Kipshidze N, Sahota H, Komorowski R, Nikolaychik V, Keelan M H
Medical College of Wisconsin, Milwaukee 53226, USA.
J Am Coll Cardiol. 1998 Apr;31(5):1152-7. doi: 10.1016/s0735-1097(98)00021-7.
This study evaluated the long-term impact of endoluminal low power red laser light (LPRLL) on restenosis in an atherosclerotic rabbit model.
Despite widespread application of balloon angioplasty for treatment of coronary artery disease, restenosis limits its clinical benefits. Restenosis is a complex process and may be partly attributed to the inability of the vascular endothelium to regenerate and cover the denuded area at the site of arterial injury. We previously demonstrated that LPRLL stimulates endothelial cell proliferation in vitro and contributes to rapid endothelial regeneration after balloon injury in nonatherosclerotic rabbits.
Rabbit abdominal aortas (n = 12) were treated in separate zones with balloon dilation and balloon dilation plus laser illumination. Endoluminal laser therapy was performed using a laser-balloon catheter delivering a single dose of 10 mW for 3 min from a helium-neon laser (632 nm). Angiography was performed before and after treatment and was repeated 8 weeks before harvesting the aortas.
Quantitative angiographic analysis demonstrated no differences in the minimal lumen diameter (MLD) between the two zones before treatment; an increase in the MLD in both zones after balloon angioplasty and a significant versus slight reduction of the MLD in the balloon treatment versus balloon plus laser zones at 8 weeks. Histologic examination showed a very high level of myointimal hyperplasia in the balloon treatment zones but a minimal level in the LPRLL-treated zones. Morphometric analysis revealed a statistically significant difference in the lumen area, intimal area and intima/media ratio between the balloon versus balloon plus laser treatment sites.
Our experimental data indicate that endoluminal irradiation with LPRLL prevents restenosis after balloon angioplasty in an atherosclerotic rabbit model.
本研究评估腔内低功率红色激光（LPRLL）对动脉粥样硬化兔模型再狭窄的长期影响。
尽管球囊血管成形术广泛应用于冠状动脉疾病的治疗，但再狭窄限制了其临床益处。再狭窄是一个复杂的过程，部分原因可能是血管内皮无法再生并覆盖动脉损伤部位的裸露区域。我们之前证明，LPRLL在体外刺激内皮细胞增殖，并有助于非动脉粥样硬化兔球囊损伤后内皮的快速再生。
对12只兔的腹主动脉不同区域分别进行球囊扩张和球囊扩张加激光照射治疗。使用激光球囊导管进行腔内激光治疗，从氦氖激光（632nm）输送单剂量10mW，持续3分钟。在治疗前后进行血管造影，并在收获主动脉前8周重复进行。
定量血管造影分析显示，治疗前两个区域的最小管腔直径（MLD）无差异；球囊血管成形术后两个区域的MLD均增加，且在8周时，球囊治疗区域的MLD显著降低，而球囊加激光区域的MLD略有降低。组织学检查显示，球囊治疗区域的肌内膜增生水平非常高，而LPRLL治疗区域的水平最低。形态计量分析显示，球囊治疗部位与球囊加激光治疗部位之间的管腔面积、内膜面积和内膜/中膜比值存在统计学显著差异。
我们的实验数据表明，在动脉粥样硬化兔模型中，腔内LPRLL照射可预防球囊血管成形术后的再狭窄。
