EVALUATION OF LASERS IN THE CARDIOVASCULAR SYSTEM

这项建议的目的是研究激光的影响。 动脉粥样硬化和血栓闭塞的动脉再通。这个 好处以及副作用将在短期和短期内进行评估 不同动物模型激光再通后的长期观察 在人类身上。此外，还将评估激光对心肌的影响 用于希氏束和心律失常灶消融。 激光已被证明可以再通血管阻塞并创建 通过阻断狗的希氏束致完全性心脏传导阻滞。然而， 尽管有了初步结果，但仍有几个问题没有得到回答：1) 再通和心肌的理想激光波长是多少？ 2)温度对动脉和血管有什么影响？ 周围组织；3)是否有组织碎片产生；4)会 光学性质的表征改善了激光的应用；5) 生色团是否会增强激光能量局部化并增加其 安全性；6)激光应用的血栓形成潜力是什么；7)可以 光纤的设计可以减少穿孔，可以有足够的通道 是在人类身上制造的；如果是这样，这些东西会保持专利吗？能持续多久？ 激光被用作生物探针，以在 再通畅。 调查的三个领域将试图解决这些问题：1) 体外研究将研究基本的激光与组织的相互作用。这些 包括正常组织学、生化和光学研究 动脉粥样硬化的动脉和心肌的最佳选择 汽化的波长和参数。生色团将被用来 加强这一过程。这些数据将允许光学 这些组织的特征，从而使激光成为一种生物 探测器。将使用热像仪和热电偶来测量温度。 动脉再通期间的变化以评估对心脏的热损伤 周围的组织。碎片将被收集和测量。2)活体内 动物研究将包括测试各种光纤设备，以 评价血管再通和希氏束消融技术。3)临床 试验将提供有关血管通道充分性和寿命的数据 由外周动脉闭塞的患者制造。这项研究将 利用血管内窥镜、血管造影术和生理学评价 维持流向闭塞血管疾病区域的血流。

The objective of this proposal is to study the effects of laser recanalization in arteries occluded by atherosclerosis and thrombosis. The benefits as well as the side effects will be evaluated in the immediate and long-term periods after laser recanalization in various animal models and in man. Also evaluation of the laser effects on myocardial muscle will be done for purposes of His Bundle and arrhythmia foci ablation. The laser has been shown to recanalize vascular obstructions and to create complete heart block by interruption of His Bundle in dogs. However, despite the preliminary results, several questions remain unanswered: 1) What is the ideal laser wavelength for recanalization and myocardial muscle vaporization; 2) What effect does temperature have on the artery and surrounding tissues; 3) Is there production of tissue debris; 4) Will characterization of the optical properties improve laser applications; 5) Will chromophores enhance laser energy localization and increase its safety; 6) What is the thrombogenic potential of laser applications; 7) Can optical fibers be designed to reduce perforations, 8) Can adequate channels be made in humans; if so, will these remain patent and for how long; 9) Can the laser be used as a biological probe to identify tissue during recanalization. Three areas of investigation will attempt to address these questions: 1) In vitro studies will investigate basic laser-tissue interactions. These include histologic, biochemical and optical studies of normal and atherosclerotic arteries, and cardiac muscle for selection of the optimal wavelength and parameters for vaporization. Chromophores will be used to enhance this process. These data will allow for the optical characterization of these tissues, thus making the laser a biological probe. Thermography and thermocouples will be used to measure temperature changes during arterial recanalization to assess thermal injury to the surrounding tissue. Debris will be collected and measured. 2) In vivo animal studies will include testing of various optical fiber devices to evaluate recanalization and His Bundle ablation techniques. 3) A clinical trial will provide data on the adequacy and longevity of vascular channels made in patients with occluded peripheral arteries. This study will utilize angioscopic, angiographic and physiologic evaluation to assess the maintenance of blood flow to areas of occlusive vascular disease.