Morcos N C, Dinh Q, Henry W, Berns M
Department of Medicine, University of California, Irvine.
J Clin Laser Med Surg. 1994 Jun;12(3):159-63. doi: 10.1089/clm.1994.12.159.
In this study the effects of excimer laser (308 nm) angioplasty on arteries have been studied. We report histology and vasoreactivity properties of human atherosclerotic and normal coronary arteries and bovine coronary arteries after exposure to pulsed excimer laser irradiation. Segments of isolated and pharmacologically active human coronary arteries were obtained within 5-8 hr postmortem. Segments of bovine arteries were obtained from fresh hearts. Side branches were ligated and vessels perfused with Krebs-Ringer's-bicarbonate solution in a perfusion apparatus to maintain their viability. Excimer laser irradiation was performed using a fused silica fiber advanced through the artery within a polyethylene cannula to assist with steerability and to protect against perforation. The fiber delivered a total of 40-60 J at its tip at 100 mJ/pulse at 15 pulses/sec. A total of 5 human atherosclerotic, 2 human normal, and 8 bovine arteries were used. Ablation of plaque was accomplished with remarkable ease and little resistance. Histologic studies showed clear-cut wedges inscribed by the catheter along the arterial wall without charring or thermal effects of coagulation necrosis. Vasoreactivity was assessed by measuring flow changes during perfusion before and after excimer angioplasty using a transient challenge with the vasoconstrictor serotonin. All excimer-irradiated arteries showed no increase in vasoreactivity during the challenge and showed preservation of relaxation properties following the challenge. In conclusion, coronary artery angioplasty by excimer laser appears to allow for effective plaque ablation with simultaneous preservation of structure and pharmacological properties of arteries.
在本研究中，已对准分子激光（308纳米）血管成形术对动脉的影响进行了研究。我们报告了人类动脉粥样硬化和正常冠状动脉以及牛冠状动脉在接受脉冲准分子激光照射后的组织学和血管反应性特性。在死后5 - 8小时内获取分离的、具有药理活性的人类冠状动脉节段。牛动脉节段取自新鲜心脏。结扎侧支，在灌注装置中用 Krebs - Ringer 碳酸氢盐溶液灌注血管以维持其活力。使用一根通过聚乙烯套管插入动脉的熔融石英光纤进行准分子激光照射，以辅助操控并防止穿孔。光纤在其尖端以100毫焦/脉冲、每秒15个脉冲的频率总共输送40 - 60焦耳能量。总共使用了5条人类动脉粥样硬化动脉、2条人类正常动脉和8条牛动脉。斑块消融操作轻松且阻力很小。组织学研究显示，导管在动脉壁上留下清晰的楔形痕迹，无碳化或凝固性坏死的热效应。通过在准分子血管成形术前后使用血管收缩剂血清素进行短暂刺激来测量灌注期间的血流变化，从而评估血管反应性。所有接受准分子激光照射的动脉在刺激期间血管反应性均未增加，并且在刺激后仍保持舒张特性。总之，准分子激光冠状动脉血管成形术似乎能够有效消融斑块，同时保留动脉的结构和药理特性。
