动脉血管钙化斑块旋磨研究综述

翟少波; 刘瑶; 沈斌; 李嘉豪; 郭占玲

doi:10.13394/j.cnki.jgszz.2023.0162

动脉血管钙化斑块旋磨研究综述

doi: 10.13394/j.cnki.jgszz.2023.0162

翟少波^1,,
刘瑶^{1, 2, ,},
沈斌³,
李嘉豪¹,
郭占玲³

1.
中北大学机械工程学院, 太原 030051
2.
广东省微创手术器械设计与精密制造重点实验室, 广州 510000
3.
浙江清华长三角研究院海纳精密加工中心, 浙江嘉兴 314000

基金项目: 广东工业大学广东省微创手术器械设计与精密制造重点实验室开发基金资助项目（MISIMT-2022-2）；浙江省自然科学基金资助项目（LY23E050002）；山西省基础研究计划面上项目（资助号：202303021211146）；平湖市科技计划项目（GY202418）。

详细信息

通讯作者:
刘瑶，男，1990年生，博士、副教授。主要研究方向：生物组织加工和精密磨削。 E-mail：liuyao@nuc.edu.cn

中图分类号: TG58; TG74; R608
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- 被引次数: 0
出版历程
- 收稿日期: 2023-08-08
- 修回日期: 2023-11-20
- 录用日期: 2023-11-28
- 网络出版日期: 2024-09-25
- 刊出日期: 2024-08-20

Review of research on arterial vascular calcified plaque grinding

ZHAI Shaobo^1
,,
LIU Yao^{1, 2
, ,},
SHEN Bin³,
LI Jiahao¹,
GUO Zhanling³

1.
School of Mechanical Engineering, North University of China, Taiyuan 030051, China
2.
Guangdong Key Laboratory of Minimally Invasive Surgical Instrument Design and Precision Manufacturing, Guangzhou 510000, China
3.
Zhejiang Tsinghua Yangtze River Delta Research Institute Haina Precision Machining Center, Jiaxing 314000, Zhejiang, China

摘要

摘要: 旋磨术是治疗血管钙化病变的一种微创技术，通过微型砂轮去除堵塞在血管内的钙化斑块组织，达到疏通血管、重建血液流动的目的。钙化斑块组织堵塞血管造成供血不足，易诱发多种心血管疾病，其硬度较大导致球囊和支架无法撑开，目前临床上普遍采用旋磨术进行疏通。首先综述了旋磨术的相关研究成果和发展趋势，并对旋磨器械发展进行了介绍；其次总结了旋磨术优劣势的相关内容；然后对旋磨机理进行了详细的分析；最后总结了旋磨术目前存在的不足与未来的研究方向。
- 旋磨术 /
- 旋磨装置 /
- 旋磨机理 /
- 差异切削 /
- 并发症
Abstract: Significance Plaques are clogging deposits formed by the accumulation of fat and calcium on the inner walls of arteries. Their formation can lead to narrowing the inner diameter of the blood vessel and hardening the blood vessel wall, thereby limiting blood flow and inducing various cardiovascular diseases such as coronary heart disease and peripheral arterial disease. Numerous factors, such as lifestyle changes and population aging, have lead to an increase in the number of patients with cardiovascular disease in China in recent years. The annual growth rate of vascular interventional therapy has remained at around 17% for a decade due to the continuous development of interventional medical means. China's large population of vascular disease and the special situation of calcified plaque lesions have created a huge demand for rotational interventional therapy. By analyzing the current research on rotary grinding, this paper summarizes the existing deficiencies and suggests a follow-up research direction to accelerate the exploration of rotary grinding's mechanism and master the core technology theory. Progress: Firstly, the research on rotary grinding instruments is summed up in three parts: (1) The rotary grinding therapeutic apparatus mentioned here contains a description of its basic features, including the RA from Boston Science and the OA from CSI. The differences between the two were compared in terms of technical indications, clinical indications, mechanism of action, and product upgrades. (2) The preparation method for the grinding wheel and the differential cutting of the grinding wheel are presented in summary. Currently, grinding wheels are mostly created by electroplating, and some experts have suggested using the "engraving" technique. Differential grinding wheel cutting involves two primary principles. Boston Science proposed differential cutting that utilizes the theory of workpiece deformation during the cutting process of flexible materials. The second mechanism is based upon the theory of the dynamic pressure film in water. (3) A summary was provided regarding the structure and techniques of two different types of special rotary grinding guide wires, as well as the potential negative consequences during operation. Secondly, the differences between treatments are compared, such as rotational atherectomy, conventional balloon stenting, rotational resection, ELCA and shock wave balloon. The advantages of plaque rotary grinding are explained in detail. The likelihood of occurrence, explanations, methods of treatment, and other research on complications following rotational grinding are evaluated and summarized. Slow/non-reflow, vascular dissection, vascular perforation, grinding head incarceration, guide wire bias, etc., are all included. Engineering proposes controlling grinding parameters and improving the performance of related equipment to reduce the probability of complications. Finally, the research related to the mechanism of rotary grinding is examined. The main factors are rotary grinding force, rotary grinding heat, and rotary grinding debris. The grinding force is analyzed in a specific way by the current research, which focuses on the impact of grinding wheel speed and quality, blood vessel diameter, fluid dynamic pressure, and other factors on the grinding force. Research on rotary grinding heat focuses on reducing temperature through liquid scrubbing, but there is limited attention paid to thermal damage from an engineering perspective. The analysis of the wear debris mostly discusses the relationship between the size and the speed of the grinding wheel. Conclusions and Prospects (1) At present, the rotary grinding device and related consumables are all imported from the United States. In the future, Chinese substitution will be an important development direction. The development of Chinese rotary grinding products is under process now. (2) The study of the differential cutting mechanism and the design of the surface characteristics of the rotary grinding head to achieve non-invasive vascular tissue removal and efficient plaque tissue removal plays an important role in reducing other injuries caused by surgery. (3) The safety of the grinding process could be improved by optimizing the grinding parameters. There are few discussions on whether other factors in the grinding process will affect parameters such as grinding force, grinding debris and grinding heat. This is the direction of continuous research. (4) There are few theoretical studies on the grinding guide wire, and the performance of the guide wire is the main factor in determining whether it is biased or broken during the operation. Explore the possibility of processing different materials into high-performance grinding guide wires and new processing methods. On the premise of ensuring product performance, minimizing device costs and surgical costs is also a key research direction in the future. (5) According to the characteristics of plaque removal, the development of new products with better performance, such as laser plaque ablation products, shock wave balloons, etc., is also very marketable.
- rotational atherectomy /
- rotary grinding device /
- rotary grinding mechanism /
- differential cutting /
- complications

