Feasibility of intravascular laser irradiation for in vivo visualization and therapy of cardiocirculatory diseases

Lee, Garrett; Ikeda, Richard M.; Dwyer, Richard M.; Hussein, Hany; Dietrich, Péter; Mason, Dean T.

doi:10.1016/0002-8703(82)90576-2

Cited by 70 publications

(12 citation statements)

References 4 publications

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“…Laser angioplasty, the ablation ofarterial obstructions with laser light, has been demonstrated in vitro (1)(2)(3)(4)(5)(6)(7)(8)(9), in animals (10)(11)(12)(13)(14)(15)(16)(17)(18), and in early clinical trials (19)(20)(21)(22)(23). While these studies have shown the feasibility of this technique, clinical application has been limited by vessel perforations, aneurysms, and other forms of inadvertant laser damage to normal tissue adjacent to or underlying the atheromas (1 1, 12, 14-17, 22, 23).…”

Section: Introductionmentioning

confidence: 99%

Preferential light absorption in atheromas in vitro. Implications for laser angioplasty.

Prince¹,

Deutsch²,

Mathews-Roth³

et al. 1986

J. Clin. Invest.

131

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Laser angioplasty, the in situ ablation of arterial obstructions with laser radiation, has been demonstrated in animal models and early clinical trials. A problem with this technique, however, is the possibility of thermal damage to adjacent or underlying normal tissues that also absorb the radiation. Using a spectrophotometer with an integrating sphere and a specially constructed tunable-dye laser-based spectrophotometer, we evaluated the transmittance and remittance of human cadaveric atheromas and adjacent normal aorta from 250 to 1,300 unm to identify wavebands where there is preferential light absorption by atheromas. Data were analyzed by both the Kubelka-Munk formalism and a Beer's law model. Both methods indicate that atheromas absorb more than normal aorta between 420 and 530 nm. At 470 nm the average Kubelka-Munk absorption coefficient of atheromas from 10 cadavers was 54±9 cm-1 compared with 26±6 cm-' for normal aortic specimens from seven cadavers. Yellow chromophores responsible for the atheroma absorbance were extractable with xylenes. Thin-layer chromatography and absorption spectra identified the extracted chromophores as predominantly consisting of a mix of carotenoids, which are known constituents of atheromatous lesions. Preferential absorption of blue light by carotenoids in atheromas may permit selective ablation of atheromatous obstructions with appropriate pulses of laser radiation.

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Section: Introductionmentioning

confidence: 99%

Preferential light absorption in atheromas in vitro. Implications for laser angioplasty.

Prince¹,

Deutsch²,

Mathews-Roth³

et al. 1986

J. Clin. Invest.

131

View full text Add to dashboard Cite

show abstract

“…The utility of using angioscopy to localize atherosclerotic lesions [Lee et al, 1982[Lee et al, , 1983[Lee et al, , 1984b[Lee et al, , 1986Spears et al, 19851 and the efficacy of the laser-heated metal cautery cap have been previously described [Lee et al, 1984al. The laser-heated cap lessens the risk of a direct free laser beam inadvertently straying at variable distances from the intended target area, thereby reducing the chance of perforation and vascular damage.…”

Section: Discussionmentioning

confidence: 99%

“…Vol 14, June 25, 1985). ity of simultaneous in vivo visualization and laser vaporization of human cadaver atherosclerotic arteries implanted in dog arteries [Lee et al, 1982, 19841. Accepted for publication, June 12, 1987 In this paper9 we report attempts to …”

Section: Introduction Materials and Methodsmentioning

confidence: 99%

Effects of simultaneous viewing and vaporization of plaques using the steerable, laser‐heated metal cap in the atherosclerotic monkey model

et al. 1987

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A steerable, fiberoptic catheter coupled to a laser light guide tipped with a metal cap was used. Four monkeys fed an atherogenic diet for 7-8 years were angiographed and were found to have extensive mural plaque in the iliac arteries. Plaque sites in these monkeys were vaporized using the laser-heated metal cap. Energies of 1.5-9 Joules were employed. Application of the energy was tangential of perpendicular to the plaque. Lased sites were examined histologically at 24 hr or at 3 months after treatment. No effect was seen at 1.5 Joules. Three to six Joules tangentially produced a superficial lesion that extended into the tunica intima. Six Joules perpendicularly produced a burn into the tunica adventitia, with damage to the vasavasorum. Nine Joules tangentially produced a burn into the tunica media. Three months after treatment, this lased site showed no stenosis or aneurysm formation.

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“…Although several different types of laser catheters have been developed (Choy, 1980;Choy et al, 1982a;Lee et a/. , 1982;O'Reilly et al, 19821, we elected to use a system that was similar in technique, style, and equipment to that used in present day percutaneous transluminal balloon angioplasty.…”

Section: Discussionmentioning

confidence: 99%

Salvage of an ischemic limb by laser angioplasty: Description of a New Technique

Ginsburg

Kim

Guthaner

et al. 1984

Clinical Cardiology

123

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Summary:A 62-year-old male with severe claudication and rest pain of the left leg resulting from a totally occluded superficial femoral artery and a 95% stenosis of the deep femoral artery was treated with laser angioplasty after attempts at surgical revascularization were unsuccessful. A 200 p silica fiber was inserted through a catheter and advanced into the lesion using 2 watts of delivered energy from an argon laser source. The fiber was then withdrawn from the lesion using 7 watts of energy to enlarge the lumen. No complications occurred, and posterior tibia1 blood flow was reestablished, as shown by Doppler flow measurements and resolution of clinical symptoms. We report a new technique of transcatheter fiberoptic-directed argon laser radiation (laser angioplasty) for the treatment of occlusive vascular disease.

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Feasibility of intravascular laser irradiation for in vivo visualization and therapy of cardiocirculatory diseases

Cited by 70 publications

References 4 publications

Preferential light absorption in atheromas in vitro. Implications for laser angioplasty.

Preferential light absorption in atheromas in vitro. Implications for laser angioplasty.

Effects of simultaneous viewing and vaporization of plaques using the steerable, laser‐heated metal cap in the atherosclerotic monkey model

Salvage of an ischemic limb by laser angioplasty: Description of a New Technique

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