School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, China.
Key Laboratory of Big Data-Based Precision Medicine Ministry of Industry and Information Technology, School of Engineering Medicine, Beihang University, Beijing, China.
Lasers Med Sci. 2023 Dec 29;39(1):18. doi: 10.1007/s10103-023-03964-2.
Vascular diseases, such as venous insufficiency and coronary artery diseases, have been threatening the health of people. Efficient treatment with proper postoperative care is required to relieve the pain of the patients. Traditionally, venous insufficiency is treated with ligation and stripping, an open surgery whose complication rate cannot be ignored. Coronary artery disease is often treated with balloon angioplasty during which undilatable lesions may be encountered, limiting the efficacy of this approach. With advances in laser photonics and percutaneous coronary intervention procedure, laser ablation is emerging as an alternative and adjunctive therapy for these diseases. Endovenous laser ablation has the advantages of high success rate, low complication risk, and fast postoperative recovery. Laser ablation in arteries can handle uncrossable or undilatable lesions with a low incidence of serious complications. In this review, previously published research concerning vascular diseases and their therapies are analyzed in order to provide a clear explanation of the mechanisms and merits of laser ablation. For endovenous laser ablation, the main mechanisms are steam bubbles, heat conduction, and heat pipe, and three main influencing factors are wavelength, fiber types, and laser energy density. For excimer laser coronary atherectomy, the main mechanisms are photochemical, photothermal, and photomechanical effects, and three main influencing factors are catheter, medium, and laser parameters.
血管疾病，如静脉功能不全和冠状动脉疾病，一直威胁着人们的健康。需要进行有效的治疗并辅以适当的术后护理，以减轻患者的痛苦。传统上，静脉功能不全采用结扎和剥脱术治疗，这是一种开放性手术，其并发症发生率不容忽视。冠状动脉疾病通常采用球囊血管成形术治疗，但可能会遇到无法扩张的病变，从而限制了这种方法的疗效。随着激光光子学和经皮冠状动脉介入治疗技术的进步，激光消融术作为这些疾病的替代和辅助治疗方法正在兴起。静脉内激光消融术具有成功率高、并发症风险低、术后恢复快的优点。激光消融术在动脉中可以处理无法跨越或无法扩张的病变，严重并发症的发生率较低。在这篇综述中，分析了以前发表的关于血管疾病及其治疗的研究，以清楚地解释激光消融术的机制和优点。对于静脉内激光消融术，主要机制是蒸汽泡、热传导和热管，三个主要影响因素是波长、光纤类型和激光能量密度。对于准分子激光冠状动脉旋磨术，主要机制是光化学、光热和光机械效应，三个主要影响因素是导管、介质和激光参数。
