Effect of pulse duration on selective ablation of atherosclerotic plaque by 480- to 490-nanometer laser radiation.

The effect of varying pulse duration on selective ablation of human arterial plaque was evaluated by measuring ablation thresholds and ablation efficiencies on fresh human fibrofatty plaque, calcified plaque, normal intima, deep media, and adventitia using 480- to 490-nm laser radiation at 1, 8, and 50-microseconds pulse durations. For all tissues examined, the ablation threshold energy increased with increasing pulse duration, but the threshold for normal tissue ablation was approximately twice that of plaque at all pulse durations. Ablation efficiency was studied at a fluence that was twice the ablation threshold for plaque. For those fluences, normal intima had detectable ablation only at 50 microseconds. The ablation efficiency of fibrofatty plaque was minimally reduced with prolongation of pulse duration; however, there was a substantial decrease in the ablation efficiency of calcified plaque when the pulse duration was lengthened from 8 to 50 microseconds. These data show significant selective ablation of fibrofatty and calcified plaque at 1, 8, and 50 microseconds and suggest that the optimal pulse width for selective ablation of all plaque in the 480- to 490-waveband is less than 50 microseconds.