Abela G S, Barbieri E, Friedl S E, Normann S J
University of Florida, Department of Medicine, Gainesville 32610.
J Clin Laser Med Surg. 1990 Jun;8(3):63-71.
Clinical use of laser recanalization has been mostly limited by arterial perforation. Two modifications of the optical fiber were used to decrease the perforation rate: (1) a guidewire to align the fiber in a coaxial position with the vascular lumen and (2) encapsulation of the optical fiber tip with a metal cap. Fourteen dogs were studied. Argon laser radiation was delivered through optical fibers, 9 with a 1.7-mm metal encapsulated fiber (Laserprobe-PLR,¿ Trimedyne, Santa Ana, CA) and 5 with a 2-mm metal encapsulated fiber with a window at the tip (Spectraprobe-PLR). Three dogs served as control, and no guidewire was used. In 11 dogs, laser irradiation was done either in advancing the probe or on pullback over a guidewire. Energy used ranged from 25 to 50 J. In vitro, this raised the probe temperature in blood to a maximum of 500 degrees C. Arterial perforation occurred in 2 of 4 lased arteries without guidewire (p less than 0.05). There was no difference in perforation rated comparing the Laserprobe (1 out of 17 arteries) and Spectraprobe (1 out of 8 arteries) (p greater than 0.05). At high laser energy (50 J), there was an increased incidence of thrombus formation, which appeared to be associated with adherence of the metal cap to the arterial wall (3 out of 6 vs. 1 out of 19, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
激光再通术的临床应用大多受到动脉穿孔的限制。对光纤进行了两种改进以降低穿孔率：（1）使用导丝使光纤与血管腔同轴定位；（2）用金属帽包裹光纤尖端。对14只犬进行了研究。通过光纤传输氩激光辐射，9只使用1.7毫米金属包裹光纤（Laserprobe-PLR，Trimedyne公司，加利福尼亚州圣安娜），5只使用尖端有窗口的2毫米金属包裹光纤（Spectraprobe-PLR）。3只犬作为对照，未使用导丝。11只犬在推进探头或沿导丝回撤时进行激光照射。使用的能量范围为25至50焦耳。在体外，这使探头在血液中的温度最高升至500摄氏度。在4条未使用导丝的激光照射动脉中，有2条发生动脉穿孔（p<0.05）。比较Laserprobe（17条动脉中的1条）和Spectraprobe（8条动脉中的1条）的穿孔率，无差异（p>0.05）。在高激光能量（50焦耳）时，血栓形成的发生率增加，这似乎与金属帽粘附于动脉壁有关（6条中的3条 vs. 19条中的1条，p<0.05）。（摘要截断于250字）
