Initial clinical experiences with rescue unipolar radiofrequency thermal balloon angioplasty after abrupt or threatened vessel closure complicating elective conventional balloon coronary angioplasty

Saïto, Shigeru; Arai, Hidekazu; Kim, Kunikane; Aoki, Naoto

doi:10.1016/0735-1097(94)90102-3

Cited by 22 publications

(12 citation statements)

References 19 publications

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“…The early thermal angioplasty demonstrated significant artery lumen dilatation effect in acute phase without mechanical injury of the artery wall [3]. While some successful therapeutic results in chronic phase were reported, most of reports demonstrated the chronic restenosis due to thermal injury in artery surrounding [4,5]. This thermal injury in artery surrounding has been the bottleneck of the thermal angioplasty.…”

Section: Introductionmentioning

confidence: 94%

Development of novel short-term heating angioplasty: thermal denaturation dynamics of collagen in artery wall

et al. 2009

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We have studied to develop the new thermal angioplasty methodology, photo-thermo dynamic balloon angioplasty (PTDBA), which provides artery dilatation with short-term (<15s) and uniform heating through the balloon by the combination of the efficient laser driven heat generation and fluid perfusion. Thermal denaturation degree of the collagen in artery media may be the important factor to attain sufficient artery dilatation for the PTDBA. In order to predict the optimum heating condition i.e. the balloon temperature and heating duration, we investigated the thermal denaturation dynamics of artery collagen in ex vivo. The extracted fresh porcine carotid artery was used. The temperature-dependent light scattering property and mechanical property of the artery specimen were simultaneously measured during artery temperature rising by specially made setup to assess the denaturation of arterial collagen. The change rate of the backscattered light intensity from the artery specimen; I(T)/I 0 with 633nm was measured to evaluate the artery scattering property change with the thermal denaturation. The artery specimen was heated from 25°C to 80°C with constant temperature rising rate of 3°C/min. The measured I(T)/I 0 was suddenly increased over 48°C. This boundary temperature might be the initiation temperature of the arterial collagen denaturation. We defined the variation of the I(T)/I 0 as the collagen denaturation ratio, and calculated the reactive enthalpy by the chemical equilibrium theory. Since the calculated enthalpy was similar to the enthalpy in literature report, the variety of I(T)/I 0 during the temperature rising might be attributed to the collagen conformational change due to the denaturation. In terms of the artery internal force measurement, the artery force was decreased with increasing of the artery temperature up to 65°C (i.e. softening), and increased over 65°C (i.e. shrinkage). We confirmed that the changes of the backscattered light (at 633nm in wavelength) from the artery might represent the artery collagen thermal denaturation degree.

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Section: Introductionmentioning

confidence: 94%

Development of novel short-term heating angioplasty: thermal denaturation dynamics of collagen in artery wall

et al. 2009

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“…Due to this architecture (Figure 1), PTDB can suppress surrounding tissue thermal damage that caused severe restenosis in previous thermal balloon angioplasty. [1][2][3][4][5] PTDBA, has shown tremendous therapeutic effect. PTDB is able to dilate vessel with only 2 atm pressure by softening vessel wall collagen, and prevent acute phase thrombus and chronic phase restenosis that both are major side-effect of optical fiber contrast medium flow stainless mesh tube thermocouple ongoing plain old balloon angioplasty.…”

Section: Photo-thermo Dynamic Balloon Angioplastymentioning

confidence: 99%

Utility of birefringence changes due to collagen thermal denaturation rate process analysis: vessel wall temperature estimation for new short term heating balloon angioplasty

et al. 2007

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Our photo thermal reaction heating architecture balloon realizes less than 10 s short term heating that can soften vessel wall collagen without damaging surrounding tissue thermally. New thermal balloon angioplasty, photo-thermo dynamic balloon angioplasty (PTDBA) has experimentally shown sufficient opening with 2 atm low pressure dilation and prevention of chronic phase restenosis and acute phase thrombus in vivo. Even though PTDBA has high therapeutic potential, the most efficient heating condition is still under study, because relationship of treatment and thermal dose to vessel wall is not clarified yet. To study and set the most efficient heating condition, we have been working on establishment of temperature history estimation method from our previous experimental results. Heating target of PTDBA, collagen, thermally denatures following rate process. Denaturation is able to be quantified with measured collagen birefringence value. To express the denaturation with equation of rate process, the following ex vivo experiments were performed. Porcine extracted carotid artery was soaked in two different temperature saline baths to enforce constant temperature heating. Higher temperature bath was set to 40 to 80°C and soaking duration was 5 to 40 s. Samples were observed by a polarizing microscope and a scanning electron microscope. The birefringence was measured by polarizing microscopic system using BraceKoehler compensator 1/30 λ. The measured birefringence showed temperature dependency and quite fit with the rate process equation. We think vessel wall temperature is able to be estimated using the birefringence changes due to thermal denaturation.

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“…Radiofrequency thermal balloon angioplasty was introduced as a new technique for percutaneous arterial dilatation in the 1990's [54][55][56] , yet due to increased restenosis rates observed in patients receiving this therapy 57 , it was soon abandoned as a percutaneous interventional treatment option. Using this system, Staab et al 58 and our laboratory 39 have investigated a porcine heat-injury restenosis model.…”

Section: Porcine Heat-injury Restenosis Modelmentioning

confidence: 99%

Importância dos estudos pré-clínicos em animais de experimentação para a cardiologia intervencionista

Suzuki¹,

Yeung²,

Ikeno³

2008

Arq. Bras. Cardiol.

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Initial clinical experiences with rescue unipolar radiofrequency thermal balloon angioplasty after abrupt or threatened vessel closure complicating elective conventional balloon coronary angioplasty

Abstract: Radiofrequency balloon angioplasty is effective in the treatment of abrupt or threatened vessel closure complicating elective coronary angioplasty even though the procedure is associated with a relatively high rate of restenosis.

Cited by 22 publications

References 19 publications

Development of novel short-term heating angioplasty: thermal denaturation dynamics of collagen in artery wall

Development of novel short-term heating angioplasty: thermal denaturation dynamics of collagen in artery wall

Utility of birefringence changes due to collagen thermal denaturation rate process analysis: vessel wall temperature estimation for new short term heating balloon angioplasty

Importância dos estudos pré-clínicos em animais de experimentação para a cardiologia intervencionista

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