Astier R, Meyer G, Englender J, Lavergne A, Steg P G, Ménasché P, Antonetti A, Lecarpentier Y
Arch Mal Coeur Vaiss. 1985 Dec;78(13):1889-94.
This study was undertaken to assess the respective values of pulsed and continuous laser emission for in vitro recanalisation of very stenosed atheromatous human coronary arteries. The Nd-YAG laser used emitted a 10 Hz 10 ns burst in the infrared band (1 064 microns). Previous spectroscopic studies had shown no specific band of absorption in the spectral field of emission of the usual lasers. The laser beam was focused in the axis of the segment of coronary artery irradiated. The crater or neo lumen obtained usually had irregular walls. No perforation of the arterial wall or macroscopic debris were observed. Histological studies showed minimal burn lesions with sparse coagulation necrosis limited to a few tens of micron thickness. The percentage recanalisation obtained with pulses of 200 mJ attained 50% for a total energy of 450 J delivered in 2 mn. This study confirmed the feasibility of disobliteration of atheromatous coronary arteries by pulsed laser. Our results suggest that ultra short pulsed laser acts more by a mechanical than by a thermal mechanism which may lead to less side effects than observed in vivo with continuous laser emission.
本研究旨在评估脉冲激光和连续激光发射对严重狭窄的人动脉粥样硬化冠状动脉进行体外再通的各自价值。所使用的钕钇铝石榴石激光在红外波段（1064微米）发射10赫兹、10纳秒的脉冲。先前的光谱研究表明，在常用激光的发射光谱范围内没有特定的吸收带。激光束聚焦在被照射冠状动脉节段的轴线上。所形成的火山口或新管腔的壁通常不规则。未观察到动脉壁穿孔或肉眼可见的碎片。组织学研究显示，烧伤病变极小，稀疏的凝固性坏死仅限于几十微米的厚度。在2分钟内输送450焦耳的总能量时，200毫焦脉冲的再通百分比达到50%。本研究证实了脉冲激光消除动脉粥样硬化冠状动脉闭塞的可行性。我们的结果表明，超短脉冲激光的作用更多地是通过机械机制而非热机制，这可能导致比连续激光发射在体内观察到的副作用更少。