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图 1 钙化斑块的形成过程和旋磨去除

Figure 1. Formation process and rotary grinding removal of calcified plaque

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图 2 旋磨装置

Figure 2. Rotary grinding device

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图 3 旋磨砂轮的制备^[11-12]

Figure 3. Preparation of rotational grinding wheel^[11-12]

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图 4 基于形变理论的差异切削

Figure 4. Differential cutting based on deformation theory

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图 5 旋磨导丝^[19-20]

Figure 5. Rotary grinding guide wire^[19-20]

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图 6 部分斑块的治疗方法

Figure 6. Some treatments of plaque

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图 7 旋磨术体外试验平台^[67]

Figure 7. Rotary grinding in vitro test platform^[67]

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图 8 旋磨参数对磨削力的影响^[74]

Figure 8. Influence of the grinding parameters on the grinding force^[74]

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图 9 热成像检测温度变化

Figure 9. Thermal imaging detects temperature changes

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图 10 旋磨热模型^[80-81]

Figure 10. Rotary grinding heat model^[80-81]

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图 11 旋磨参数与磨屑尺寸的关系^[74,83,85]

Figure 11. Relationship between grinding parameters and debris size^[74,83,85]

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表 1 RA与OA对比

Table 1. Comparison of RA and OA

分类	比较项目	OA	RA
技术指征	旋磨砂轮	双向磨削	单向磨削
	旋磨砂轮	1.25 mm砂轮处理较大直径的斑块	多个尺寸( 8个)， 1.25 ～2.05 mm
	导丝	ViperWire	RotaWire
	动力源	电子系统	气动系统
	转速	80 000～120 000 r/min	140 000～ 190 000 r/min
作用机理	旋转方式	公转 + 自转	自转
	旋转方式	偏心安装的金刚石砂轮利用离心力做轨道运动	金刚石磨头尖端在导丝上同心旋转
	去除方式	砂轮磨削	砂轮磨削
临床指征		导丝可通过严重钙化的冠状动脉病变，不适合多次更换旋磨砂轮的情况	导丝穿过较困难时，采用小直径砂轮开通闭塞病变

