Autofluorescence spectroscopy using a XeCl excimer laser system for simultaneous plaque ablation and fluorescence excitation.

Laser-induced fluorescence may be used to guide laser ablation of atherosclerotic lesions. This study was performed to evaluate arterial autofluorescence spectroscopy in vitro using a single XeCl excimer laser (308 nm) for simultaneous tissue ablation and fluorescence excitation. The laser beam was coupled to a 600-microns silica fiber transmitting 40-50 mJ/mm2 per pulse. The fluorescence radiation emanating retrogradely from the fiber was collected by a concave mirror spectroscopic analysis over a range of 321-657 nm. The arterial media (n = 26), lipid plaques (n = 26), and calcified lesions (n = 27) of aortic specimens from ten human cadavers were investigated in air, saline, and blood. Whereas the spectrum of calcified lesions changed with the surrounding optical medium, the other spectra remained constant. In air and blood, the spectra of arterial media, lipid plaques, and calcified lesions could be differentiated qualitatively and quantitatively (P < 0.0001). In saline, there was no clearcut spectroscopic difference between lipid plaques and calcified lesions. However, normal arterial media and atherosclerotic lesions (lipid plaques plus calcified lesions) could still be discriminated. Thus spectroscopy and plaque ablation can be combined using a single XeCl excimer laser. These encouraging results should stimulate further studies to determine the potential use of this approach to guide laser angioplasty in humans.