Palanker Daniel, Vankov Alexander, Freyvert Yev, Huie Philip
Department of Ophthalmology, Stanford University School of Medicine, Stanford, California 94305-4085, USA.
Bioelectromagnetics. 2008 Feb;29(2):100-7. doi: 10.1002/bem.20368.
A variety of medical procedures is aimed to selectively compromise or destroy vascular function. Such procedures include cancer therapies, treatments of cutaneous vascular disorders, and temporary hemostasis during surgery. Currently, technologies such as lasers, cryosurgery and radio frequency coagulation, produce significant collateral damage due to the thermal nature of these interactions and corresponding heat exchange with surrounding tissues. We describe a non-thermal method of inducing temporary vasoconstriction and permanent thrombosis using short pulse (microseconds) electrical stimulation. The current density required for vasoconstriction increases with decreasing pulse duration approximately as t(-0.25). The threshold of electroporation has a steeper dependence on pulse duration-exceeding t(-0.5). At pulse durations shorter than 5 micros, damage threshold exceeds the vasoconstriction threshold, thus allowing for temporary hemostasis without direct damage to surrounding tissue. With a pulse repetition rate of 0.1 Hz, vasoconstriction is achieved approximately 1 min after the beginning of treatment in both arteries and veins. Thrombosis occurs at higher electric fields, and its threshold increases with vessel diameter. Histology demonstrated a lack of tissue damage during vasoconstriction, but vascular endothelium was damaged during thrombosis. The temperature increase does not exceed 0.1 degrees C during these treatments.
多种医疗程序旨在选择性地损害或破坏血管功能。此类程序包括癌症治疗、皮肤血管疾病的治疗以及手术期间的临时止血。目前,诸如激光、冷冻手术和射频凝固等技术,由于这些相互作用的热性质以及与周围组织相应的热交换,会产生显著的附带损伤。我们描述了一种使用短脉冲(微秒级)电刺激诱导临时血管收缩和永久性血栓形成的非热方法。血管收缩所需的电流密度随着脉冲持续时间的缩短大致按t(-0.25)增加。电穿孔阈值对脉冲持续时间的依赖性更强——超过t(-0.5)。在脉冲持续时间短于5微秒时,损伤阈值超过血管收缩阈值,从而能够实现临时止血而不会对周围组织造成直接损伤。在脉冲重复频率为0.1Hz时,在动脉和静脉中,治疗开始后约1分钟可实现血管收缩。在更高的电场下会形成血栓,其阈值随血管直径增加。组织学显示血管收缩期间不存在组织损伤,但血栓形成期间血管内皮会受损。在这些治疗过程中,温度升高不超过0.1摄氏度。