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表 2 旋磨术并发症

Table 2. Rotary grinding complications

并发症	图片	产生原因	处理方法
慢血流/无复流^[40-43]		·血小板聚集，血栓形成 ·远端冠状动脉痉挛 ·旋磨头直径过大，转速快，病变长，单次旋磨时间过长	·维持动脉血压 ·使用冠状动脉血管扩张剂 ·冠脉内注射药物（硝酸甘油、维拉帕米） ·使用小尺寸砂轮和较低速度
血管夹层^{[41, 44-46]}		·磨头过大，推进速度过快 ·转速过高、旋磨次数过多	·停止旋磨 ·保持导丝位置而后使用血管成形术等方法治疗
血管穿孔^{[41, 44-46]}		·病变严重成角 ·旋磨头过大 ·导丝偏离 ·球囊尺寸或压力过大 ·支架尺寸或释放压力过大 ·不适当的手法	·尽量避免在病变严重扭曲的情况下使用 ·使用小尺寸砂轮和较低速度 ·紧急采用心包穿刺 ·采用球囊填充、覆膜支架等技术
旋磨头嵌顿^{[41, 47-49]}		·旋磨头离病变过近 ·转速过低（＜10 000 r/min） ·旋磨头在病变中间停顿 ·已发生痉挛或夹层的病变 ·未注入旋磨液	·来回拉动导丝 ·插入导管切割砂轮驱动轴 ·植入球囊扩张与砂轮相邻，扩张球囊以松动旋磨砂轮 ·取回失败时采用外科手术
导丝偏置和断裂^[50]		·弥漫、迂曲病变 ·导丝进入细小成角的血管分支 ·导丝弯曲、打折 ·导丝嵌顿后用力回撤	·送入另一根导丝，小球囊推送，以助导丝退出 ·经导管撤出旋磨导丝

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参考文献(85)

