O'Reilly G V, Forrest M D, Clarke R H, Schoene W C
Department of Radiology, Beth Israel Hospital, Boston, Massachusetts.
Acta Radiol Suppl. 1986;369:586-90.
Rebleeding after aneurysmal subarachnoid hemorrhage has a 45 per cent mortality rate. The peak incidence is within 24 hours of the initial bleed. During the ensuing 2 weeks 20 per cent of patients with suffer a second hemorrhage. To avoid this, surgical treatment must be instituted promptly but, logistically, this is often difficult to implement. To this end, we have devised an intravascular laser-catheter technique that may provide expeditious treatment for intracranial aneurysms. We have coagulated experimental aneurysms in the rabbit carotid artery using laser energy transmitted through an intra-arterial optical fiber. The special fiber tip was positioned in the aneurysm by a catheter introduced from the femoral artery. Laser power of 750 mW and an exposure of 15 seconds caused aneurysm ablation leaving the feeding artery patent. To date, 4 experimental aneurysms have been occluded by this technique and long term histologic results are pending in this ongoing study.
动脉瘤性蛛网膜下腔出血后的再出血死亡率为45%。其发病高峰在初次出血后的24小时内。在随后的2周内，20%的患者会再次出血。为避免这种情况，必须迅速开展手术治疗，但在实际操作中，这往往很难实施。为此，我们设计了一种血管内激光导管技术，该技术可为颅内动脉瘤提供快速治疗。我们使用通过动脉内光纤传输的激光能量，凝固了兔颈动脉中的实验性动脉瘤。通过从股动脉插入的导管将特殊的光纤尖端置于动脉瘤内。750毫瓦的激光功率和15秒的照射导致动脉瘤消融，供血动脉保持通畅。迄今为止，已有4个实验性动脉瘤通过该技术闭塞，在这项正在进行的研究中，长期组织学结果尚未得出。
