Bowker T J, Fox K M, Cross F W, Poole-Wilson P A, Bown S G, Rickards A F
National Heart Hospital, London.
Br Heart J. 1988 Apr;59(4):429-37. doi: 10.1136/hrt.59.4.429.
Laser angioplasty can cause early (acute perforation) or late (stenosis or aneurysm) complications. To find how much intravascular laser energy can be delivered via a 100 microns core optical fibre passed down a balloon angioplasty catheter without causing angiographic abnormalities up to 10 days later, argon laser energy was delivered percutaneously under radiographic screening to the coronary circulation of 12 normal closed chest dogs. With the balloon inflated, sequential laser pulses were delivered to the same site. Angiograms were recorded before, immediately, and again at one week, after laser delivery. There were two laser-induced perforations (both fatal). Mechanical perforation with the 100 microns fibre occurred four times, but there were no haemodynamic sequelae. To find the acute perforation threshold of similar sized arteries to energy delivered via the bare 100 microns core fibre, the tip of which was held in contact with the luminal surface, 32 argon laser pulses were delivered transluminally in vivo to separate sites in normal rabbit iliac and canine coronary arteries. The acute perforation threshold with energy delivered via the angioplasty catheter lay between 6 and 10 J and that without the balloon angioplasty catheter lay between 3 and 4 J. After delivery of up to 6 J via a balloon angioplasty catheter, there were no angiographic abnormalities at one week. Fibre optic transluminal delivery of laser energy may improve the primary success rate of, and perhaps widen the indications for, coronary angioplasty.
激光血管成形术可引发早期（急性穿孔）或晚期（狭窄或动脉瘤）并发症。为了确定通过一根外径100微米的芯光纤经球囊血管成形术导管传输至血管内的激光能量在长达10天内不会引起血管造影异常的情况下能达到多少，在X线透视筛查下经皮向12只正常闭胸犬的冠状动脉循环输送氩激光能量。球囊充气后，向同一部位依次发射激光脉冲。在激光发射前、发射即刻以及发射一周后记录血管造影图像。出现了两例激光诱导穿孔（均致命）。100微米光纤造成机械穿孔4次，但未出现血流动力学后遗症。为了确定与通过裸露的100微米芯光纤传输能量时类似大小动脉的急性穿孔阈值（光纤尖端与管腔表面接触），在正常兔髂动脉和犬冠状动脉的不同部位经腔内向活体输送32个氩激光脉冲。通过血管成形术导管传输能量时的急性穿孔阈值在6至10焦耳之间，而不使用球囊血管成形术导管时的急性穿孔阈值在3至4焦耳之间。通过球囊血管成形术导管输送高达6焦耳的能量后，一周时未出现血管造影异常。经光纤经腔输送激光能量可能会提高冠状动脉成形术的初次成功率，或许还能扩大其适应证范围。
