超声再通慢性闭塞冠脉及碎片的体外研究

An in vitro study on ultrasound recanalization of coronary artery occlusion and debris

目的体外观察低频高能超声介入技术在再通慢性完全闭塞冠脉中的效果,分析产生的消融碎片形态和大小。方法体外对10条完全闭塞的冠脉血管片段行超声成形术,消融前后行血管造影检查;再通后的血管内腔冲洗液收集于孔径0.5μm滤器,并送电镜检查。结果10条100%闭塞的冠脉片段经超声成形术均成功再通,平均残余狭窄(70.3±4.2)%,无血管壁穿孔和夹层现象;消融碎片形态多数为颗粒形(70.2%类圆形,28.0%多角形);碎片平均长径(5.9±8.0)μm,短径(4.8±5.0)μm。结论超声消融治疗慢性闭塞冠脉是有效的,消融碎片微小而不致血管远端栓塞。

Objective To assess the efficacy of ultrasonic energy on recanalization of human coronary arteries and analyze debris of plaque during the experiment in vitro. Methods Ultrasound angioplasty was performed in vitro on totally occluded coronary arteries （n= 10）. Angiographic analysis was finished before and after ultrasound process in all segments. Luminal surface of each artery was effused, and effluent was filtered through 0. 5 μm filter, which was examined by scanning electron microscopy. Results Ultrasonic angioplasty achieved successful recanalization without perforation and dissection in all experimental segments with a mean residual stenosis of （70. 3±4. 2）%. Most of the particles appeared as granules （ball-shaped 70. 2%, muhangular 28. 0% ）. The mean size of debris was （5.9±8. 0） μm （long diameter） and （4. 8±5.0） μm （short diameter）. Conclusion Ultrasound angioplasty is effective in the recanalization of total coronary occlusion. In vitro experimental findings suggest that the debris particles of disruption were too small to result in distal embolism of the arteries.