Ischinger T, Coppenrath K, Weber H, Enders S, Ruprecht L, Unsöld E, Hessel S
Division of Cardiology, Hospital Munich-Bogenhausen, Federal Republic of Germany.
Lasers Surg Med. 1990;10(2):112-23. doi: 10.1002/lsm.1900100203.
A modified concept using a movable fiber with radial light dispersion was developed for combining mechanical balloon dilatation and intraluminal circumferential Nd-Yag laser irradiation of the arterial wall. The aims of the study were the technical feasibility and the acute and chronic vascular tissue effects of laser-assisted balloon dilatation. The carotid arteries (n = 9 dogs) and femoral arteries (n = 5 dogs) of dogs were mechanically dilated and simultaneously circumferentially irradiated through the balloon by 1,064 nm Nd-Yag laser (20-25 W). Temperature at the adventitial surface was kept constant at 50 degrees C, 60 degrees C, 70 degrees C, or 80 degrees C for either 8 or 15 seconds by a computerized feedback system for temperature control. Angiographic and histological results were available acutely, subacutely (2 days), and at 3 months. Angiographically, stable and smooth enlargement of the lumen was demonstrated acutely. At 3 months, occlusions, probably thrombotic in origin, had occurred in 5 of the carotid arteries and none of the femoral arteries. Histologically, laser-induced coagulation of the arterial wall with loss of cellular elements was demonstrated. Collagen and elastic fibers remained relatively intact. In two carotid arteries intimal proliferation was observed at the treated site. Thus, this technique appears to be technically feasible, yet further study is needed to assess its potential to reduce or repair acute vascular complications (dissections) and to reduce restenoses after percutaneous transluminal coronary angioplasty (PTCA). However, the clinical value of this technique appears to be limited in view of the thromboses and reactive proliferations observed in this preliminary study.
为了将机械球囊扩张与动脉壁腔内圆周Nd-Yag激光照射相结合，开发了一种使用具有径向光散射的可移动光纤的改进概念。本研究的目的是评估激光辅助球囊扩张技术的可行性以及对血管组织的急慢性影响。对犬的颈动脉（n = 9只）和股动脉（n = 5只）进行机械扩张，并通过球囊同时进行1064 nm Nd-Yag激光（20 - 25 W）圆周照射。通过计算机化温度控制系统，将外膜表面温度在50℃、60℃、70℃或80℃下保持8秒或15秒。急性、亚急性（2天）和3个月时可获得血管造影和组织学结果。血管造影显示，急性时管腔呈稳定且平滑的扩大。3个月时，5条颈动脉发生闭塞，可能源于血栓形成，股动脉无一发生闭塞。组织学显示，激光导致动脉壁凝固，细胞成分丧失。胶原纤维和弹性纤维相对保持完整。在两条颈动脉的治疗部位观察到内膜增生。因此，该技术在技术上似乎是可行的，但仍需进一步研究以评估其减少或修复急性血管并发症（夹层）以及降低经皮腔内冠状动脉成形术（PTCA）后再狭窄的潜力。然而，鉴于在这项初步研究中观察到的血栓形成和反应性增生，该技术的临床价值似乎有限。
