White C J, Ramee S R, Collins T J, Mesa J E, Paulsen D B, Murgo J P
Ochsner Medical Institutions, New Orleans, Louisiana 70121.
Lasers Surg Med. 1991;11(3):250-6. doi: 10.1002/lsm.1900110308.
Laser recanalization of totally occluded swine iliac arteries was performed to assess the safety and efficacy of a lensed fiber laser angioplasty system with a holmium:YAG (2.1 microns) laser. Silica lenses of 1.0 mm, 1.3 mm, and 1.5 mm in diameter attached to the distal end of a 300-microns diameter silica fiber delivered fluences of 79.5 J/cm2, 31.4 J/cm2, and 25.5 J/cm2, respectively. The pulse duration of the laser was 250 microseconds and the repetition rate was 4 Hz. The mean length of the total occlusions was 5.3 +/- 2.0 cm (range 0.5 cm to 8.0 cm). Successful recanalization was obtained in 16/16 lesions without angiographic vessel perforation. Angiographically significant residual stenoses (greater than 50%) remained in every case following successful laser recanalization. Histologically there was minimal evidence of thermal or acoustic tissue injury; however, in 4 of 16 arteries there was evidence of deep arterial dissection following laser recanalization. We conclude that this lensed fiber coupled with a holmium:YAG laser is a safe and effective method for crossing total occlusions in the relatively straight iliac arteries of this animal model.
对完全闭塞的猪髂动脉进行激光再通，以评估带有钬:钇铝石榴石（2.1微米）激光的透镜光纤激光血管成形系统的安全性和有效性。直径为1.0毫米、1.3毫米和1.5毫米的石英透镜连接到直径300微米的石英光纤末端，分别传递79.5 J/cm²、31.4 J/cm²和25.5 J/cm²的能量密度。激光的脉冲持续时间为250微秒，重复频率为4赫兹。完全闭塞的平均长度为5.3±2.0厘米（范围为0.5厘米至8.0厘米）。16个病变中有16个成功实现再通，且血管造影未发现血管穿孔。成功进行激光再通后，每个病例均存在血管造影显示的明显残余狭窄（大于50%）。组织学检查显示热或声学组织损伤的证据极少；然而，16条动脉中有4条在激光再通后出现深部动脉夹层的证据。我们得出结论，这种与钬:钇铝石榴石激光耦合的透镜光纤是在该动物模型相对笔直的髂动脉中穿过完全闭塞的一种安全有效的方法。
