Davis G S, Bott-Silverman C, Goormastic M, Gerrity R G, Kittrell C, Feld M, Kramer J R
Department of Cardiology, Cleveland Clinic Foundation, OH 44106.
Lasers Surg Med. 1988;8(1):72-6. doi: 10.1002/lsm.1900080113.
Using an optically shielded fiber optic laser catheter, the amount of gas produced when firing an argon ion laser into 0.9% saline solution or blood alone and into atheromatous aorta in either a blood or 0.9% saline medium was quantitated. Energies from 0.25 to 4 joules (J) were used at powers of 2, 5, and 8 W. We found that total volume of gas produced is small not only at equilibrium (0.3 +/- 0.1 microliter/J when firing in blood alone and also when ablating aorta in blood or saline media) but also at peak (2.5 +/- 0.2 microliters/J firing in blood alone and 1.0 +/- 0.1 microliter/J or 0.9 +/- 0.1 microliter/J when ablating aorta in saline or blood, respectively). Because these volumes are small, a clinically significant event from a gas embolus is unlikely during intravascular laser ablation of atheromatous plaque in the energy and power range studied. No gas was quantitated when firing the argon ion laser into 0.9% saline solution alone. The peak gas volume when firing in blood alone was significantly greater than that produced in the other chamber environments. This is thought to be due to increased absorption of argon laser light by hemoglobin. The gas volumes produced by lasing aorta in 0.9% saline or blood were not statistically different.
使用光学屏蔽的光纤激光导管，对在0.9%盐溶液或单独血液中以及在血液或0.9%盐溶液介质中的动脉粥样硬化主动脉中发射氩离子激光时产生的气体量进行了定量。在2瓦、5瓦和8瓦的功率下使用了0.25至4焦耳（J）的能量。我们发现，产生的气体总体积不仅在平衡时很小（单独在血液中发射时为0.3±0.1微升/焦耳，在血液或盐溶液介质中消融主动脉时也是如此），而且在峰值时也很小（单独在血液中发射时为2.5±0.2微升/焦耳，在盐溶液或血液中消融主动脉时分别为1.0±0.1微升/焦耳或0.9±0.1微升/焦耳）。由于这些体积很小，在所研究的能量和功率范围内，在血管内激光消融动脉粥样硬化斑块期间，不太可能发生由气体栓子引起的具有临床意义的事件。单独将氩离子激光发射到0.9%盐溶液中时未检测到气体。单独在血液中发射时的峰值气体体积明显大于在其他腔室环境中产生的体积。这被认为是由于血红蛋白对氩激光的吸收增加所致。在0.9%盐溶液或血液中激光消融主动脉产生的气体体积没有统计学差异。