[1]	FALK E, SHAH P K, FUSTER V. Coronary plaque disruption [J]. Circulation,1995,92(3):657-671. doi: 10.1161/01.CIR.92.3.657
[2]	ALLALI A, ABDEL-WAHAB M, ELBASHA K, et al. Rotational atherectomy of calcified coronary lesions: current practice and insights from two randomized trials [J]. Clinical Research in Cardiology,2022,112(9):1143-1163. doi: 10.1007/s00392-022-02013-2
[3]	CHAMBERS J W, DIAGE T. Evaluation of the Diamondback 360 coronary orbital atherectomy system for treating de novo, severely calcified lesions [J]. Expert Review of Medical Devices,2014,11(5):457-466. doi: 10.1586/17434440.2014.929493
[4]	GéNéREUX P, BETTINGER N, REDFORS B, et al. Two‐year outcomes after treatment of severely calcified coronary lesions with the orbital atherectomy system and the impact of stent types: Insight from the ORBIT II trial [J]. Catheterization and Cardiovascular Interventions,2016,88(3):369-377. doi: 10.1002/ccd.26554
[5]	GÉNÉREUX P, LEE A C, KIM C Y, et al. Orbital atherectomy for treating de novo severely calcified coronary narrowing (1-year results from the pivotal ORBIT II trial) [J]. The American Journal of Cardiology,2015,115(12):1685-1690. doi: 10.1016/j.amjcard.2015.03.009
[6]	PIETZSCH J B, GEISLER B P, IKENO F. Cost-effectiveness of orbital atherectomy compared to rotational atherectomy in treating patients with severely calcified coronary artery lesions in Japan [J]. Cardiovascular Intervention and Therapeutics,2018,33:328-336. doi: 10.1007/s12928-017-0488-3
[7]	KINI A S, VENGRENYUK Y, PENA J, et al. Optical coherence tomography assessment of the mechanistic effects of rotational and orbital atherectomy in severely calcified coronary lesions [J]. Catheterization and Cardiovascular Interventions,2015,86(6):1024-1032. doi: 10.1002/ccd.26000
[8]	CHAMBERS J W, FELDMAN R L, HIMMELSTEIN S I, et al. Pivotal trial to evaluate the safety and efficacy of the orbital atherectomy system in treating de novo, severely calcified coronary lesions (ORBIT II) [J]. JACC: Cardiovascular Interventions,2014,7(5):510-518. doi: 10.1016/j.jcin.2014.01.158
[9]	UETANI T, ISHII H, SAKAI S I, et al. Beneficial effect of rotational atherectomy with low platform speed on late outcomes [J]. International Journal of Cardiology,2004,94(1):35-40. doi: 10.1016/j.ijcard.2003.03.014
[10]	LYU J J, LIU Y, GURM H S, et al. Electroplating a miniature diamond wheel for grinding of the calcified plaque inside arteries [J]. Medical Engineering and Physics,2023,113:103969. doi: 10.1016/j.medengphy.2023.103969
[11]	NAKAO M, TSUCHIYA K, MAEDA W, et al. A rotating cutting tool to remove hard cemented deposits in heart blood vessels without damaging soft vessel walls [J]. CIRP Annals,2005,54(1):37-40. doi: 10.1016/S0007-8506(07)60044-4
[12]	LEE G Y, WIE K H, HONG Y S, et al. A study of tool pattern design for calcified-atherosclerotic-plaque removal robot [C]//Proceedings of the 2010 3rd IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics, September 26-29, 2010, [s.n.], Tokyo. New York: IEEE, 2010: 582-587.
[13]	李雄, 刘芳菲, 彭晖, 等. 冠状动脉钙化及旋磨术研究进展 [J]. 心脑血管病防治,2010,10(6):460-461. doi: 10.3969/j.issn.1009-816X.2010.06.23 LI Xiong, LIU Fangfei, PENG Hui, et al. Research progress of coronary artery calcification and rotational atherectomy [J]. Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases,2010,10(6):460-461. doi: 10.3969/j.issn.1009-816X.2010.06.23
[14]	KIM M H, KIM H J, KIM N N, et al. A rotational ablation tool for calcified atherosclerotic plaque removal [J]. Biomedical Microdevices,2011,13:963-971. doi: 10.1007/s10544-011-9566-y
[15]	HAMROCK B J, SCHMID S R. Fundamentals of fluid film lubrication [M]. Boca Raton, Florida: CRC Press,2004.
[16]	SHIH A J, LIU Y, ZHENG Y. Grinding wheel motion, force, temperature, and material removal in rotational atherectomy of calcified plaque [J]. CIRP Annals,2016,65(1):345-348. doi: 10.1016/j.cirp.2016.04.012
[17]	SHIH A, DENKENA B, GROVE T, et al. Fixed abrasive machining of non-metallic materials [J]. CIRP Annals - Manufacturing Technology,2018(2):767-790.
[18]	ZHENG Y, LIU Y, PITRE J J, et al. Computational fluid dynamics modeling of the burr orbital motion in rotational atherectomy with particle image velocimetry validation [J]. Annals of Biomedical Engineering,2018,46:567-578. doi: 10.1007/s10439-018-1984-z
