Gandy K L, Hartz R S, Shih S R, Roth S I
Department of Surgery, Northwestern University Medical School, Chicago, IL 60611.
Virchows Arch B Cell Pathol Incl Mol Pathol. 1990;58(6):411-6. doi: 10.1007/BF02890100.
This study describes the effects of CO2 laser radiation on the histology of the normal rabbit arterial wall, using models that simulate laser angioplasty and anastomosis. Rabbit arteries were exposed to laser treatments similar to those used clinically; 40, 0.5 sec pulses of 40-60 mW, CO2 continuous wavelength laser, or a 1/2-circumferential laser anastomosis with a 60-80 mW continuous pulse. Aneurysms developed in 8 of 22 femoral, 1 of 22 carotid, and no controls at 12 week. There were small breaks in the internal elastic lamina with atrophy, loss of muscularis, "packing" of the elastica, thinning of the muscularis at the damage site, and enlargement of the arterial diameter. Aneurysms developed in one femoral and no carotid anastomosed artery. Laser anastomoses demonstrated more muscle damage and loss, with extensive scarring and a wider area of elastic loss than the controls. The intima was reestablished with focal reduplication of the internal elastic lamina. There were no histologic differences between the arteries which developed aneurysms and those which did not in either series. These results suggest that low power laser damage of the arterial wall consists mainly of destruction of the muscularis propria, with minimal damage to the elastica.
本研究利用模拟激光血管成形术和吻合术的模型，描述了二氧化碳激光辐射对正常兔动脉壁组织学的影响。兔动脉接受了类似于临床使用的激光治疗；40次0.5秒的40 - 60毫瓦二氧化碳连续波长激光脉冲，或60 - 80毫瓦连续脉冲的半周激光吻合术。12周时，22条股动脉中有8条、22条颈动脉中有1条出现动脉瘤，对照组未出现。内弹性膜有小的断裂，伴有萎缩、肌层丧失、弹性组织“堆积”、损伤部位肌层变薄以及动脉直径增大。1条股动脉和无颈动脉吻合动脉出现动脉瘤。与对照组相比，激光吻合术显示出更多的肌肉损伤和丧失，伴有广泛的瘢痕形成和更大面积的弹性组织丧失。内膜通过内弹性膜的局灶性重复而重建。在这两个系列中，发生动脉瘤的动脉和未发生动脉瘤的动脉之间在组织学上没有差异。这些结果表明，动脉壁的低功率激光损伤主要包括固有肌层的破坏，而对弹性组织的损伤最小。
