DEVELOPMENT OF THE ENDOVASCULAR THROMBOLYSIS SYSTEM WITH SHOCK WAVE

背景和目的脑栓塞的治疗存在一些固有的问题，如治疗时间窗窄和纤溶药物的严重副作用。因此，有必要开发一种新的方法，使用更少量的纤溶药物更快地清除脑血栓。在本研究中，我们研究了液体射流诱导钬（Ho）：YAG激光照射在water.Materials和MethodsIn这项研究中，脉冲Ho：YAG激光器的波长，脉冲宽度和能量分别为2.1 μm，350 μs，和350 mJ/pulse，分别。Ho的行为：YAG激光诱导的气泡在毛细管充满纯水中观察到在不同的间距（L ;之间的距离光纤端部和毛细管出口）。之后，通过将光纤（直径：0.6mm）插入填充有纯水的导管（6 Fr）中来制造液体喷射发生器。该装置产生的液体射流的最大穿透深度为 ...更多信息 在不同的间隔距离（L ;光纤端部和导管出口之间的距离）处测量明胶人造血栓。并分别用阴影法和PVDF针穿刺法观察导管周围的压力和现象。基于这些结果，选择了一个13 mm的间距，以调查尿激酶（UK）的功效的增强，只有一个单一的操作的液体喷射装置在人造血栓制成的人blood.ResultsA激光诱导的气泡在毛细管中迅速向前生长，并产生液体射流。液体射流发生导管的最大穿透深度随L的增加而增加，当L为13 mm时达到最大值（9 mm）。在与少量UK孵育10 min和30 min后，主要通过单次使用激光诱导液体射流来提高（5.4 ± 2.4 vs.22.6 ± 6.1和7.3 ± 3.8 vs.38.3 ± 5.6（均数±标准差，p<0.001））。结论Ho：YAG激光照射毛细血管内可形成液体射流，促进纤溶药物的作用。此外，这种射流伴随着冲击波，这可能有助于通过破碎内膜下钙化病变来促进血管内球囊血管成形术。该液体射流发生系统结构简单，在不久的将来将被应用于脑纤维蛋白溶解的血管内系统。少

Background and ObjectiveThere are several problems inherent in the treatment of cerebral embolisms, such as the narrow therapeutic time window and the severe side effects of fibrinolytic drugs. It is thusnecessary to develop a new method of removing a cerebral thrombus more rapidly using smaller amounts of fibrinolytics. In the present, we investigated a liquid jet induced by holmium (Ho) : YAG laser irradiation in water.Materials and MethodsIn this study, a pulsed Ho : YAG laser whose wavelength, pulse duration, and energy were 2.1 μm, 350 μs, and 350 mJ/pulse, respectively. Behavior of Ho : YAG laser induced bubble in a capillary tube filled with pure water was observed at various stand-off distances (L ; distance between the optical fiber end and the capillary exit). After that, a liquid-jet generator was made by insertion of an optical fiber (diameter : 0.6 mm) into a catheter (6Fr) filled with pure water. The maximum penetration depth of a liquid jet generated with this device int … More o a gelatin artificial thrombus was measured at various stand-off distances (L ; destance between the optical fiber end and catheter exit). Moreover, the phenomenon and the pressure around the catheter were observed with a shadowgraph and PVDF needle hydrophon, respectively. Based on these results, a stand-off distance of 13 mm was chosen to investigate the enhancement of urokinase (UK) efficacy by only a single operation of the liquid-jet device in artificial thrombi made of human blood.ResultsA laser-induced bubble in a capillary tube rapidly grew forward and generated a liquid jet. Maximum penetration depth with the liquid-jet generating catheter increased in proportion to L and reached a maximum value (9 mm) when L was around 13 mm. A shock wave whose overpressure at a point several mm away from the catheter exit was over 12MPa was captured with shadowgraph Fabrinolysis rates (%) after incubation with a small amount of UK for 10 min and 30 min were predominantly raised by a single use of the laser-induced liquid jet (5.4 ± 2.4 vs. 22.6 ± 6.1 and 7.3 ± 3.8 vs. 38.3 ± 5.6, respectively (mean ± SD, p<0.001)).ConclusionsHo : YAG laser irradiation within a capillary tube filled with water caused liquid jet formation, which promoted the effect of fibrinolytics. Moreover, this jet was accompanied with shock waves, which might enable to facilitate endovascular balloon angioplasty by cracking subintimal calcified lesions. The liquid jet generation system is so simple that will be applied to an endovascular system for cerebral fibrinolysis in the near future. Less