Geschwind H J, Boussignac G, Teisseire B, Benhaiem N, Bittoun R, Laurent D
Br Heart J. 1984 Nov;52(5):484-9. doi: 10.1136/hrt.52.5.484.
To establish the optimal conditions for recanalisation of obstructed arteries without damage to vessel walls, a Nd-YAG laser coupled to a 0.2 mm diameter optic fibre was used on obstructed human cadaver coronary and peripheral arteries and on popliteal arteries in amputated limbs. Vaporization of atheromatous plaques was consistently obtained with an energy of 360-600 J and a diluted blood perfusate (3 g/100 ml haemoglobin) at a rate of 20 ml/min. The arterial wall was protected from thermal injury by inserting the optic fibre into an inflated balloon catheter and by cooling the system with the perfusate. Since recanalisation of occluded arteries was consistently obtained without damage to the arterial wall or debris and thin and flexible optic fibres were easy to guide in the arteries, percutaneous transluminal Nd-YAG laser angioplasty was used in obstructed femoral and popliteal arteries in three patients. The first European trials in man showed the method to be feasible, effective, and harmless, although further studies are required to improve penetration of the obstruction and increase the diameter of tunnel.
为了在不损伤血管壁的情况下建立阻塞动脉再通的最佳条件，将一台与直径0.2毫米的光纤耦合的钕钇铝石榴石激光用于阻塞的人体尸体冠状动脉和外周动脉以及截肢肢体的腘动脉。使用360 - 600焦耳的能量和以20毫升/分钟的速率灌注稀释的血液（血红蛋白含量为3克/100毫升），始终能实现动脉粥样硬化斑块的汽化。通过将光纤插入充气球囊导管并利用灌注液冷却系统，可保护动脉壁免受热损伤。由于始终能够实现阻塞动脉的再通且不损伤动脉壁或产生碎片，并且细而柔韧的光纤易于在动脉中引导，因此对三名患者的阻塞股动脉和腘动脉采用了经皮腔内钕钇铝石榴石激光血管成形术。欧洲首次人体试验表明该方法可行、有效且无害，不过还需要进一步研究以提高对阻塞物的穿透能力并增加通道直径。
