioscopy. Rapid recanalization was obtained between 200°C and 300°C. The results indicate that this novel laser system is feasible and hot‐tip temperature between 200°C and 300°C is ideal for treatment of chronic arterial obstruction in Japanese patients. (J Interven C

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00834.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00835.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A combination of interventional devices including the RotablatorRand directional coronary atherectomy (DCA) was used to treat a 39‐year‐old patient with a complex lesion of the right coronary artery. The devices enabled the recanalization and reconstruction of the diseased vessel without laceration or dissection, leaving a smooth‐edged segment. The histological analysis of the tissue obtained from DCA revealed no predictors of restenosis, like highly cellular material or media. Thus, combination of mechanical interventional devices allowed to treat a highly complex lesion without lacerating the vessel and leaving an excellent acute and long‐term outcome.(J Interven Cardiol 1992; 5:

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00836.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Angioplasty in the setting of poor left ventricular function may involve coronary anatomy with special challenges to the technique of the operator and the safety of the patient. Spontaneous coronary aneurysms involve a disruption of the tissue of the vessel and the linear geometry of the lumen. This case reports the dilatation of a stenosis traversing a large spontaneous aneurysm in a patient with severe left ventricular dysfunction. Using a novel guidewire technique to traverse the lesion and a perfusion balloon catheter to slowly dilate it, an excellent angiographic and clinical result was achieved. (J Interven Cardiol 1992; 5:232–33

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00837.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Guiding catheter strategies form an important component of successful PTCA. Selection of appropriate guiding catheters is essential for providing adequate back‐up support and visualization. Hockey stick guiding catheters are an excellent choice for performing PTCA of the right coronary artery and for saphenous vein grafts. (J Interven Cardiol 1992; 5:331–

ISSN:0896-4327    

DOI:10.1111/j.1540-8183.1992.tb00838.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY