Abstract
Our clinical peripheral artery experience with therapeutic ultrasound, confirming its safety and feasibility and suggesting some areas of potential use, gave us confidence to attempt its use during percutaneous coronary angioplasty, when a sufficiently flexible waveguide had been developed [1,2]. Our coronary experience started in 1993 [3] using the Baxter system, which is composed of a 20 kHz generator with a 4.6 Fr diameter catheter ensheathing a nickel-titanium waveguide (see Chapter 14). This waveguide terminates in a probe tip, which was initially of 1.7 mm diameter. The catheter is of rapid exchange design, with the guide wire lumen accommodating a 0.018 inch wire, though in practice we have used 0.014 inch wires to ensure free movement of the probe. During ultrasound energy application, a saline flush is used at a rate of 10ml/min. We have routinely used guiding catheters of 8 Fr diameter; although standard Judkins shapes are often used, for better support and stability other configurations, such as Amplatz and Voda, are more often used than in conventional percutaneous transluminal coronary angioplasty (PTCA).
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References
Siegel RJ, Gaines P, Crew JR, Cumberland DC. Clinical trial of percutaneous peripheral ultrasound angioplasty. J Am Coll Cardiol 22:480–485, 1993.
Siegel RJ, Gaines P, Procter A, Fischell TA, Cumberland DC. Clinical demonstration that catheter-delivered ultrasound energy reverses arterial vasoconstriction. J Am Coll Cardiol 20:732–735, 1992.
Siegel RJ, Gunn J, Ahsan A, Fishbein MC, Bowes RJ, Oakley D, Wales C, Steffen W, Campbell S, Nita H, Mills T, Silverton P, Myler RK, Cumberland DC. Clinical coronary experience. The use of therapeutic ultrasound in percutaneous coronary angioplasty. Circulation 89:1587–1592, 1994.
Chenu P, Zakhia R, Marchandise B, Jamart J, Michel X, Schroeder E. Resistance of the atherosclerotic plaque during coronary angioplasty: A multivariate analysis of clinical and angiographic variables. Cathet Cardiovas Diagn 29:203–209, 1993.
Gunn J, Wales C, Baig W, Siegel RJ, Cumberland DC. Ultrasonic angioplasty for chronic total coronary artery occlusion. Lancet 344:1225, 1994.
Demer LL, Ariani M, Siegel RJ. High intensity ultrasound increases distensibility of calcific atherosclerotic arteries. J Am Coll Cardiol 18:1259–1262, 1991.
Steffen W, Fishbein MC, Luo H, Lee DY, Nita H, Cumberland DC, Maurer G, Siegel RJ. Use of high intensity, low frequency catheter delivered ultrasound to dissolve occlusive thrombi in coronary arteries. J Am Coll Cardiol 24:1571–1579, 1994.
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© 1996 Kluwer Academic Publishers
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Cumberland, D.C., Gunn, J., Wales, C., Myler, R.K., Siegel, R.J. (1996). Therapeutic Ultrasound in Percutaneous Coronary Angioplasty: Sheffield Experience. In: Siegel, R.J. (eds) Ultrasound Angioplasty. Developments in Cardiovascular Medicine, vol 178. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1243-7_17
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DOI: https://doi.org/10.1007/978-1-4613-1243-7_17
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