Single-laser approach for fluorescence guidance of excimer laser angioplasty at 308 nm: Evaluation in vitro and during coronary angioplasty

Moguet, Andreas J.; Gabriel, Ruth E.; Buchwald, A.; Werner, Gerald S.; Nyga, Ralf; Kreuzer, H

doi:10.1002/(sici)1096-9101(1997)20:4<382::aid-lsm3>3.0.co;2-m

Cited by 19 publications

(17 citation statements)

References 32 publications

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“…The spectral emission of coronary artery has been reported for both ex vivo 9,10,23,24 and in vivo 12,13 investigation and for various excitation wavelengths: 308 nm, 12 325 nm, 23,24 337 nm, 10 and 476 nm. 9 The time-integrated spectra of normal coronary artery described by our study are in agreement with the emission spectra reported by the research groups that used 337 nm and 325 nm for excitation.…”

Section: Spectral and Temporal Fluorescence Characteristicsmentioning

confidence: 99%

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Discrimination of Human Coronary Artery Atherosclerotic Lipid-Rich Lesions by Time-Resolved Laser-Induced Fluorescence Spectroscopy

Marcu

Fishbein

Maarek

et al. 2001

ATVB

103

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Abstract-Lesion composition plays a significant role in atherosclerotic lesion instability and rupture. Current clinical techniques cannot fully characterize lesion composition or accurately identify unstable lesions. This study investigates the use of time-resolved fluorescence spectroscopy for unstable atherosclerotic lesion diagnosis. The fluorescence of human coronary artery samples was induced with nitrogen laser and detected in the 360-to 510-nm wavelength range. The samples were sorted into 7 groups according to the AHA classification: normal wall and types I, II a (fatty streaks), III (preatheroma), IV (atheroma), V a (fibrous), and V b (calcified) lesions. Spectral intensities and time-dependent parameters [average lifetime f ; decay constants: 1 (fast-term), 2 (slow-term), A 1 (fast-term amplitude contribution)] derived from the time-resolved spectra of coronary samples were used for tissue characterization. We determined that a few intensity values at longer wavelengths (Ͼ430 nm) and time-dependent parameters at peak emission region (390 nm) discriminate between all types of arterial samples except between normal wall and type I lesions. The lipid-rich lesions (more unstable) can be discriminated from fibrous lesions (more stable) on the basis of time-dependent parameters (lifetime and fast-term decay). We inferred that features of lipid fluorescence are reflected on lipid-rich lesion emission. Our results demonstrate that analysis of the time-resolved spectra may be used to enhance the discrimination between different grades of atherosclerotic lesions and provide a means of discrimination between lipid-rich and fibrous lesions. Key Words: atherosclerosis Ⅲ lesion instability Ⅲ time-resolved laser-induced fluorescence Ⅲ spectroscopy R upture of coronary atherosclerotic lesions leads to the acute coronary syndromes of unstable angina, acute myocardial infarction, and ischemic sudden death. [1][2][3] Evidence suggests that lesion composition plays a crucial role in lesion instability and that lipid-rich lesions are more prone to rupture than fibrous lesions. [1][2][3] Current clinical techniques (angiography, angioscopy, ultrasound) are limited in their ability to characterize lesion composition and identify lipidrich lesions. 3 Various techniques are currently under study as potential new tools for identification of lipid-rich lesions (MRI, 4 near-infrared spectroscopy, 5 Raman spectroscopy 6 ) or markers of instability, such as macrophage activation in fibrous cap (local thermography 7 ).Several groups have investigated laser-induced fluorescence spectroscopy (LIFS) as a tool for analyzing plaque composition in the attempt to guide laser angioplasty and to evaluate the likelihood of restenosis. 8 -13 The research was carried out for both ex vivo 8 -12 and in vivo 12,13 conditions. These early studies have demonstrated the potential of LIFS to characterize a few types of atherosclerotic lesions (fibrous, atheromatous, calcified) and to discriminate those from the normal arterial wall. These studies,...

