Percutaneous Laser Thermal Angioplasty: Initial Clinical Results With a Laser Probe in Total Peripheral Artery Occlusions

Cumberland, D.C.; Tayler, D I; Welsh, Christopher L.; Guben, Jon K.; Sanborn, Timothy A.; Moore, David; Greenfield, Alan J.; Ryan, Thomas J.

doi:10.1016/s0140-6736(86)91498-4

Cited by 239 publications

(28 citation statements)

References 9 publications

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] In the present study, based on our previous serial studies, the optimal conditions for endovascular laser intervention by Argon laser were an output power and exposure time of 6 W in output and 3 s, respectively, for the bare laser fiber, and a tip temperature and exposure time of 200°C and 5 sec, respectively, for the heated tip. 2,16) On the other hand, several other sets of laser parameters (6-12 W output, 3-10 s irradiation time) have been reported depending on to the kind of laser system and laser fibers used.…”

Section: Discussionmentioning

confidence: 99%

The Viability of Endovascular Laser Intervention for Peripheral Arterial Diseases

Okada

Yoshida

2010

LASER THERAPY

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Section: Discussionmentioning

confidence: 99%

The Viability of Endovascular Laser Intervention for Peripheral Arterial Diseases

Okada

Yoshida

2010

LASER THERAPY

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“…Although the laser probe is the only laser catheter to date that has been extensively tested in animal preparations4 5 and in human trials of peripheral6' 7,10 and coronary8 revascularization, few data are available concerning the thermal characteristics of the laser probe ablation process.…”

Section: Discussionmentioning

confidence: 99%

“…This allows the controlled conductive transfer of heat to the vessel wall. Although the laser probe has been used extensively in short-and long-term animal experiments4 5 and has more recently been introduced in the treatment of human peripheral6' 7 and coronary arterial disease,8 thermal analysis of laser probe tissue ablation has not been described to date. The aims of this study were therefore to (1) determine the thermal characteristics of the metal-tipped laser probe, (2) measure the temperature changes and the extent of histologic damage produced by the heated probe on normal and atherosclerotic aortic tissue, and (3) contrast the effects of the laser probe as a contact heat source with those of direct laser irradiation on the same types of tissue.…”

mentioning

confidence: 99%

Laser probe ablation of normal and atherosclerotic human aorta in vitro: a first thermographic and histologic analysis.

et al. 1987

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The metal-tipped optical fiber or "laser probe" has been extensively studied in animal preparations in vivo and in human clinical trials of revascularization. The aim of this study was to evaluate the thermal characteristics of laser probe tissue ablation and to contrast the vascular tissue response to exposure to the laser probe and bare optical fiber. A 2 mm laser probe was heated with up to 4 W of argon-ion laser irradiation and applied to six postmortem strips ofhuman nonatherosclerotic aorta as well as to five atherosclerotic aortic specimens. Surface temperature maps of the laser probe and of the vascular tissue in air were obtained via 8 to 12 ,um thermographic imaging. Laser probe temperature was additionally monitored via thermocouples. Two strips each of normal and diseased aorta were irradiated directly with the bare optical fiber. Thus a total of 43 laser probe application sites and 19 bare fiberoptic laser irradiation sites on a total of 15 aortic strips were analyzed both thermographically and histologically. Based on measured temperature rises and histologic findings, the following observations were made: (1) The laser probe heats initially at its tip and attains a uniform surface temperature distribution within 5 sec. The steady-state temperature attained by the probe is inversely related to the thermal conductivity of the surrounding media. In all media studied, probe temperature increases linearly with applied laser energy. (2) Tissue ablation starts at temperatures greater than 1000 C, and ablation temperatures typically exceed 1800 C. Adventitial temperatures during laser probe application may reach 700 C. Tissue ablation is enhanced both by greater laser energy deposition in the probe and by higher force at which the probe is applied to tissue. (3) Ablation of fibrofatty atheromata is more extensive than of nonatherosclerotic aortic tissue. This may be due to the lower thermal conductivity of atheromatous tissue. (4) In contrast to direct argon-ion laser ablation of aortic tissue, laser probe-mediated ablation occurs in a controlled fashion, is not associated with extensive subintimal dissections, and allows uniform conduction of heat to tissue as reflected by essentially "isothermal" injury lines. Circulation 76, No. 5, 1353No. 5, -1363No. 5, , 1987 ATHEROSCLEROTIC arterial occlusive disease continues to constitute the major cause of morbidity and mortality in the United States. Over the past 4 years, substantial work has been done in an attempt to develop a laser technology that can be applied to the percutaneous revascularization of obstructive peripheral vascular and coronary artery disease. In contrast to conFrom the Biomedical Engineering Program of the

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“…Although some success has already been reported [1][2][3], further progress is ham pered by lack of a suitable animal model. A method is required which can produce steno sis within the coronary arteries at a predeter mined position.…”

Section: Introductionmentioning

confidence: 99%

Coronary Artery Plaque Rapidly Induced by Local Electromagnetic Stimulation in the Baboon

Breuer¹,

Fincham

Hinrichsen³

et al. 1989

Eur Surg Res

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A reliable method has been developed to produce stenosis of the right coronary artery of baboons as a consequence of electrostimulation of the vessel at a chosen position. At that site a pair of electrodes were implanted and activated with a train of 9-volt pulses (length: 10 ms, separation: 100 ms) for 30 min, 5 days/week, up to 6 weeks. 13 animals were included in the experiment, 2 of those served as controls. Pathohistologically the structure of the artificially produced constrictions is similar to atherosclerotic lesions. On average the stenoses occupied 55% of the available lumen; total occlusion and no stenosis were observed in 1 case each.

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Percutaneous Laser Thermal Angioplasty: Initial Clinical Results With a Laser Probe in Total Peripheral Artery Occlusions

Cited by 239 publications

References 9 publications

The Viability of Endovascular Laser Intervention for Peripheral Arterial Diseases

The Viability of Endovascular Laser Intervention for Peripheral Arterial Diseases

Laser probe ablation of normal and atherosclerotic human aorta in vitro: a first thermographic and histologic analysis.

Coronary Artery Plaque Rapidly Induced by Local Electromagnetic Stimulation in the Baboon

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