Heat‐induced contraction of blood vessels

Gorisch, W.; Boergen, K.-P.

doi:10.1002/lsm.1900020101

Cited by 103 publications

(32 citation statements)

References 9 publications

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“…27 It is known that the extent of CA stenosis correlates with the amount of heat-induced denaturation of collagen fibers in the vessel wall. 28, 29 Replacement of the coronary arterial media with proliferating extracellular matrix, as shown in a study of 9 mongrel dogs, led to severe hyperplasia and intravascular thrombosis. 30 In these experiments investigators also compared the effects of RFA with the orientation of the lesion line and its proximity to CAs.…”

Section: Mechanisms Of Rfa-induced Coronary Artery Damagementioning

confidence: 97%

Coronary artery pathophysiology after radiofrequency catheter ablation: Review and perspectives

et al. 2011

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Radiofrequency ablation (RFA) has proven to be an effective and safe treatment in patients with ventricular and atrial tachyarrhythmias. Among complications arising after RFA, the incidence of coronary artery (CA) injury is exceedingly low. When CA injury does occur, however, it can be clinically devastating. The proximity of CAs to common ablation sites suggests that the relationship between RFA and CA perfusion pathophysiology is important. While others have described the presentation and outcomes of patients with CA injury after ablation, a review that consolidates the mechanisms of CA injury after RFA has yet to be presented in the cardiology literature. We conducted an extensive literature search of studies published over the past thirty years that relate the biophysics of RFA with CA perfusion pathophysiology and injury. From this, we present a review of the dynamic relationship between RFA and CA perfusion. We describe RFA lesion pathology, mechanisms of CA injury from RFA, and factors that influence lesion formation such as convective cooling and the ‘shadow effect.’ Finally, we summarize methods to mitigate CA injury after RFA and propose new research avenues to optimize lesion formation and safe arrhythmia treatments when tissue is ablated in the vicinity of CAs.

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Section: Mechanisms Of Rfa-induced Coronary Artery Damagementioning

confidence: 97%

Coronary artery pathophysiology after radiofrequency catheter ablation: Review and perspectives

et al. 2011

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“…In contrast, the RBHS method of cautery uses saline-cooled bipolar delivery of radiofrequency energy, which contracts and seals small blood vessels [[19]] at tissue temperature <100°C [[14],[20],[21]]. Some evidence also supports the efficacy of RBHS for hemostasis during bleeding from bone surfaces, by way of shrinking collagen in the walls of blood vessels [[22]].…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency bipolar hemostatic sealer reduces blood loss, transfusion requirements, and cost for patients undergoing multilevel spinal fusion surgery: a case control study

et al. 2014

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BackgroundA relatively new method of electrocautery, the radiofrequency bipolar hemostatic sealer (RBHS), uses saline-cooled delivery of energy, which seals blood vessels rather than burning them. We assessed the benefits of RBHS as a blood conservation strategy in adult patients undergoing multilevel spinal fusion surgery.MethodsIn a retrospective cohort study, we compared blood utilization in 36 patients undergoing multilevel spinal fusion surgery with RBHS (Aquamantys®, Medtronic, Minneapolis, MN, USA) to that of a historical control group (n = 38) matched for variables related to blood loss. Transfusion-related costs were calculated by two methods.ResultsPatient characteristics in the two groups were similar. Intraoperatively, blood loss was 55% less in the RBHS group than in the control group (810 ± 530 vs. 1,800 ± 1,600 mL; p = 0.002), and over the entire hospital stay, red cell utilization was 51% less (2.4 ± 3.4 vs. 4.9 ± 4.5 units/patient; p = 0.01) and plasma use was 56% less (1.1 ± 2.4 vs. 2.5 ± 3.4 units/patient; p = 0.03) in the RBHS group. Platelet use was 0.1 ± 0.5 and 0.3 ± 0.6 units/patient in the RBHS and control groups, respectively (p = 0.07). The perioperative decrease in hemoglobin was less in the RBHS group than in the control group (−2.0 ± 2.2 vs. –3.2 ± 2.1 g/dL; p = 0.04), and hemoglobin at discharge was higher in the RBHS group (10.5 ± 1.4 vs. 9.7 ± 0.9 g/dL; p = 0.01). The estimated transfusion-related cost savings were $745/case by acquisition cost and approximately 3- to 5-fold this amount by activity-based cost.ConclusionsThe use of RBHS in patients undergoing multilevel spine fusion surgery can conserve blood, promote higher hemoglobin levels, and reduce transfusion-related costs.

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“…In these experiments, the aneurysmal tissue contracted around the steel caps and underwent progressive fibrosis. Photocoagulation and thermocoagulation injuries are essentially pure thermal processes 21,29,30 . The photocoagulation effect was not a significant consequence of tissue irradiation in our study.…”

Section: Discussionmentioning

confidence: 99%

Effects of Endothelial Injury on the Rate of Thrombus Organization in Canine Carotid Arteries Occluded with Microcoils

Abruzzo

Shengelaia²,

Workman³

et al. 2003

Interv Neuroradiol

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Thrombus organization in canine carotid arteries occluded with platinum microcoils was studied to determine if endothelial injury created with a Xenon Chloride Excimer Laser (XEL) could acclerate endovascular fibrosis. Ten common carotid artery stumps were created in ten dogs. Each of four stumps were schematically divided into four longitudinally contiguous injury zones (thermal ablation injury, non-ablative injury, proximal and distal non-injury zones) to test the effects of ablative and non-ablative injury and to establish a set of internal controls that would account for proximity to circulating blood at the ostium of the occluded artery. Following XEL irradiation of the endothelium through an arteriotomy, each stump was embolized with microcoils. Four control stumps were subjected to sham laser procedures, and embolized in an identical fashion. Two additional stumps were embolized in the absence of sham surgery. Angiographic, gross and histologic analysis was performed after four weeks. Specimens of freshly clotted whole blood mixed with microcoils were used as an additional control. In irradiated stumps and non-irradiated stumps (sham and embolization only), angiography revealed no evidence of coil compaction or recanalization. In all irradiated stumps the thermal ablation zone contained fibrous tissue and neovascularity without unorganized thrombus. The other zones in the irradiated stumps were indistingnishable from each other and from all zones in the non-irradiated sham stumps, containing primarily unorganized thrombus. Stumps embolized in the absence of sham surgery were filled with material that was grossly and microscopically identical to specimens of freshly clotted whole blood containing microcoils. The results indicate that thermal ablation injury of the endothelium accelerates thrombus organization in canine carotid arteries occluded with platinum microcoils.

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Heat‐induced contraction of blood vessels

Cited by 103 publications

References 9 publications

Coronary artery pathophysiology after radiofrequency catheter ablation: Review and perspectives

Coronary artery pathophysiology after radiofrequency catheter ablation: Review and perspectives

Radiofrequency bipolar hemostatic sealer reduces blood loss, transfusion requirements, and cost for patients undergoing multilevel spinal fusion surgery: a case control study

Effects of Endothelial Injury on the Rate of Thrombus Organization in Canine Carotid Arteries Occluded with Microcoils

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