Effects of simultaneous viewing and vaporization of plaques using the steerable, laser-heated metal cap in the atherosclerotic monkey model.

A steerable, fiberoptic catheter coupled to a laser light guide tipped with a metal cap was used. Four monkeys fed an atherogenic diet for 7-8 years were angiographed and were found to have extensive mural plaque in the iliac arteries. Plaque sites in these monkeys were vaporized using the laser-heated metal cap. Energies of 1.5-9 Joules were employed. Application of the energy was tangential of perpendicular to the plaque. Lased sites were examined histologically at 24 hr or at 3 months after treatment. No effect was seen at 1.5 Joules. Three to six Joules tangentially produced a superficial lesion that extended into the tunica intima. Six Joules perpendicularly produced a burn into the tunica adventitia, with damage to the vasavasorum. Nine Joules tangentially produced a burn into the tunica media. Three months after treatment, this lased site showed no stenosis or aneurysm formation.