Geschwind H, Teisseire B, Boussignac G, Benhaiem N, Vieilledent C, Laurent D
Arch Mal Coeur Vaiss. 1985 Jun;78(6):961-6.
In order to determine the optimal conditions for disobliteration of occluded arteries without damaging the arterial wall, the effects of a Nd-YAG laser connected to a 0.2 mm diameter fibre optic system were studied on post-mortem coronary arteries and popliteal and tibial arteries of amputated limbs. Vaporisation of atheromatous plaques was consistently obtained with energies of 300 to 600 joules associated with perfusion of the vessel with dilated blood (3 g/100 ml of haemoglobin) at a flow rate of 20 ml/min. Protection of the arterial wall was ensured by introducing the fibre aortic system through a balloon catheter and by cooling with the perfusion liquid. The reproducibity of these results in the absence of major arterial wall damage, and the facility of manipulation of the fibre optic system due to its flexibility and narrow diameter, encouraged us to use this method clinically. The first three applications on peripheral arteries (femoral and popliteal arteries) confirmed that this method of arterial disobliteration can be used with a certain degree of efficacy with only a slight risk of arterial perforation. Further studies are essential to improve the degree of laser penetration of the arterial obstruction and to increase the diameter of the tunnel of recanalisation.
为了确定在不损伤动脉壁的情况下使闭塞动脉再通的最佳条件，研究了连接到直径0.2毫米光纤系统的钕钇铝石榴石激光对尸体冠状动脉以及截肢肢体的腘动脉和胫动脉的作用。在能量为300至600焦耳、血管以20毫升/分钟的流速灌注稀释血液（血红蛋白3克/100毫升）的情况下，始终能实现动脉粥样硬化斑块的汽化。通过将光纤主动脉系统经球囊导管插入并使用灌注液冷却来确保动脉壁得到保护。在无严重动脉壁损伤的情况下这些结果具有可重复性，并且由于其柔韧性和细直径，光纤系统易于操作，这促使我们在临床上使用该方法。对外周动脉（股动脉和腘动脉）的前三次应用证实，这种动脉再通方法可以在一定程度上有效使用，动脉穿孔风险很小。进一步的研究对于提高激光穿透动脉阻塞的程度以及增加再通隧道的直径至关重要。
