Percutaneous ultrasonic angioplasty:initial clinical experience.
Percutaneous catheter-delivered ultrasound energy for arterial recanalisation was applied in eight patients with peripheral vascular disease. Four patients had severe claudication with total occlusion and four high-grade stenosis in a superficial femoral or popliteal artery. A prototype ultrasound probe, with a frequency of 20 kHz and a power output of 20-35 W/cm2, was ensheathed in a 7F catheter and advanced to the occlusions under angiographic guidance. Three of four complete occlusions were recanalised in 120s or less, leaving a residual stenosis of mean (SD) diameter 54 (5)%. Ultrasound energy reduced the diameter of the isolated stenoses from 77 (14)% to 37 (21)%. All lesions were further treated with balloon angioplasty, resulting in a mean residual stenosis of 20 (9)%. There was no evidence of arterial emboli, dissection, spasm, or perforation. The major limitations of this ultrasound system are ease of steering and flexibility. Percutaneous catheter-delivered ultrasound energy appears promising for safe and effective use in atherosclerotic peripheral vessels to reduce arterial stenoses and recanalise complete arterial obstructions.
Siegel
R J
RJ
Cedars-Sinai Medical Center, Los Angeles, California.
Cumberland
D C
DC
Myler
R K
RK
DonMichael
T A
TA
D000800:Angioplasty, Balloon / Q000379:methods*; D001161:Arteriosclerosis / Q000517:prevention & control / Q000628:therapy*; D002408:Catheters, Indwelling; D005069:Evaluation Studies as Topic; D005263:Femoral Artery; D006801:Humans; D011150:Popliteal Artery; D014465:Ultrasonics / Q000295:instrumentation / Q000379:methods*