Percutaneous transluminal ultrasonic angioplasty: preliminary clinical report of ultrasound plaque ablation in totally occluded peripheral arteries.
Peripheral arterial obstructive disease has been treated with ultrasound ablation. Thirty two patients (pts), mean age 67 +/- 10 years underwent angiosonoplasty, with a prototype ultrasonic system, due to severe claudication (31%), rest pain (44%), rest pain and ulceration (25%). Angiosonoplasty was successful in 26/32 (81%) stenoses, (1/2 iliac, 9/2 femorals, 11/12 popliteal, 5/6 tibial). Angiography before and after angiosonoplasty confirmed that the lesions were successfully opened, (81%, p less than 0.05). A mean of 3 +/- 2 passes were required to adequately remove sufficient plaque. Balloon angioplasty was used in combination with angiosonoplasty in 11/32 (34%) occluded vessels. Complications included groin hematoma in 4 pts (12%) and vascular spasm in two patients (6%). Within 24 hours, 27/32 (94%) pts were discharged clinically improved. Reocclusion occurred in 4 pts (12%) immediately after the procedure. Ankle brachial indices significantly increased from 0.52 +/- 0.10 before to 0.70 +/- 0.12 after (p less than 0.05). In conclusion, the use of ultrasound energy to ablate atherosclerotic plaque would appear safe, and has shown no restenosis and a low incidence of complications over a six month period.
Monteverde-Grether
C
C
Coronary Care Unit, Hospital of Cardiology Luis Méndez, Centro Médico Nacional, Inst. Mexicano del Seguro Social, D.F.
Valez y Tello de Meneses
M
M
Nava-López
G
G
Jauregui
R
R
Borges
J
J
Abundes
A
A
López-Cuéllar
M
M
Armilla
M
M
D000368:Aged; D000800:Angioplasty, Balloon / Q000295:instrumentation / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000628:therapy*; D012008:Recurrence; D014464:Ultrasonic Therapy / Q000009:adverse effects / Q000295:instrumentation