Prevosti L G, Wynne J J, Becker C G, Linsker R, Shires G T
Department of Surgery, New York Hospital, Cornell Medical Center, New York City.
J Vasc Surg. 1988 Apr;7(4):500-6.
Clinical use of laser angioplasty is limited by the lack of an adequate guidance system. As a first step toward developing a reliable guidance system, laser-induced surface fluorescence and a fluorescent probe were used to differentiate plaque from normal arterial wall. The aortas from four normal New Zealand white rabbits and six atherosclerotic rabbits were studied in vitro. Rabbits from each group received 2.5 mg/kg of hematoporphyrin derivative intravenously 24 hours before death. Segments of the aortas were irradiated with a helium-cadmium laser, and the tissue surface fluorescence spectra were recorded with an optical multichannel analyzer. A plaque index, based on the resulting spectra, was calculated for each specimen of aorta. The spectra from normal aorta without hematoporphyrin derivative, normal aorta with hematoporphyrin derivative, and from plaque of atherosclerotic rabbits without hematoporphyrin derivative showed the same wavelength dependence. The plaque index values were not significantly different from one another. However, in plaque from atherosclerotic rabbits given hematoporphyrin derivative, the spectrum was markedly different, showing a broad spectral peak at 632 nm. This spectral peak corresponds to the spectral peak of hematoporphyrin derivative and was only seen in the plaque of atherosclerotic rabbits given hematoporphyrin derivative. The plaque index for these specimens was significantly different from all other specimens (p less than 0.001). This difference in fluorescence spectra and plaque index could be incorporated into a guidance system for laser angioplasty.
激光血管成形术的临床应用因缺乏合适的引导系统而受到限制。作为开发可靠引导系统的第一步,利用激光诱导的表面荧光和一种荧光探针来区分斑块与正常动脉壁。对4只正常新西兰白兔和6只动脉粥样硬化兔的主动脉进行了体外研究。每组兔子在处死前24小时静脉注射2.5mg/kg血卟啉衍生物。用氦镉激光照射主动脉段,并用光学多通道分析仪记录组织表面荧光光谱。根据所得光谱计算每个主动脉标本的斑块指数。未注射血卟啉衍生物的正常主动脉、注射血卟啉衍生物的正常主动脉以及未注射血卟啉衍生物的动脉粥样硬化兔斑块的光谱显示出相同的波长依赖性。斑块指数值彼此之间无显著差异。然而,在注射了血卟啉衍生物的动脉粥样硬化兔的斑块中,光谱明显不同,在632nm处呈现一个宽光谱峰。这个光谱峰与血卟啉衍生物的光谱峰相对应,且仅在注射了血卟啉衍生物的动脉粥样硬化兔的斑块中出现。这些标本的斑块指数与所有其他标本有显著差异(p小于0.0