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Section: Spectral and Temporal Fluorescence Characteristicsmentioning

confidence: 99%

“…8 -13 The research was carried out for both ex vivo 8 -12 and in vivo 12,13 conditions. These early studies have demonstrated the potential of LIFS to characterize a few types of atherosclerotic lesions (fibrous, atheromatous, calcified) and to discriminate those from the normal arterial wall.…”

mentioning

confidence: 99%

Discrimination of Human Coronary Artery Atherosclerotic Lipid-Rich Lesions by Time-Resolved Laser-Induced Fluorescence Spectroscopy

Marcu

Fishbein

Maarek

et al. 2001

ATVB

103

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“…Initially the research was focused on autofluorescence emission for disease characterization [6][7][8] and for using it as a guidance for laser angioplasty system [9,10]. But due to the poor biochemical information carried out by fluorescence spectrum, the use of near-infrared Raman spectroscopy (NIRS) for tissue classification has been gaining evidence [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Correlation between near‐infrared Raman spectroscopy and the histopathological analysis of atherosclerosis in human coronary arteries

et al. 2002

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“…However, to our knowledge this is the first report of clinical measurements, using transcutaneous cannulization, of fluorescence in coronary atheroma with a comparative study. Bartorelli et al 20 and Morguet et al 21 used coronary arterial autofluorescence in a feedback system in laser angioplasty, but because it has become possible to clearly differentiate the fluorescence of DOXY, a substance which is not naturally present in the body, from autofluorescence, this method was considered to be a simple and smart guidance system. With further improvements to this system, it should be useful in studies of coronary atherosclerosis.…”

Section: Fluorescence Spectral Analysis Of Arteriosclerotic Lesions Umentioning

confidence: 99%

Fluorescence Spectrum Analysis of Atherosclerotic Plaque Using Doxycycline

et al. 1999

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arious interventional therapies are presently used in the treatment of ischemic heart disease. In clinical trials in the US, percutaneous transluminal laser coronary angioplasty (PTLCA) was performed on 3,000 patients and 3,592 lesions using excimer laser, with a reported success rate of 84%. 1 When this method is compared with percutaneous transluminal coronary angioplasty (PTCA) using a balloon, PTLCA can be performed on diffuse lesions in which PTCA is difficult, and it may be possible to use the laser to recanalize a chronic total occlusion, a lesion in which the passage of a guide wire would be very difficult. In addition, PTCA is contraindicated in ostial stenosis, and PTLCA is considered the first choice in closed chest treatment. In PTLCA, however, unexpected coronary perforation occurs in between 1.2 to 2.4% of cases, 1-4 a rate which is obviously higher than for PTCA. As avoidance of coronary perforation is the paramount consideration in PTLCA, the requirement is for an appropriate guidance system to show the condition of the hypertrophic intima and the degree of ablation in real time, so that the atheroma alone is selectively ablated and the tunica media not irradiated.At present, evaluation of coronary arteriosclerotic lesions is made using angioscopy and intravascular ultrasound, neither of which can be inserted into the coronary artery at the same time as the laser irradiation system and so cannot be the appropriate guidance system. Fluorescence spectrum analysis is a method by which the fluorescence induced by irradiation at specific wavelengths of an arteriosclerotic lesion is examined in detail to make the diagno-

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Single-laser approach for fluorescence guidance of excimer laser angioplasty at 308 nm: Evaluation in vitro and during coronary angioplasty

Cited by 19 publications

References 32 publications

Discrimination of Human Coronary Artery Atherosclerotic Lipid-Rich Lesions by Time-Resolved Laser-Induced Fluorescence Spectroscopy

Discrimination of Human Coronary Artery Atherosclerotic Lipid-Rich Lesions by Time-Resolved Laser-Induced Fluorescence Spectroscopy

Correlation between near‐infrared Raman spectroscopy and the histopathological analysis of atherosclerosis in human coronary arteries

Fluorescence Spectrum Analysis of Atherosclerotic Plaque Using Doxycycline

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