Arterial response to excimer and argon laser irradiation in the atherosclerotic swine

Higginson, Lyall; Farrell, Edward M.; Walley, Virginia M.; Taylor, R. S.; Keon, Wilbert J.

doi:10.1007/bf02032603

Cited by 7 publications

(1 citation statement)

References 13 publications

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“…Animal experiments have demonstrated that excimer laser energy can be applied in a controlled fashion in vivo with little evidence of thermal injury to surrounding vascular tissue [62]. In addition, there are data suggesting that excimer-induced vascular injury heals more rapidly and completely than injury induced by continuous wave lasers [62].…”

Section: Direct Excimer Laser Systemmentioning

confidence: 99%

New technologies for the treatment of obstructive arterial disease

Fischell

Stadius

1991

Cathet. Cardiovasc. Diagn.

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The well-known limitations of balloon angioplasty include unpredictable abrupt closure, chronic total occlusion, diffuse disease, and restenosis, among other factors. These limitations have prompted the development of new technologic approaches to angioplasty including laser applications for plaque ablation, mechanical device applications for plaque removal/debridement, and stent devices for structural maintenance of vascular lumen patency. Devices which directly apply laser energy for ablation of plaque material include a balloon-centered laser angioplasty system, excimer laser ablation catheter systems, and a fluorescence-guided spectral feedback laser system. Experience with these devices indicates that plaque can be successfully ablated by using laser energy. Vessel perforation and dissection are complications reported with these devices and the effects of laser angioplasty on restenosis remain unclear. Indirect application of laser energy has been tested by using a "hot tip" catheter and a laser balloon angioplasty system. Although the hot tip device has received FDA approval for use in peripheral arteries, it appears to have very limited applications in the coronary arteries. Laser balloon angioplasty appears to be beneficial in the setting of threatened acute closure; the device continues to be evaluated for potential beneficial impact on restenosis. Mechanical atherectomy catheters are designed to remove atherosclerotic plaque from the arterial system and include the AtheroCath, the Transluminal Extraction Catheter (TEC), and the Pullback Atherectomy Catheter (PAC). The Rotablator is an atheroablation device which debrides the obstructing plaque material with distal embolization of the particulate debris. Successful removal/debridement of atherosclerotic plaque has been demonstrated with the AtheroCath, Rotablator, and the TEC device. Pre-clinical studies demonstrate successful removal of plaque material with the PAC device. Despite the theoretic advantage of removing plaque material when performing angioplasty with these devices, there has been little or no reduction in restenosis rates based on a significant experience with the AtheroCath and the Rotablator. Intravascular stent devices including one self-expanding device design and two balloon-expandable device designs have been employed successfully in the elective setting to treat recurrent restenosis lesions. Two of the devices have been successfully tested in the setting of threatened acute closure. Early follow-up studies suggest some improvement in restenosis rates in certain clinical settings following intravascular stenting. Acute and subacute thrombosis remain substantial problems for stent devices and very aggressive anticoagulation regimens are necessary to minimize the adverse events. In summary, a number of a new technologic approaches for treatment of atherosclerotic lesions have been developed and are undergoing significant clinical evaluation.(ABSTRACT TRUNCATED AT 400 WORDS)

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Section: Direct Excimer Laser Systemmentioning

confidence: 99%

New technologies for the treatment of obstructive arterial disease

Fischell

Stadius

1991

Cathet. Cardiovasc. Diagn.

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In vitro study of a radiofrequency guidewire aimed at recanalization of totally occluded peripheral arteries

Melnik

Dupouy

Kvasnička

et al. 1994

Cathet. Cardiovasc. Diagn.

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A novel radiofrequency ablative system (40 msec-train pulses with twenty 200 msec pulses at the carrier frequency of 750 KHz and 1 Hz repetition rate) aimed at recanalizing totally occluded peripheral arteries was investigated by means of in vitro tissue ablation from human postmortem arterial wall samples. The samples were submitted to irradiation with a guidewire 150 cm long, maximum diameter of ceramic tip 0.033 inch positioned perpendicular to the tissue surface in saline, contrast medium or blood using varying generator power. Ablation efficacy was determined as the depth of vaporization per pulse delivered. Electrical current for the train duration was measured as voltage at the 1 ohm-resistor. In saline, the ablation efficacy increased from 8 to 65 microns/pulse with generator power increasing from 11 W to 27.5 W. There was no significant difference in the ablation efficacy between saline and blood. In contrast medium, the ablation efficacy was significantly lower. For the same generator power, the electrical current varied during the ablation procedure from 1.3 +/- 0.2 A at the beginning of the procedure to 1.1 +/- 0.2 A after the first pulses and to 2.0 A before artery wall perforation occurred. Neither tissue ablation nor current variations were observed when radiofrequency energy was emitted on calcified tissue. The diameter of craters was 0.89 +/- 0.1 mm (range: 0.85-0.96 mm). No major thermal injury such as carbonization or charring was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

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Immediate and Chronic Effects of Laser Angioplasty

Abela¹

1990

Developments in Cardiovascular Medicine

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Arterial response to excimer and argon laser irradiation in the atherosclerotic swine

Cited by 7 publications

References 13 publications

New technologies for the treatment of obstructive arterial disease

New technologies for the treatment of obstructive arterial disease

In vitro study of a radiofrequency guidewire aimed at recanalization of totally occluded peripheral arteries

Immediate and Chronic Effects of Laser Angioplasty

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