Oomen A, van Erven L, Vandenbroucke W V, Verdaasdonk R M, Slager C J, Thomsen S L, Borst C
Interuniversity Cardiology Institute of The Netherlands.
Lasers Surg Med. 1990;10(4):363-74. doi: 10.1002/lsm.1900100410.
Pulsed lasers are being promoted for laser angioplasty because of their capacity to ablate obstructions without producing adjacent thermal tissue injury. The implicit assumption that thermal injury to the artery is to be avoided was tested. Thermal lesions were produced in the iliac arteries and aorta of normal rabbits by a) electrical spark erosion, b) the metal laser probe, and c) continuous wave neodymium-yttrium aluminum garnet (Nd-YAG) laser energy through the sapphire contact probe. High-energy doses were used to induce substantial damage without perforating the vessel wall. Thermal lesions (n = 77) were compared with mechanical lesions (n = 22) induced by oversized balloon dilation. Medial necrosis was induced by all four injury methods. Provided no extravascular contrast was observed after the injury, all damaged segments were patent after 1 to 56 days. The progression of healing with myointimal proliferation was remarkably similar for all injuries. At 56 days, the neointima measured up to 370 microns. In conclusion, provided no perforation with contrast extravasation occurred, the normal rabbit artery recovered well from transmural thermal injury. The wall healing response is largely nonspecific.
由于脉冲激光能够在不产生相邻热组织损伤的情况下消融阻塞物，因此正被推广用于激光血管成形术。对避免动脉热损伤这一隐含假设进行了测试。通过以下方式在正常兔的髂动脉和主动脉中产生热损伤：a）电火花腐蚀，b）金属激光探头，以及c）通过蓝宝石接触探头的连续波钕钇铝石榴石（Nd-YAG）激光能量。使用高能量剂量在不穿透血管壁的情况下诱导实质性损伤。将热损伤（n = 77）与超大球囊扩张引起的机械损伤（n = 22）进行比较。所有四种损伤方法均诱导了中层坏死。如果损伤后未观察到血管外造影剂，则所有受损节段在1至56天后均保持通畅。所有损伤的愈合过程伴肌内膜增生的进展非常相似。在56天时，新生内膜厚度可达370微米。总之，如果未发生穿孔及造影剂外渗，正常兔动脉经透壁热损伤后恢复良好。血管壁愈合反应在很大程度上是非特异性的。
