Laser Catheter for Dethrombosis of Arterial Occlusion

激光导管用于动脉闭塞除血栓

• 批准号: 6848004
• 负责人: BRANT D WATSON
• 金额: $ 17.52万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-02-01 至 2007-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6848004
• 关键词: artery occlusion; biomedical equipment development; carotid artery; clinical biomedical equipment; erythrocytes; fibrin; fluoroscopy; histology; laboratory rat; laser therapy; light microscopy; method development; nonhuman therapy evaluation; platelets; statistics /biometry; thrombosis; ultraviolet radiation

DESCRIPTION (provided by applicant): The chief goal of this proposal is construct a catheter-based interventional device containing an ultraviolet (UV) light-conducting glass optical fiber, which will be used to remove, from a common carotid artery (CCA) of a rat, an occlusive blood clot (thrombus) and to demonstrate, in particular, the effectiveness of this device against thrombi containing platelets only, or containing fibrin, red blood cells and platelets. The basis of this device's function is our newly patented (U.S. No. 6,539,944) process of ultraviolet (UV) laser-facilitated dethrombosis, defined as the dissolution of a platelet aggregate into individual platelets without the use of a thrombolytic agent. Thrombus dissociation is initiated by endoscopic UV laser irradiation of the interior surface of the arterial segment just proximal to the thrombus. This facilitates smooth muscle relaxation and thus dilation of the arterial segment, and most unusually, of the thrombus also. This allows for efficient penetration of blood into and throughout the thrombus and presages recanalization of the artery. UV laser irradiation proceeds sequentially through the thrombus, as one segment after another is recanalized. We will first construct a prototype single-lumen catheter, which can admit, via separate channels, an optical fiber to conduct the UV laser light and also infusion of solutions, such as saline, X-ray contrast fluid, or drugs. We will then insert the device via a femoral artery under X-ray fluoroscopy, first to examine the effectiveness of this device to dilate the rat CCA, and then to use these experimental parameters to begin dethrombosis of pure platelet (PP) or platelet-fibrin-red cell (FPE) occlusive thrombi. It may be possible to observe the progress of dethrombosis by fluoroscopy even during UV irradiation, owing to only moderate absorption of the UV light by the X-ray contrast fluid. For the PP and FPE thrombi we will determine the time taken to recanalize the CCA after endoscopic UV treatment and compare these dissolution times to the corresponding times when UV treatment is applied in conjunction with a special thrombolytic (tPA) drug, reteplase, and to those times resulting from drug treatment itself. Finally, we will examine by histologic staining and microscopy the treated portion of the CCA for residual thrombotic material.

描述（由申请人提供）： 本提案的主要目标是构建一种包含紫外（UV）光导玻璃光纤的基于导管的介入器械，该器械将用于从大鼠颈总动脉（CCA）中清除闭塞性血凝块（血栓），并特别证明该器械对仅含血小板或含纤维蛋白、红细胞和血小板的血栓的有效性。该设备功能的基础是我们新获得专利的紫外线（UV）激光辅助去血栓形成过程（US No.6，539，944），定义为在不使用血栓溶解剂的情况下将血小板聚集体溶解成单个血小板。通过内窥镜紫外激光照射血栓近端动脉段的内表面来启动血栓解离。这有助于平滑肌松弛，从而扩张动脉段，最不寻常的是，也扩张血栓。这允许血液有效地渗透到血栓中并贯穿血栓，并预示动脉的再通。随着一个接一个的血管段再通，紫外激光照射依次穿过血栓。我们将首先构建一个原型单腔导管，它可以通过单独的通道允许光纤传导UV激光，也可以输注溶液，如盐水，X射线造影液或药物。然后，我们将在X线透视下通过股动脉插入该装置，首先检查该装置扩张大鼠CCA的有效性，然后使用这些实验参数开始对纯血小板（PP）或血小板-纤维蛋白-红细胞（FPE）闭塞性血栓进行去血栓形成。由于X射线造影液仅适度吸收紫外线，因此即使在紫外线照射期间，也可以通过荧光透视观察血栓清除的进展。对于PP和FPE血栓，我们将确定内镜UV治疗后CCA再通所需的时间，并将这些溶解时间与UV治疗联合特殊溶栓（tPA）药物瑞替普酶时的相应时间以及药物治疗本身产生的时间进行比较。最后，我们将通过组织学染色和显微镜检查CCA治疗部分的残留血栓物质。