Spears J R
Cardiovasc Intervent Radiol. 1986;9(5-6):303-12. doi: 10.1007/BF02577961.
In recent years, rapid progress in the application of lasers to the percutaneous treatment of atherosclerosis has been made. An overview of this progress is provided herein in terms of a description of promising laser approaches and problems to be solved. Direct vaporization of obstructing atheroma with fiberoptic delivery of laser energy has been associated with a high incidence of mural perforation, but each of a variety of techniques, including those for improved energy delivery, plaque recognition, alignment of the fiberoptic, and, perhaps, reduction of unnecessary thermal injury, has shown promise for reducing this complication. Nonablation applications of laser energy may also have a role in the treatment of atherosclerosis. During laser balloon angioplasty, the tissue coagulation effects of laser-thermal energy may be used during balloon inflation to eliminate arterial dissections and to reduce elastic recoil, thereby potentially eliminating abrupt reclosure and, perhaps, reducing the incidence of restenosis associated with conventional balloon angioplasty. Photochemical destruction of viable plaque tissue and vasa vasorum with porphyrins and intraarterial light represents a nonthermal, laser-based approach that could have a prophylactic role in slowing progression of diffuse atherosclerotic disease. The remarkable versatility of lasers is responsible for the multiplicity of approaches being investigated and for the current optimism that lasers will eventually play an important role in the percutaneous treatment of atherosclerosis.
近年来，激光在经皮动脉粥样硬化治疗中的应用取得了快速进展。本文将根据有前景的激光治疗方法及有待解决的问题对这一进展进行概述。利用光纤传输激光能量直接汽化阻塞性动脉粥样硬化斑块与较高的血管壁穿孔发生率相关，但包括改善能量传输、斑块识别、光纤对准以及或许减少不必要热损伤等在内的多种技术，都显示出降低这种并发症的潜力。激光能量的非消融应用在动脉粥样硬化治疗中也可能发挥作用。在激光球囊血管成形术中，激光热能的组织凝固效应可在球囊扩张时用于消除动脉夹层并减少弹性回缩，从而有可能消除急性再闭塞，并或许降低与传统球囊血管成形术相关的再狭窄发生率。用卟啉和动脉内光对存活的斑块组织及滋养血管进行光化学破坏是一种基于激光的非热方法，可能在减缓弥漫性动脉粥样硬化疾病进展方面具有预防作用。激光的显著多功能性导致了正在研究的多种治疗方法，也使得人们目前乐观地认为激光最终将在经皮动脉粥样硬化治疗中发挥重要作用。
