Perspectives of coronary excimer laser angioplasty: Multiplexing, saline flushing, and acoustic ablation control

Haase, Karl K.; Rose, Carsten; Duda, Stephan H.; Baumbach, Andreas; Oberhoff, Martin; Anthanasiadis, Anastasios; Karsch, Karl R.

doi:10.1002/(sici)1096-9101(1997)21:1<72::aid-lsm11>3.0.co;2-b

Cited by 11 publications

(7 citation statements)

References 14 publications

(14 reference statements)

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“…In pulsed laser angioplasty, shock waves play an important role in tissue ablation [35] but are, on the other hand, considered to be responsible for adjacent tissue damage [1]. Shock waves generated during ESWL are known to cause side effects such as transient hematuria and sometimes subcapsular renal hematomas [36].…”

Section: Biological Relevancementioning

confidence: 99%

See 1 more Smart Citation

Laser-induced shock wave endothelial cell injury

Sondén¹,

Svensson

Roman³

et al. 2000

Lasers Surg. Med.

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Section: Biological Relevancementioning

confidence: 99%

“…excimer laser angioplasty [1], ophthalmologic laser capsulotomy [2,3], laser lithotripsy [4], and extracorporeal shock wave lithotripsy (ESWL) [5]. Pressure transients may also be generated under battlefield conditions, where impact from high velocity missiles and blasts can induce pressure waves within the target [6,7].…”

Section: Introductionmentioning

confidence: 99%

Laser-induced shock wave endothelial cell injury

Sondén¹,

Svensson

Roman³

et al. 2000

Lasers Surg. Med.

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“…The expansion of cavitation bubble induces a fast dilation of the vessel wall, while the subsequent bubble collapse leads to an invagination of the vessel wall ( Fig. The incidence of dissection may be reduced by pulse multiplexing (Oberhoff et al 1992;Haase et al 1997) or by infusing saline through the guide catheter during excimerlaser angioplasty (Litvack et al 1993;van Leeuwen et al 1996). Both effects are responsible for the observed structural deformation of the adjacent tissue.…”

Section: Collateral Effects Induced By Cavitationmentioning

confidence: 99%

“…Both effects are responsible for the observed structural deformation of the adjacent tissue. In a later study, Haase et al (1997) conducted experiments on pressure wave propagation during pulsed laser ablation using conventional and experimental XeCl lasers emitting light at a wavelength of 308 nm and pulse duration of 115 ns. The incidence of dissection may be reduced by pulse multiplexing (Oberhoff et al 1992;Haase et al 1997) or by infusing saline through the guide catheter during excimerlaser angioplasty (Litvack et al 1993;van Leeuwen et al 1996).…”

Section: Collateral Effects Induced By Cavitationmentioning

confidence: 99%

Cavitation in Non-Newtonian Fluids

Brujan

2011

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“…[34] This dilatation was associated with dissections and vessel wall damage beyond the penetration depth of the laser irradiation used. [32,33,[35][36][37][38][39] In vitro and animal experiments have shown that infusion of saline solution during excimer laser radiation could avoid bubble formation and increase of acoustic pressure which is otherwise seen after activation of the laser in blood. Saline infusion during laser activation significantly decreased vessel wall trauma.…”

Section: Saline Infusion Techniquementioning

confidence: 99%

Laser Coronary Angioplasty

Köster

Kähler

Brockhoff

et al. 2002

American Journal of Cardiovascular Drugs

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The efficacy of percutaneous transluminal coronary angioplasty (PTCA) is limited by remaining plaque tissue and the development of restenosis. It has been demonstrated that the restenosis rate is low if a large lumen diameter is achieved after coronary intervention. Debulking of coronary stenoses is a concept to increase the luminal diameter after intervention. Laser angioplasty debulks coronary stenoses by ablation of atherosclerotic plaque. Since the first intravascular laser intervention, the technique has been significantly improved by the use of optimized wavelength, the development of flexible optimally spaced multifiber catheters and an additional saline flush technique. These technical advancements allowed a reduction in the incidence of adverse events, such as the number of dissections and perforations, associated with the use of the laser technique. Coronary laser angioplasty is commonly combined with adjunctive balloon angioplasty to optimize the outcome. Laser coronary angioplasty was not followed by a lower restenosis rate compared with plain balloon angioplasty in lesions without stents, however, a randomized comparison of the techniques including the use of the saline flush technique is not available yet. The value of excimer (acronym for excited dimer) laser coronary angioplasty for treatment of in-stent restenosis is still under investigation. So far, nonrandomized single center studies have not suggested a relevant benefit for this technique used for in-stent restenosis. In nonstented lesions there remain niche indications for laser angioplasty such as the treatment of ostial lesions, diffuse lesions or lesions traversable with a guidewire but not with an angioplasty balloon. Laser coronary angioplasty may also be useful after a failed balloon angioplasty and in patients with chronic total occlusions. The potential advantages of combining laser coronary angioplasty with vaporization of thrombus in patients with acute coronary syndromes are currently under evaluation.

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Perspectives of coronary excimer laser angioplasty: Multiplexing, saline flushing, and acoustic ablation control

Cited by 11 publications

References 14 publications

Laser-induced shock wave endothelial cell injury

Laser-induced shock wave endothelial cell injury

Cavitation in Non-Newtonian Fluids

Laser Coronary Angioplasty

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