[A new transluminal angioplasty for the treatment of arteriosclerosis obliterans].
A Peripheral Simpson Atherectomy Catheter (PSAC), which permits transluminal excision and removal of diseased intima, has been tested experimentally and clinically. The device consists of a tubular housing and a cutting mechanism to excise the intima protruding into the housing. Experimentally, vascular clay model was used to estimate its efficacy. Multiple passages improved lumen size and inner smoothness, and there was some difficulty to treat curved models. Clinically, 9 lesions in 7 patients of iliofemoral atheromatous disease were treated with PSAC. Recanalization was achieved successfully except for two lesions, one a soft atheroma and the other a curved vessel. No angiographic dissections or acute arterial occlusions occurred. Despite the procedure was complicated, it seemed safe and effective. In order to improve this method, an angioplastic catheter which had a laser probe in its housing was newly designed. Nd-YAG laser was irradiated with this catheter to the atherosclerotic lesions which were induced by a high cholesterol diet in rabbit. It left smoother surface and less thermal injury than usual irradiation with contact laser probe, but it needed more energy. These results showed that PSAC can be an alternative transluminal angioplasty and the new designed laser catheter is useful, but more experiments are required to establish these procedures.
Kohno
H
H
Second Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D000818:Animals; D001161:Arteriosclerosis / Q000601:surgery; D001162:Arteriosclerosis Obliterans / Q000628:therapy*; D002404:Catheterization / Q000295:instrumentation; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D011817:Rabbits