Potential use of holmium lasers for angioplasty: Evaluation of a new solid‐state laser for ablation of atherosclerotic plaque
Potential use of holmium lasers for angioplasty: Evaluation of a new solid‐state laser for ablation of atherosclerotic plaque
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钬激光器在血管成形术中的潜在用途：评估用于消融动脉粥样硬化斑块的新型固态激光器
DOI：
10.1002/lsm.1900110306
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发表时间：
1991
影响因子：
2.4
通讯作者：
K. Karsch
中科院分区：
文献类型：
--
作者：
K. Haase;A. Baumbach;M. Wehrmann;S. Duda;G. Cerullo;B. Rückle;E. Steiger;K. Karsch
评价了中红外钬激光（发射波长为2130 nm）的组织效应。这种波长是有吸引力的，因为它结合了高吸水性和容易通过标准光纤传输。激光器以100μsec范围内的脉冲持续时间和2至6赫兹之间的重复频率脉冲。对于所有实验，使用2赫兹的重复率。将激光束耦合到纤芯直径为200和800μm的无水石英光纤中，耦合效率分别为70%和80%。在800μm光纤的消融阈值为10 J/cm 2和200μm光纤的消融阈值为40 J/cm 2的条件下进行了动脉粥样硬化斑块的消融。可以清除钙化斑块。消融效率随着脉冲能量的增加而以非线性方式增加。对于200μm光纤，在能量注量为1000 J/cm 2时，每个脉冲的烧蚀率约为2 mm，对于800μm光纤，在能量注量为70 J/cm 2时，每个脉冲的烧蚀率约为1.25 mm;能量密度的进一步增加不会导致更高的烧蚀率。在肉眼检查中，仅在弹坑附近的组织结构中发现非常有限的热损伤。火山口边缘是均匀的，没有发现火山口炭化或火山口内腔碎片的迹象。然而，组织学样本显示热损伤区域向邻近组织横向延伸100至1000μm。热损伤随着辐射暴露的增加而增加，并取决于所使用的介质。
Tissue effects of the mid‐IR Holmium laser (emitting at a wave‐length of 2130nm) were evaluated. This wavelength is attractive because it combines high water absorption and easy transmission through standard optical fibres. The laser was pulsed with pulse durations in the range of 100μsec and repetition rates between 2 and 6 Hertz. For all experiments a repetition rate of 2 Hertz was used. The laser beam was coupled into waterfree quartz fibers with core diameters of 200 and 800μm with an efficiency of 70 and 80%, respectively. Ablation of atherosclerotic plaque has been performed at an ablation threshold of 10J/cm2 for the 800μm and 40J/cm2 for the 200μm fibre. Removal of calcified plaque was possible. Ablation efficiency increased in a non‐linear fashion with increasing pulse energies. The ablation rate per pulse was approximately 2mm at energy fluences of 1000J/cm2 for the 200μm fibre and 1.25mm at energy fluences of 70J/cm2 for the 800μm fibre; a further increase in energy densities did not result in higher ablation rates. On macroscopic examination only very limited thermal injury was found in crater adjacent tissue structures. Crater edges were even and did not reveal signs of crater charring or debris in the crater lumen. However, the histologic specimens revealed zones of thermal damage extending 100 up to 1000μm lateral into adjacent tissue. Thermal damage increased with increasing radiant exposures and depended on the medium used.