Arndt V R, Duda S H, Wehrmann M, Huppert P E, Haase K K, Claussen C D
Department of Diagnostic Radiology, University of Tübingen, Germany.
Thromb Haemost. 1996 May;75(5):849-53.
Since most clinical laser angioplasties require the use of over-the-wire delivery systems, we studied the effects of pulsed dye laser energy (504 nm, 1.4 microseconds on arterial vessel walls in combination with a multifiber catheter system.
Postmortem arterial segments (n = 368) were exposed under blood or saline. Laser pulses (n = 100-800) were transmitted via 9F-multifiber-catheters, at energy densities of 3-16 J/cm2. Ablation characteristics revealed by histologic examination and morphometry were analyzed by multiple analysis of variance.
Ablation occurred more frequently in saline compared to blood. Below an energy density of 10 J/cm2 ablation occurred in saline only. Specimens irradiated under blood showed only thermal changes at 10 J/cm2. In saline, 92% of normal, 88% of fibro-fatty and 60% of calcified tissue showed ablation at 13 J/cm2. The average ablation threshold in saline was about 3-4 J/cm2 per pulse for normal tissue, 5 J/cm2 for fatty plaques, and 8-9 J/cm2 for calcified plaques. In blood, the average ablation thresholds did not differ significantly between the different stages of arteriosclerosis (12 J/cm2 for normal tissue, 11 J/cm2 for fatty plaque, and 10 J/cm2 for calcified tissue). Carbonization and vacuolization were seen regularly at energy levels > or = 13.4 J/cm2.
Selective ablation of arteriosclerotic tissue with the pulsed dye laser could not be found. Further investigation is needed before an effective ablation of arteriosclerotic arterial tissue can be expected.
由于大多数临床激光血管成形术需要使用过线输送系统，我们研究了脉冲染料激光能量（504纳米，1.4微秒）结合多光纤导管系统对动脉血管壁的影响。
在血液或盐水中暴露死后动脉段（n = 368）。通过9F多光纤导管传输激光脉冲（n = 100 - 800），能量密度为3 - 16 J/cm²。通过组织学检查和形态测量揭示的消融特征采用多因素方差分析进行分析。
与血液相比，盐水中的消融更频繁。在能量密度低于10 J/cm²时，仅在盐水中发生消融。在血液中照射的标本在10 J/cm²时仅显示热变化。在盐水中，92%的正常组织、88%的纤维脂肪组织和60%的钙化组织在13 J/cm²时显示消融。正常组织在盐水中的平均消融阈值约为每脉冲3 - 4 J/cm²，脂肪斑块为5 J/cm²，钙化斑块为8 - 9 J/cm²。在血液中，不同动脉硬化阶段的平均消融阈值无显著差异（正常组织为12 J/cm²，脂肪斑块为11 J/cm²，钙化组织为10 J/cm²）。在能量水平≥13.4 J/cm²时经常可见碳化和空泡化。
未发现脉冲染料激光对动脉硬化组织的选择性消融。在预期有效消融动脉硬化动脉组织之前，还需要进一步研究。
