Muto Y, DuPree J J, Duemler S, Yang Y, Koyanagi N, Cuffari W J, Matsumoto T
Department of Surgery, Hahnemann University School of Medicine, Philadelphia, PA 19102-1192.
J Vasc Surg. 1988 Apr;7(4):562-7. doi: 10.1067/mva.1988.avs0070562.
The laser has been shown to vaporize arterial atheromatous plaque, but little information is available about its effect on various vascular materials. This study attempts to determine a safe margin for laser graft thrombectomy. An 18 watt argon laser with a 2 mm metal-encased sapphire tip fiberoptic system was used. Specimens such as autogenous vein, polytetrafluoroethylene (PTFE), and Dacron grafts as well as polypropylene and PTFE sutures were harvested from amputated human legs. Laser energy was delivered from the tip of the fiberoptic system while perpendicular to and in direct contact with these materials. The effects were examined histologically and compared by determining the bursting pressure of the grafts and the breaking strength of the sutures. The results indicate that seven sections of autogenous vein grafts and 11 sections of PTFE grafts were perforated by laser delivery of 32.9 +/- 9.9 and 50.0 +/- 7.1 joules, respectively, whereas two sections of Dacron grafts were easily perforated after only 10 joules was delivered. The bursting pressure of PTFE and autogenous vein grafts after laser application was determined to be more than 300 mm Hg. The breaking strength of 6-0 PTFE sutures was compared before and after receiving 200 joules by contact laser application. No significant difference was found; in a before laser application the breaking strength was 585.0 +/- 9.6 gm compared with 560.0 +/- 16.4 gm after laser application (n = 4, p greater than 0.1). However, 6-0 polypropylene sutures were easily melted after receiving 10 joules of laser energy.(ABSTRACT TRUNCATED AT 250 WORDS)
激光已被证明可汽化动脉粥样斑块,但关于其对各种血管材料的影响却知之甚少。本研究旨在确定激光血管移植血栓切除术的安全边界。使用了一个带有2毫米金属包裹蓝宝石尖端光纤系统的18瓦氩激光。从截肢的人腿上获取了诸如自体静脉、聚四氟乙烯(PTFE)、涤纶移植物以及聚丙烯和PTFE缝线等标本。激光能量从光纤系统尖端垂直传递并直接接触这些材料。通过组织学检查其效果,并通过测定移植物的破裂压力和缝线的断裂强度进行比较。结果表明,分别在传递32.9±9.9焦耳和50.0±7.1焦耳的激光后,7段自体静脉移植物和11段PTFE移植物被穿孔,而仅传递10焦耳激光后,2段涤纶移植物就很容易被穿孔。激光照射后PTFE和自体静脉移植物的破裂压力被测定为超过300毫米汞柱。通过接触式激光照射,比较了6-0 PTFE缝线在接受200焦耳激光前后的断裂强度。未发现显著差异;激光照射前断裂强度为585.0±9.6克,激光照射后为560.0±16.4克(n = 4,p>0.1)。然而,6-0聚丙烯缝线在接受10焦耳激光能量后很容易熔化。(摘要截短于250字)