Recanalization of Infrainguinal Vessels: Silverhawk, Laser, and the Remote Superficial Femoral Artery Endarterectomy

Shafique, Shoaib; Nachreiner, Ryan; Murphy, Michael P.; Cikrit, Dolores F.; Sawchuk, Alan P.; Dalsing, Michael C.

doi:10.1053/j.semvascsurg.2007.02.002

Cited by 21 publications

(19 citation statements)

References 35 publications

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“…This was caused by several principal limitations, such as embolization with large debris, the low and heterogeneous optical absorbance properties of plaque tissues that were used as optical absorbers, restenosis of artery walls and, most importantly, a high risk of thermal damage to an artery wall [135–137]. As a result, the modern laser-based methods were eventually redirected from arteries to veins [135] with their current, rather limited, clinical applications for treating atherosclerotic disease [138]. We have suggested employing NP-generated PTBs for selective mechanical disruption and removal of the plaque or thrombus tissue without thermal and mechanical damage to the arterial wall (Figure 20).…”

Section: Biomedical Properties Of Gold Np-generated Ptbsmentioning

confidence: 99%

Plasmonic Nanoparticle-Generated Photothermal Bubbles and Their Biomedical Applications

2009

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This article is focused on the optical generation and detection of photothermal vapor bubbles around plasmonic nanoparticles. We report physical properties of such plasmonic nanobubbles and their biomedical applications as cellular probes. Our experimental studies of gold nanoparticle-generated photothermal bubbles demonstrated the selectivity of photothermal bubble generation, amplification of optical scattering and thermal insulation effect, all realized at the nanoscale. The generation and imaging of photothermal bubbles in living cells (leukemia and carcinoma culture and primary cancerous cells), and tissues (atherosclerotic plaque and solid tumor in animal) demonstrated a noninvasive highly sensitive imaging of target cells by small photothermal bubbles and a selective mechanical, nonthermal damage to the individual target cells by bigger photothermal bubbles due to a rapid disruption of cellular membranes. The analysis of the plasmonic nanobubbles suggests them as theranostic probes, which can be tuned and optically guided at cell level from diagnosis to delivery and therapy during one fast process. Keywordscell; imaging; laser; plasmonic nanoparticle; photothermal; theranostics; vapor bubble Biomedical applications of plasmonic nanoparticles (NPs) have demonstrated their biocompatibility [1,2], excellent optical scattering [3][4][5][6][7] and photothermal (PT) [8][9][10][11][12] properties and high photo-and thermal stability in comparison to any molecular optical absorbers. The combination of PT-sensing techniques [13] with plasmonic properties of the NPs has shown very promising results with a detection limit of several nanometers [14]. However, the sensitivity of PT sensing requires an increase in the laser-induced temperature, which may cause thermal damage to cells and tissues. Laser-induced PT phenomena include the initial thermalization of NPs that, in turn, rapidly causes several environmental thermal processes: the heating of the surrounding media [15][16][17] (due to thermal diffusion), its vaporization (if the temperature exceeds the vaporization threshold) and the generation of acoustic and shock waves [18]. Pulses that are too long (or continuous optical activation) cause a large spatial spread of the thermal field (many orders of magnitude larger than NP size) due to the thermal diffusion. This limits the selectivity and safety of NP-based PT diagnostics and therapy. Ultra-short laser pulses concentrate the thermal field within the NP but generate pressure (and shock) waves that also spread over a large volume and may cause uncontrollable damage [19]. The sensitivity, safety and specificity of NP methods are limited at cell and molecular levels by the strong scattering background of a highly heterogeneous bioenvironment and also by the incidental (nonspecific) accumulation of NPs in normal cells and tissues. Therefore, despite the apparent advantages of nanomaterials, their biomedical application does not yet bring a significant gain on the established methods. NIH Public AccessAutho...

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Section: Biomedical Properties Of Gold Np-generated Ptbsmentioning

confidence: 99%

Plasmonic Nanoparticle-Generated Photothermal Bubbles and Their Biomedical Applications

2009

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“…Patients who were scheduled to undergo atherectomy utilizing a silverhawk device and its well-defined procedure [40] were approached to participate in this study. During the procedure, the segments of atheromatous plaque that were removed were placed directly into a sterile container utilizing strict aseptic procedures.…”

Section: Methodsmentioning

confidence: 99%

A Possible Role of Bacterial Biofilm in the Pathogenesis of Atherosclerosis

Wolcott¹,

Wolcott²,

Palacio³

et al. 2012

J Bacteriol Parasitol

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Multiple culture and molecular based studies have established the presence of bacteria in atherosclerotic plaques. Although bacteria are present within the plaque, there is no clear understanding or putative pathway as to what part bacteria might play, if any, in the pathogenesis of atherosclerosis. The current models for the pathogenesis of atherosclerotic plaque suggest that persistent infl ammation is an important factor; however, the possible sources for this sustained infl ammation are limited. The concept of biofi lm infection, "a new paradigm of bacterial pathogenesis," is introduced to show that bacteria, organized into a biofi lm phenotype mode of growth, produces a sustained hyperinfl ammatory host niche. Biofi lm produces an oxidative environment in a host infection. Samples of plaque from 10 patients were examined to compare 16S rDNA to 18S rDNA. Also 4 samples were evaluated in 2 separate locations to evaluate the homogeneity of bacteria within the sample. The 16S rDNA was also sequenced to identify the microorganisms present and their relative contribution to the sample. Several samples demonstrated large amounts of bacterial DNA. The spatial arrangement of bacterial DNA showed a very heterogeneous distribution of bacteria in the plaque. A heat map data analysis shows that for samples that were evaluated in 2 locations the bacteria identifi ed closely correlated. For all the samples combined, the predominant microbial species identifi ed have often been associated with the oral cavity. Several samples show bacterial DNA far exceeding what would be expected by contamination, suggesting the bacteria may be propagating in the plaque. If bacteria are propagating within the plaque, this would most likely be a biofi lm phenotype mode of growth. Biofi lm is known to produce a hyperinfl ammatory response in host environments, and therefore is a candidate for being the "engine" for the persistent infl ammation necessary for the pathogenesis of atherosclerosis.

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“…To prevent blood vessel wall damage some devices use a shielded drill head, such as in the clinically available devices Rotarex (Straub Medical, Wang, Switzerland; in use for peripheral acute occlusions for over 20 years) [94,95] and the Silverhawk Plaque Excision System (Rockhawk, Covidien (ev3), Irvine, CA; in use for peripheral acute occlusions) [96]. Rotarex is a highly effective and efficient treatment tool for peripheral acute and chronic occlusions with reported success rates of over 95% [94].…”

Section: ) Resection -Tangentialmentioning

confidence: 99%

“…Lasers (In use for peripheral and coronary chronic occlusions): A laser for plaque resection and removal was first described in 1984. A currently available laser for recanlizing CTOs is the CVX-300 excimer laser system (Spectranetics, Colorado Springs, CO; a pulsed xenon monochloride excimer laser, with a wavelength of 308 nm, pulse duration of 125-200 ns, a repetition rate of 25-80 Hz, and an energy level of 30-80 mJ/mm 2 ; in use for peripheral and coronary chronic occlusions) [96,159,160] in combination with the Excimer Laser Coronary Atherectomy (ELCA) Laser catheter (Spectranetics, Colorado Springs, CO) [161] or TURBO Elite Laser Atherectomy Catheter (Spectranetics, Colorado Springs, CO) (FDA approved since 2006) [7]. Furthermore, the general use of catheterintegrated lasers is described for clot disruption in [162][163][164] (see Fig.…”

Section: ) State Changementioning

confidence: 99%