[19]	CORPORATION B S. RotaWire [EB/OL]. https://www.bostonscientific.com/jp-JP/products/atherectomy-system/Rotablator.html
[20]	INC C S. ViperWire [EB/OL]. https://csi360.com/diamondback-coronary-orbital-atherectomy-system/
[21]	IANNOPOLLO G, FRANCESCO G M, ANTONIO M M, et al. Tips and tricks for rotational atherectomy [J]. Journal of Invasive Cardiology,2019,31(12):E376-E383.
[22]	CHOU S H, LIN C P, LIN Y C, et al. Double guiding catheters for complex percutaneous coronary intervention [J]. Texas Heart Institute Journal,2012,39(1):112.
[23]	MEDDA M, CASILLI F, BANDE M, et al. Protected rotational atherectomy with double–guiding catheter technique for unprotected distal left main [J]. JACC: Cardiovascular Interventions,2019,12(4):e27-e29. doi: 10.1016/j.jcin.2018.10.058
[24]	IANNACCONE M, COLANGELO S, COLOMBO F, et al. Rotational atherectomy with the new RotaPro system over RG3 guidewire in subadventitial retrograde highly calcified CTO PCI [J]. Catheterization and Cardiovascular Interventions,2020,95(2):242-244. doi: 10.1002/ccd.28438
[25]	OISHI Y, OKAMOTO M, SUEDA T, et al. Guidewire bias in rotational atherectomy in the angled lesion evaluation based on the thickness of the ablated intima and media [J]. Circulation Journal,2002,66(7):659-664. doi: 10.1253/circj.66.659
[26]	ZHENG Y, LYU J, LIU Y, et al. Grinding wheel motion and force during plaque removal by rotational atherectomy in angulated coronary artery [C]// Proceedings of the International Manufacturing Science and Engineering Conference, June 18-22, 2018, [s.n.], College Station, Texas, USA. New York: ASME, 2018.
[27]	RITCHIE J, HANSEN D, INTLEKOFER M, et al. Rotational approaches to atherectomy and thrombectomy [J]. Zeitschrift Fur Kardiologie,1987,76:59-65.
[28]	NICHOLLS S J, TUZCU E M, SIPAHI I, et al. Statins, high-density lipoprotein cholesterol, and regression of coronary atherosclerosis [J]. JAMA,2007,297(5):499-508. doi: 10.1001/jama.297.5.499
[29]	INSULL W . The pathology of atherosclerosis: Plaque development and plaque responses to medical treatment [J]. The American Journal of Medicine,2009,122(1):S3-S14. doi: 10.1016/j.amjmed.2008.10.013
[30]	ZHANG Y, KORADIA A, KAMATO D, et al. Treatment of atherosclerotic plaque: Perspectives on theranostics [J]. Journal of Pharmacy and Pharmacology,2019,71(7):1029-1043. doi: 10.1111/jphp.13092
[31]	FERNANDEZ J P, HOBSON A R, MCKENZIE D, et al. Beyond the balloon: excimer coronary laser atherectomy used alone or in combination with rotational atherectomy in the treatment of chronic total occlusions, non-crossable and non-expansible coronary lesions [J]. Euro Intervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology,2013,9(2):243-250. doi: 10.4244/EIJV9I2A40
[32]	KIM M H, KIM H J, KIM N N, et al. A rotational ablation tool for calcified atherosclerotic plaque removal [J]. Biomedical Microdevices,2011,13(6):963-971.
[33]	甄艳华, 郑加贺. 斑块切除联合药物涂层球囊治疗股腘动脉硬化闭塞症应用进展 [J]. 中国介入影像与治疗学,2018,15(10):632-636. doi: 10.13929/j.1672-8475.201803003 ZHEN Yanhua, ZHENG Jiahe. Application progress of plaque resection combined with drug-coated balloon in the treatment of femoropopliteal arteriosclerosis obliterans [J]. China Interventional Imaging and Therapeutics,2018,15(10):632-636. doi: 10.13929/j.1672-8475.201803003
[34]	崔文军, 王兵, 安乾, 等. 斑块旋切术联合药物涂层球囊治疗股腘动脉硬化闭塞症 [J]. 实用医学杂志,2018,34(24):4106-4109. doi: 10.3969/j.issn.1006-5725.2018.24.022 CUI Wenjun, WANG Bing, AN Qian, et al. Plaque atherectomy combined with drug-coated balloon in the treatment of femoropopliteal arteriosclerosis obliterans [J]. Practical Medical Journal,2018,34(24):4106-4109. doi: 10.3969/j.issn.1006-5725.2018.24.022
[35]	李明星, 兰方琛, 黄建强, 等. Silverhawk斑块旋切联合药物涂层球囊治疗下肢动脉闭塞的临床研究 [J]. 湖南师范大学学报(医学版),2021,18(6):205-208. doi: 10.3969/j.issn.1673-016X.2021.06.061 LI Mingxing, LAN Fangchen, HUANG Jianqiang, et al. Clinical study of silverhawk atherectomy combined with drug-coated balloon in the treatment of lower extremity arterial occlusion [J]. Journal of Hunan Normal University ( Medical Edition ),2021,18(6):205-208. doi: 10.3969/j.issn.1673-016X.2021.06.061
