Samuel S. Ahn, M. D. , David Auth, Ph. D. , Daniel R. Marcus, M. D

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Presentation transcript:

Removal of focal atheromatous lesions by angioscopically guided high-speed rotary atherectomy Samuel S. Ahn, M.D., David Auth, Ph.D., Daniel R. Marcus, M.D., Wesley S. Moore, M.D. Journal of Vascular Surgery Volume 7, Issue 2, Pages 292-300 (February 1988) DOI: 10.1016/0741-5214(88)90148-6 Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Atherectomy burr and guide wire. Burrs of 1.25 and 4.5 mm diameter, respectively, are shown. Note diamond microchips embedded in distal half of burr. Also note the coaxial spring-tip (top) and semirigid (bottom) guide wires. Journal of Vascular Surgery 1988 7, 292-300DOI: (10.1016/0741-5214(88)90148-6) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Atherectomy catheter system. See text for details. Journal of Vascular Surgery 1988 7, 292-300DOI: (10.1016/0741-5214(88)90148-6) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Differential cutting: its application in soft and hard tissue. Journal of Vascular Surgery 1988 7, 292-300DOI: (10.1016/0741-5214(88)90148-6) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Photomicrographs of successfully atherectomized artery seen on cross section. Note smooth, highly polished, intraluminal surface denuded of intima and endothelial cells. (Hematoxylin-eosin stain; original magnification × 40.) Journal of Vascular Surgery 1988 7, 292-300DOI: (10.1016/0741-5214(88)90148-6) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Same specimen as in Fig. 4. Note that elastin fibers of outer media and adventitia are intact. (Verhoeff-van Gieson stain; original magnification × 40.) Journal of Vascular Surgery 1988 7, 292-300DOI: (10.1016/0741-5214(88)90148-6) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Scanning electron microscopy at 20 × magnification of sagittally cut, atherectomized popliteal artery. Note smooth, polished luminal surface. Journal of Vascular Surgery 1988 7, 292-300DOI: (10.1016/0741-5214(88)90148-6) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Angiogram of an in situ human cadaver superficial femoral artery (A) before and (B) after rotary atherectomy. Journal of Vascular Surgery 1988 7, 292-300DOI: (10.1016/0741-5214(88)90148-6) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 8 Coulter counter analysis of atherectomized particles. Vertical axis is the distribution of particles. Horizontal axis is the relative threshold in size of the particles. PPT Small = precipitate of particles generated by 2.5 mm burr; PPT Large = precipitate of particles generated by 4.5 mm burr; SNT Small = supernatant of centrifuged colloidal suspension generated by 2.5 mm burr; SNT Large = supernatant of centrifuged colloidal suspension generated by 4.5 mm burr. Note that particles are generally smaller than 10 μm. Journal of Vascular Surgery 1988 7, 292-300DOI: (10.1016/0741-5214(88)90148-6) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 9 Radionuclide scan of dog injected with technetium 99m—labeled atherectomized particles. Note that most particles pass through leg and accumulate in the lung, liver, and spleen, the reticuloendothelial system. Journal of Vascular Surgery 1988 7, 292-300DOI: (10.1016/0741-5214(88)90148-6) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 10 Radionuclide scan of control dog injected with technetium 99m in saline solution. Note accumulation of technetium radioactivity in the parotid gland, thyroid, heart, stomach, bladder, and joints. Journal of Vascular Surgery 1988 7, 292-300DOI: (10.1016/0741-5214(88)90148-6) Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions