Amplatz 血栓切割器的研究

目的：评估Ａｍｐｌａｔｚ血栓切割器的安全有效性。方法：用人体血液制备成４天或１０天血凝块，采用转速为８００００ｒｐｍ、１０００００ｒｐｍ和１２００００ｒｐｍ，时间为３０ｓ切割，然后用不同网径过滤称重得到切割后血栓颗粒大小分布，并对１０例股浅动脉或人造血管血栓病人进行血栓切割，采用转速１０００００ｒｐｍ，时间为３２～３３０ｓ。结果：以转速８００００ｒｐｍ、１０００００ｒｐｍ和１２００００ｒｐｍ切割血栓后，颗粒小于１５μｍ占总重量分别为９４．２０％、９６．２９％和９４．７０％。４ｄ和１０ｄ血凝块切割后，颗粒大于１５μｍ分别为５．１６％和４．７８％。临床应用中，１０例病人有８例获取完全成功，２例部分成功。结论：Ａｍｐｌａｔｚ血栓切割器对急性、亚急性血栓切割安全有效，尤其对人造血管内的血栓有效。     

Comparison of Standard and Irrigated Radiofrequency Ablation in the Canine Ventricle

Standard and Irrigated RF Ablation Lesions. Introduction : radiofrequency ablation is successful for treating some arrhythmias but not for CAD-VT, possibly due to insufficient lesion size. Irrigated electrodes were developed to apply higher power for longer duration to create larger lesions. Our objective was to characterize and compare irrigated and standard ablation in terms of lesion size, crater, and coagulum formation. Additionally, a method is proposed for creating large irrigated lesions without craters.
Methods and Results : Three ablation protocols were conducted in canine ventricles. Protocol I: standard ablation was performed in power mode at 10, 20, 30, and 50 W, and electrode-temperature mode at 70° and 90°C (120 sec). Protocol II: irrigated ablation was conducted with 30 and 50 W (30 and 120 sec). Protocol III: to create large lesions without craters, irrigated ablation was performed at 20 W (5 and 10 min). With a standard electrode, the largest lesions were created using 20 W (358 ± 194 mm³) and using 90°C (301 ± 130 mm²). Ablation duration decreased with power for the power mode standard ablations. The largest irrigated lesions were formed using 50 W (986 ± 357 mm²). Large lesions without craters were created with irrigation using 20 W for 10 minutes (602 ± 175 mm²). Coagulum was seen for most standard ablations but infrequently for irrigated ablations. Craters were observed with 30 and 50 W irrigated ablation but were not observed with 20 W irrigated ablation.
Conclusion : Irrigated ablation created larger lesions than standard; large lesions may be created without craters using moderate power and long duration.