[36]	邓建武, 王子路, 张海军. Turbo Hawk斑块旋切术联合药物涂层球囊治疗长段股浅动脉硬化闭塞症的疗效分析 [J]. 中华血管外科杂志,2021,6(3):183-187. doi: 10.3760/cma.j.cn101411-20210331-00032 DENG Jianwu, WANG Zilu, ZHANG Haijun. Efficacy analysis of Turbo Hawk atherectomy combined with drug-coated balloon in the treatment of long-segment superficial femoral arteriosclerosis obliterans [J]. Chinese Journal of Vascular Surgery,2021,6(3):183-187. doi: 10.3760/cma.j.cn101411-20210331-00032
[37]	张小兵. Turbohawk斑块切除术联合药物涂层球囊治疗下肢动脉硬化闭塞症的临床效果 [J]. 微创医学,2022,17(6):821-823. doi: 10.11864/j.issn.1673.2022.06.36 ZHANG Xiaobing. Clinical effect of Turbohawk plaque resection combined with drug-coated balloon in the treatment of lower extremity arteriosclerosis obliterans [J]. Minimally Invasive Medicine,2022,17(6):821-823. doi: 10.11864/j.issn.1673.2022.06.36
[38]	刘房春, 张健. 震波治疗在严重冠状动脉钙化病变中应用进展 [J]. 中国心血管杂志,2022,27(6):593-596. doi: 10.3969/j.issn.1007-5410.2022.06.019 LIU Fangchun, ZHANG Jian. Application progress of shock wave therapy in severe coronary artery calcification lesions [J]. Chinese Journal of Cardiology,2022,27(6):593-596. doi: 10.3969/j.issn.1007-5410.2022.06.019
[39]	《冠状动脉钙化病变诊治中国专家共识》专家组. 冠状动脉钙化病变诊治中国专家共识(2021版) [J]. 中国介入心脏病学杂志,2021,29(5):251-259. doi: 10.3969/j.issn.1004-8812.2021.05.002 Chinese Expert Consensus on Diagnosis and Treatment of Coronary Artery Calcification. Chinese expert consensus on diagnosis and treatment of coronary artery calcification (2021 edition) [J]. Chinese Journal of Interventional Cardiology,2021,29(5):251-259. doi: 10.3969/j.issn.1004-8812.2021.05.002
[40]	BARBATO E, CARRIé D, DARDAS P, et al. European expert consensus on rotational atherectomy [J]. EuroIntervention,2015,11(1):30-36. doi: 10.4244/EIJV11I1A6
[41]	SHARMA S K, TOMEY M I, TEIRSTEIN P S, et al. North American expert review of rotational atherectomy [J]. Circulation: Cardiovascular Interventions,2019,12(5):e007448. doi: 10.1161/CIRCINTERVENTIONS.118.007448
[42]	ZOTZ R J, ERBEL R, PHILIPP A, et al. High‐speed rotational angioplasty‐induced echo contrast in vivo and in vitro optical analysis [J]. Catheterization and Cardiovascular Diagnosis,1992,26(2):98-109. doi: 10.1002/ccd.1810260205
[43]	张奇, 沈卫峰. 冠状动脉钙化病变旋磨治疗当代理念 [J]. 国际心血管病杂志,2016,43(4):193-195. doi: 10.3969/j.issn.1673-6583.2016.04.001 ZHANG Qi, SHEN Weifeng. Contemporary concept of rotational atherectomy for coronary artery calcification [J]. International Journal of Cardiovascular Disease,2016,43(4):193-195. doi: 10.3969/j.issn.1673-6583.2016.04.001
[44]	SHIMONY A, JOSEPH L, MOTTILLO S, et al. Coronary artery perforation during percutaneous coronary intervention: A systematic review and meta-analysis [J]. Canadian Journal of Cardiology,2011,27(6):843-850. doi: 10.1016/j.cjca.2011.04.014
[45]	COHEN B M, WEBER V J, RELSMAN M, et al. Coronary perforation complicating rotational ablation: The US multicenter experience [J]. Catheterization and Cardiovascular Diagnosis,1996:55-59.
[46]	KINNAIRD T, ANDERSON R, OSSEI-GERNING N, et al. Coronary perforation complicating percutaneous coronary intervention in patients with a history of coronary artery bypass surgery: an analysis of 309 perforation cases from the British Cardiovascular Intervention Society Database [J]. Circulation: Cardiovascular Interventions,2017,10(9):e005581. doi: 10.1161/CIRCINTERVENTIONS.117.005581
[47]	SAKAKURA K, AKO J, MOMOMURA S I. Successful removal of an entrapped rotablation burr by extracting drive shaft sheath followed by balloon dilatation [J]. Catheterization and Cardiovascular Interventions,2011,78(4):567-570. doi: 10.1002/ccd.22957
[48]	CUNNINGTON M, EGRED M. GuideLiner, a child‐in‐a‐mother catheter for successful retrieval of an entrapped rotablator burr [J]. Catheterization and Cardiovascular Interventions,2012,79(2):271-273. doi: 10.1002/ccd.23032
[49]	TANAKA Y, SAITO S. Successful retrieval of a firmly stuck rotablator burr by using a modified STAR technique [J]. Catheterization and Cardiovascular Interventions,2016,87(4):749-756. doi: 10.1002/ccd.26342
[50]	SAKAKURA K, ITO Y, SHIBATA Y, et al. Clinical expert consensus document on rotational atherectomy from the Japanese association of cardiovascular intervention and therapeutics [J]. Cardiovascular Intervention and Therapeutics,2021,36(1):1-18. doi: 10.1007/s12928-020-00715-w
