Objective To evaluate the relative contribution of every part of vascul ar wall to lumen area loss after angioplasty.Methods Angioplasty was performed on rabbits iliac atherosclerosis mode l. Histomorphometric resul...Objective To evaluate the relative contribution of every part of vascul ar wall to lumen area loss after angioplasty.Methods Angioplasty was performed on rabbits iliac atherosclerosis mode l. Histomorphometric results of histological cross sectional areas from target vessels of animals killed immediately after angioplasty (acute group, n=20) were compared with those of the same areas from animals killed 4 weeks after the proc edure (chronic group, n=23), when restenosis occurred in this model. If taking 3 0% diameter decrease as restenosis criteria, the chronic group was further divid ed into two subgroups (nonrestenosis subgroup and restenosis subgro up )and their histomorphometric results were also compared.Results The lumen area decreased by 0.48 mm 2 from acute group to chro nic group (acute group 0.86±0.23?mm 2 vs chronic group 0.38±0.20?mm 2, P< 0.001). Over the same period intimal area increased by 0.12 mm 2 and the area circumscribed by inner elastic lamina (IEL area) decreased by 0.36 mm 2. Intimal hyperplasia could only explain 25% of the later lumen area loss. We further found a more significant IEL area decrease in RS subgroup than in NRS s ubgro up (0.68±0.35?mm 2 vs 0.94±0.14?mm 2, P<0.05), despite the sam e intimal area (0.39±0.16?mm 2 vs 0.41± 0.31?mm 2, P=NS). T he d ifferent lumen area between RS subgroup and NRS subgroup (0.27±0.10?mm 2 vs 0 .55±0.10?mm 2, P<0.001) was predominantly due to the greater IEL shrinking in RS subgroup.Conclusion Our data indicate that later lumen area loss after angiopla sty results from both intimal hyperplasia and arterial shrinking (remodeling ), but the latter plays a much greater role.展开更多
We reported 11 cases of excimer laser coronary angioplasty (ELCA). All were males, the average age being 59.7 years. Five patients had sustained previous myocardial infarctions with post-infarction angina in 2 cases a...We reported 11 cases of excimer laser coronary angioplasty (ELCA). All were males, the average age being 59.7 years. Five patients had sustained previous myocardial infarctions with post-infarction angina in 2 cases and 6 presented angina only. Coronary angiograms showed stenosis in LAD (N9), LCX(N6) and RCA (N6). According to the ACC/AHA classification, 6 were categorized as type B, and 5 type C. ELCA with adjunctive PTCA were performed in all 8 patients, 1. 3 mm (energy density 14. 5 mJ) and 1.6 mm (energy density 21.0 mJ) laser catheters with 20Hz pulse frequency were used There was one failure and in another ELCA was successful but death followed the procedure. The overall result was laser success 10 out of the 11 cases and procedure success 9.展开更多
目的评价扩张微导管(channel dilator)在冠状动脉慢性完全闭塞(chronic total occlusion,CTO)病变介入治疗中的安全性及疗效。方法5例冠状动脉CTO患者入选。其中4例右冠状动脉病变,1例左前降支病变;开口处病变2例,3例患者闭塞处有分支...目的评价扩张微导管(channel dilator)在冠状动脉慢性完全闭塞(chronic total occlusion,CTO)病变介入治疗中的安全性及疗效。方法5例冠状动脉CTO患者入选。其中4例右冠状动脉病变,1例左前降支病变;开口处病变2例,3例患者闭塞处有分支存在。5例患者均采用逆向导丝技术进行冠状动脉介入治疗。结果4例患者扩张微导管顺利通过间隔支,1例顺利通过回旋支至右冠状动脉侧支;其中2例通过圈套器套扎逆向导丝的方法完成介入治疗,2例逆向导丝通过扩张微导管送至前向指引导管内,1例扩张微导管未能送至闭塞血管近段,未能开通闭塞血管。5例患者住院期间均未出现并发症及死亡。结论扩张微导管用于冠状动脉CTO病变逆向介入治疗是安全、有效的。展开更多
文摘Objective To evaluate the relative contribution of every part of vascul ar wall to lumen area loss after angioplasty.Methods Angioplasty was performed on rabbits iliac atherosclerosis mode l. Histomorphometric results of histological cross sectional areas from target vessels of animals killed immediately after angioplasty (acute group, n=20) were compared with those of the same areas from animals killed 4 weeks after the proc edure (chronic group, n=23), when restenosis occurred in this model. If taking 3 0% diameter decrease as restenosis criteria, the chronic group was further divid ed into two subgroups (nonrestenosis subgroup and restenosis subgro up )and their histomorphometric results were also compared.Results The lumen area decreased by 0.48 mm 2 from acute group to chro nic group (acute group 0.86±0.23?mm 2 vs chronic group 0.38±0.20?mm 2, P< 0.001). Over the same period intimal area increased by 0.12 mm 2 and the area circumscribed by inner elastic lamina (IEL area) decreased by 0.36 mm 2. Intimal hyperplasia could only explain 25% of the later lumen area loss. We further found a more significant IEL area decrease in RS subgroup than in NRS s ubgro up (0.68±0.35?mm 2 vs 0.94±0.14?mm 2, P<0.05), despite the sam e intimal area (0.39±0.16?mm 2 vs 0.41± 0.31?mm 2, P=NS). T he d ifferent lumen area between RS subgroup and NRS subgroup (0.27±0.10?mm 2 vs 0 .55±0.10?mm 2, P<0.001) was predominantly due to the greater IEL shrinking in RS subgroup.Conclusion Our data indicate that later lumen area loss after angiopla sty results from both intimal hyperplasia and arterial shrinking (remodeling ), but the latter plays a much greater role.
文摘We reported 11 cases of excimer laser coronary angioplasty (ELCA). All were males, the average age being 59.7 years. Five patients had sustained previous myocardial infarctions with post-infarction angina in 2 cases and 6 presented angina only. Coronary angiograms showed stenosis in LAD (N9), LCX(N6) and RCA (N6). According to the ACC/AHA classification, 6 were categorized as type B, and 5 type C. ELCA with adjunctive PTCA were performed in all 8 patients, 1. 3 mm (energy density 14. 5 mJ) and 1.6 mm (energy density 21.0 mJ) laser catheters with 20Hz pulse frequency were used There was one failure and in another ELCA was successful but death followed the procedure. The overall result was laser success 10 out of the 11 cases and procedure success 9.
文摘目的评价扩张微导管(channel dilator)在冠状动脉慢性完全闭塞(chronic total occlusion,CTO)病变介入治疗中的安全性及疗效。方法5例冠状动脉CTO患者入选。其中4例右冠状动脉病变,1例左前降支病变;开口处病变2例,3例患者闭塞处有分支存在。5例患者均采用逆向导丝技术进行冠状动脉介入治疗。结果4例患者扩张微导管顺利通过间隔支,1例顺利通过回旋支至右冠状动脉侧支;其中2例通过圈套器套扎逆向导丝的方法完成介入治疗,2例逆向导丝通过扩张微导管送至前向指引导管内,1例扩张微导管未能送至闭塞血管近段,未能开通闭塞血管。5例患者住院期间均未出现并发症及死亡。结论扩张微导管用于冠状动脉CTO病变逆向介入治疗是安全、有效的。
