Hirano T, Komatsu M, Ezura M, Uenohara H, Takahashi A, Takayama K, Yoshimoto T
Department of Neurosurgery; Tohoku University Graduate School of Medicine, Shock Wave Research Center; Institute of Fluid Science, Tohoku University; Sendai, Japan -
Interv Neuroradiol. 2001 Dec 22;7(Suppl 1):35-40. doi: 10.1177/15910199010070S103. Epub 2002 Jan 10.
There are some problems such as a narrow therapeutic time window and severe side effects of fibrinolytics in the therapy of cerebral embolisms. Therefore, it is necessary to develop a new method to remove a cerebral thrombus more rapidly with fewer fibrinolytics. A Q-switch pulsed holmium (Ho): YAG laser with 86 mJ/pulse, pulse duration of 200ns and wavelength of 2.1 mm was used. The laser beam was transmitted through a 0.6 mm diameter quartz optical fiber. Experiments were conducted in a stainless steel container equipped with observation windows . The test chamber was filled with distilled water at 283K. At first, the formation of laser-induced bubbles in a 4 mm diameter glass tube was observed. The bubble gradually expanded and reached a maximum size at about 1 ms after irradiation. A shock wave induced by ignition of silver azide pellet was interacted with it at 500mus before Ho:YAG laser irradiation, which resulted in forming a liquid jet. This liquid jet penetrated into an artificial thrombus made of gelatin, and its maximum penetration depth was 4.2 mm, which was nearly twice deeper than the laser irradiation only (2.2 mm). Combination of this liquid jet and fibrinolytics will realize more rapid recanalization with fewer drugs.
在脑栓塞治疗中,存在一些问题,如纤溶剂的治疗时间窗狭窄和严重副作用。因此,有必要开发一种新方法,用更少的纤溶剂更快速地清除脑栓。使用了一种调Q脉冲钬(Ho):钇铝石榴石激光器,其能量为86 mJ/脉冲,脉冲持续时间为200纳秒,波长为2.1毫米。激光束通过直径0.6毫米的石英光纤传输。实验在一个配备观察窗的不锈钢容器中进行。测试腔中充满了283K的蒸馏水。首先,观察了直径4毫米玻璃管中激光诱导气泡的形成。气泡逐渐膨胀,在照射后约1毫秒达到最大尺寸。在钬:钇铝石榴石激光照射前500微秒,由叠氮化银颗粒点火诱导的冲击波与气泡相互作用,从而形成了液体射流。该液体射流穿透由明胶制成的人工血栓,其最大穿透深度为4.2毫米,几乎是仅激光照射深度(2.2毫米)的两倍。这种液体射流与纤溶剂相结合将以更少的药物实现更快速的再通。