[51]	CAVUSOGLU E, KINI A S, MARMUR J D, et al. Current status of rotational atherectomy [J]. Catheterization and Cardiovascular Interventions,2004,62(4):485-498. doi: 10.1002/ccd.20081
[52]	KOLLER P T, FREED M, GRINES C L, et al. Success, complications, and restenosis following rotational and transluminal extraction atherectomy of ostial stenoses [J]. Catheterization and Cardiovascular Diagnosis,1994,31(4):255-260. doi: 10.1002/ccd.1810310402
[53]	MORII I, MIYAZAKI S. Current overview of rotational atherectomy. does rotablator make sense [J]. Emodinamica,2000,22:2-9.
[54]	SAFIAN R D, FELDMAN T, MULLER D W, et al. Coronary angioplasty and Rotablator atherectomy trial (CARAT): Immediate and late results of a prospective multicenter randomized trial [J]. Catheterization and Cardiovascular Interventions,2001,53(2):213-220. doi: 10.1002/ccd.1151
[55]	WARTH D C, LEON M B, O'NEILL W, et al. Rotational atherectomy multicenter registry: Acute results, complications and 6-month angiographic follow-up in 709 patients [J]. Journal of the American College of Cardiology,1994,24(3):641-648. doi: 10.1016/0735-1097(94)90009-4
[56]	MOTWANI J G, RAYMOND R E, FRANCO I, et al. Effectiveness of rotational atherectomy of right coronary artery ostial stenosis [J]. The American Journal of Cardiology,2000,85(5):563-567. doi: 10.1016/S0002-9149(99)00812-7
[57]	DIETZ U, RUPPRECHT H J, EKINCI O, et al. Angiographic analysis of immediate and long‐term results of PTCR vs. PTCA in complex lesions (COBRA study) [J]. Catheterization and Cardiovascular Interventions,2001,53(3):359-367. doi: 10.1002/ccd.1181
[58]	TSUBOKAWA A, UEDA K, SAKAMOTO H, et al. Effect of intracoronary nicorandil administration on preventing no-reflow/slow flow phenomenon during rotational atherectomy [J]. Circulation Journal,2002,66(12):1119-1123. doi: 10.1253/circj.66.1119
[59]	MATSUO H, WATANABE S, WATANABE T, et al. Prevention of no-reflow/slow-flow phenomenon during rotational atherectomy: A prospective randomized study comparing intracoronary continuous infusion of verapamil and nicorandil [J]. American Heart Journal,2007,154(5):994e1-e6. doi: 10.1016/j.ahj.2007.07.036
[60]	KINI A, REICH D, MARMUR J D, et al. Reduction in periprocedural enzyme elevation by abciximab after rotational atherectomy of type B2 lesions: results of the Rota ReoPro randomized trial [J]. American Heart Journal,2001,142(6):965-969. doi: 10.1067/mhj.2001.119382
[61]	BADEL P, AVRIL S, LESSNER S, et al. Mechanical identification of layer-specific properties of mouse carotid arteries using 3D-DIC and a hyperelastic anisotropic constitutive model [J]. Computer Methods in Biomechanics and Biomedical Engineering,2012,15(1):37-48. doi: 10.1080/10255842.2011.586945
[62]	KARIMI A, NAVIDBAKHSH M, FAGHIHI S, et al. A finite element investigation on plaque vulnerability in realistic healthy and atherosclerotic human coronary arteries [J]. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine,2013,227(2):148-161. doi: 10.1177/0954411912461239
[63]	RAMAZANI-REND R, CHELIKANI S, SPARROW E M, et al. Experimental and numerical investigation of orbital atherectomy: Absence of cavitation [J]. Journal of Biomedical Science and Engineering,2010,3(11):1108. doi: 10.4236/jbise.2010.311144
[64]	吴永新, 陈曼华. 冠状动脉内旋磨术并发无复流的研究进展 [J]. 中国心血管病研究,2022,20(7):650-655. doi: 10.3969/j.issn.1672-5301.2022.07.011 WU Yongxin, CHEN Manhua. Research progress of coronary rotational atherectomy with no-reflow [J]. Chinese Cardiovascular Research,2022,20(7):650-655. doi: 10.3969/j.issn.1672-5301.2022.07.011
[65]	GEHANI A A, REES M R. Can rotational atherectomy cause thermal tissue damage? A study of the potential heating and thermal tissue effects of a rotational atherectomy device [J]. Cardiovascular and Interventional Radiology,1998,21:481-486. doi: 10.1007/s002709900308
[66]	KAWAGUCHI Y, TAMURA T, MASUDA S, et al. Impact of the degree of wire bias in the vessel's healthy portion on coronary perivascular trauma in rotational atherectomy [J]. Cardiovascular Revascularization Medicine,2022,40:123-131. doi: 10.1016/j.carrev.2021.11.006
