Hiehle J F, Bourgelais D B, Shapshay S, Schoen F J, Kim D, Spears R
Am J Cardiol. 1985 Dec 1;56(15):953-7. doi: 10.1016/0002-9149(85)90411-4.
The hypothesis that thermal fusion of disrupted layers of atheromatous arterial wall can be achieved with a neodymium-yttrium aluminum garnet (Nd-YAG) laser was tested. Fresh postmortem human atheromatous plaque was separated from the underlying arterial wall to simulate a dissection in 1-cm2 arterial wall sections. With the plaque and underlying arterial wall subsequently compressed between glass slides, 17 W of continuous-wave Nd-YAG laser radiation were delivered through an optical fiber to the luminal surface of the plaque over a 4-mm2 area. Fusion of the plaque to the underlying arterial wall invariably occurred when tissue compression was applied during lasing and a thin blood film was present between the tissues. The load supported by tissue welds depended on plaque thickness, plaque composition, and exposure duration and was as great as 25 g. In postmortem, blood-filled, whole-artery segments, in which plaque had been completely separated from the media, this technique was applied intraluminally during angioplasty with a prototype balloon catheter. Lateral dispersion of Nd-YAG radiation from the termination of an optical fiber within the balloon allowed fusion of plaque to the underlying arterial wall during balloon inflation to 2 atm. Histologic examination of laser-treated tissues showed coagulation of tissues at the junction between the intimal plaque and media. It is concluded that thermal fusion of separated layers of atheromatous arterial wall can be achieved with Nd-YAG laser irradiation. This concept may be useful in the treatment of arterial dissections.
对用钕钇铝石榴石（Nd-YAG）激光实现动脉粥样硬化动脉壁破裂层热融合这一假说进行了测试。从新鲜的尸检人体动脉粥样硬化斑块与下方的动脉壁分离，以模拟1平方厘米动脉壁切片中的剥离。随后将斑块和下方的动脉壁夹在载玻片之间，通过光纤将17瓦的连续波Nd-YAG激光辐射传输到斑块管腔表面4平方毫米的区域。当在激光照射期间施加组织压缩且组织之间存在薄血膜时，斑块与下方动脉壁的融合总是会发生。组织焊接所承受的负荷取决于斑块厚度、斑块成分和暴露持续时间，最大可达25克。在尸检的充满血液的全动脉段中，斑块已与中膜完全分离，在使用原型球囊导管进行血管成形术期间，该技术在管腔内应用。Nd-YAG辐射从球囊内光纤末端的横向散射使得在球囊充气至2个大气压期间斑块与下方动脉壁融合。对激光治疗组织的组织学检查显示内膜斑块与中膜交界处的组织凝固。得出结论，用Nd-YAG激光照射可实现动脉粥样硬化动脉壁分离层的热融合。这一概念可能对动脉夹层的治疗有用。
