Shangguan H Q, Gregory K W, Casperson L W, Prahl S A
Oregon Medical Laser Center, Portland 97225, USA.
Lasers Surg Med. 1998;23(3):151-60. doi: 10.1002/(sici)1096-9101(1998)23:3<151::aid-lsm4>3.0.co;2-o.
Current techniques for laser thrombolysis are limited because they can not completely clear thrombotic occlusions in arteries, typically leaving residual thrombus on the walls of the artery. The objective of this study was to investigate the possibility of using photomechanical drug delivery to enhance laser thrombolysis by delivering drugs into mural thrombus during laser thrombolysis.
STUDY DESIGN/MATERIALS AND METHODS: Three experimental protocols were performed in vitro to quantitatively compare the effectiveness of thrombolysis by 1) constant infusion of drug, 2) laser thrombolysis, and 3) photomechanical drug delivery. A fiber-optic flushing catheter delivered drug (a solution of 1 microm fluorescent microspheres) and light ( a 1 micros pulsed dye laser) into a gelatin-based thrombus model. The process of laser-thrombus interaction was visualized using flash photography and the laser-induced pressure waves were measured using an acoustic transducer.
Lumen sizes generated by mechanically manipulating the catheter through the thrombus were smaller than those generated by laser ablation. The microspheres could be driven several hundred microns into the mural thrombus.
Photomechanical drug delivery has potential for enhancement of laser thrombolysis. Two mechanisms seem to be involved in photomechanical drug delivery: 1) mural deposition of the drug at the ablation site and 2) increased exposure of the thrombus surface area to the drug.
目前的激光溶栓技术存在局限性，因为它们无法完全清除动脉中的血栓性阻塞，通常会在动脉壁上留下残余血栓。本研究的目的是探讨在激光溶栓过程中通过光机械给药将药物输送到壁内血栓中以增强激光溶栓效果的可能性。
研究设计/材料与方法：在体外进行了三个实验方案，以定量比较以下三种溶栓方法的效果：1）持续输注药物，2）激光溶栓，3）光机械给药。一根光纤冲洗导管将药物（1微米荧光微球溶液）和光（1微秒脉冲染料激光）输送到基于明胶的血栓模型中。使用闪光摄影观察激光与血栓相互作用的过程，并使用声换能器测量激光诱导的压力波。
通过机械操作导管穿过血栓产生的管腔尺寸小于激光消融产生的管腔尺寸。微球可以被驱动进入壁内血栓数百微米。
光机械给药具有增强激光溶栓效果的潜力。光机械给药似乎涉及两种机制：1）药物在消融部位的壁内沉积，2）血栓表面积对药物的暴露增加。