[67]	LIU Y, LI B, KONG L, et al. Experimental and modeling study of temperature in calcified plaque grinding [J]. The International Journal of Advanced Manufacturing Technology,2018,99:1013-1021. doi: 10.1007/s00170-018-2522-8
[68]	LI X, CHERNJAVSKY P, ANGJELI K, et al. Experimental investigation of the material removal rate in grinding of calcified plaque by rotational atherectomy [C]// Proceedings of the International Manufacturing Science and Engineering Conference, June 21-25, 2021, [s.n.], Virtual Online. New York: ASME, 2021: MSEC2021-64056.
[69]	ZHENG Y. Grinding wheel motion and force analysis in atherosclerotic plaque removal by atherectomy [D]. Ann Arbor: University of Michigan, 2016.
[70]	ZHENG Y, BELMONT B, SHIH A J. Experimental investigation of the grinding wheel dynamics in atherectomy [J]. Procedia Manufacturing,2015,1:879-891. doi: 10.1016/j.promfg.2015.09.080
[71]	ADAMS G L, KHANNA P K, STANILOAE C S, et al. Optimal techniques with the diamondback 360 system achieve effective results for the treatment of peripheral arterial disease [J]. Journal of Cardiovascular Translational Research,2011,4(2):220-229. doi: 10.1007/s12265-010-9255-x
[72]	KOHLER R, NGUYEN T, MCBROOM J. Removal of calcified plaque utilizing orbital atherectomy [C]// Proceedings of the International Manufacturing Science and Engineering Conference, June 6-13, 2014, [s.n.], Detroit Michigan, USA. New York: ASME, 2014: MSEC2014-4209.
[73]	ZHENG Y, LIU Y, LIU Y, et al. Experimental investigation of the grinding force in rotational atherectomy [J]. Procedia Manufacturing,2016,5:838-848. doi: 10.1016/j.promfg.2016.08.069
[74]	ZHU Z, GAO C, HUANG Z, et al. Evolution of novel grinding tool in removing coronary artery calcification tissue process [J]. Medical Engineering & Physics,2022,109:103893.
[75]	刘瑶. 心血管钙化组织磨削机理及其应用研究 [D].上海:东华大学, 2018. LIU Yao. Cardiovascular calcification tissue grinding mechanism and its application research [D]. Shanghai: Donghua University, 2018.
[76]	GADER A, AL‐MASHHADANI S, AL‐HARTHY S. Direct activation of platelets by heat is the possible trigger of the coagulopathy of heat stroke [J]. British Journal of Haematology,1990,74(1):86-92. doi: 10.1111/j.1365-2141.1990.00082.x-i1
[77]	朱国标, 甘韶雨, 张克俊, 等. 外界高温与毛细血管内皮细胞膜损伤 [J]. 微循环学杂志,1995(3):4-6. ZHU Guobiao, GAN Shaoyu, ZHANG Kejun, et al. External high temperature and capillary endothelial cell membrane damage [J]. Journal of Microcirculation,1995(3):4-6.
[78]	REISMAN M, SHUMAN B J, DILLARD D, et al. Analysis of low‐speed rotational atherectomy for the reduction of platelet aggregation [J]. Catheterization and Cardiovascular Diagnosis,1998,45(2):208-214. doi: 10.1002/(SICI)1097-0304(199810)45:2<208::AID-CCD21>3.0.CO;2-F
[79]	REISMAN M, SHUMAN B J, HARMS V. Analysis of heat generation during rotational atherectomy using different operational techniques [J]. Catheterization and Cardiovascular Diagnosis,1998,44(4):453-455. doi: 10.1002/(SICI)1097-0304(199808)44:4<453::AID-CCD21>3.0.CO;2-I
[80]	LIU Y, LIU Y, ZHENG Y, et al. Catheter thermal energy generation and temperature in rotational atherectomy [J]. Medical Engineering & Physics,2019,70:29-38.
[81]	LIU Y, LI B, KONG L, et al. Experimental and modeling study of temperature in calcified plaque grinding [J]. International Journal of Advanced Manufacturing Technology,2018(1/2/3/4):1013-1021.
[82]	KUME T, OKURA H, KAWAMOTO T, et al. Assessment of the histological characteristics of coronary arterial plaque with severe calcification [J]. Circulation Journal,2007,71(5):643-647. doi: 10.1253/circj.71.643
[83]	LIU Y, LI B, ZHENG Y, et al. Experiment and smooth particle hydrodynamics simulation of debris size in grinding of calcified plaque in atherectomy [J]. CIRP Annals,2017,66(1):325-328. doi: 10.1016/j.cirp.2017.04.090
[84]	HANSEN D D, AUTH D C, VRACKO R, et al. Rotational atherectomy in atherosclerotic rabbit iliac arteries [J]. American Heart Journal,1988,115(1):160-165. doi: 10.1016/0002-8703(88)90532-7
[85]	LI X X, CHERNJAVSKY P, ANGJELI K, et al. Experimental investigation of the material removal rate in grinding of calcified plaque by rotational atherectomy [C]//Proceedings of the International Manufacturing Science and Engineering Conference,2021.