LASER ANGIOPLASTY GUIDANCE BY FIBEROPTIC FLUORIMETRY

目前，安全有效激光的主要障碍 血管成形术是动脉穿孔的高发部位。其目的是 这项研究项目的目的是评估以下假设 纤维光学荧光法可以区分动脉粥样硬化和正常 从而引导激光能量对斑块的输送 消融。初步调查显示， 低功率可在人动脉粥样硬化中诱导荧光 激光辐射。一根光纤导管可以在那里传输低电波 用于荧光分析的功率辐射，如果正确 有针对性的，随后发射高功率激光辐射 斑块消融术。该提案将评估光纤 正常人和动脉粥样硬化人身体主动脉的荧光测定法， 氦镉激光在髂股动脉和冠状动脉的应用 (波长325 nm)用于荧光诱导，以及 基于微型机的光学多道分析仪 荧光分析。具体目标是： 1)推导判别函数进行判别 动脉粥样硬化来自正常动脉组织学基础 关于激光诱导的荧光特性； 2)评价光纤激光诱导荧光光谱 在流体环境中(生理盐水、血液或氟溶胶)； 3)以斑块的形式评价动脉荧光变化 联合使用光纤荧光法进行消融 高峰值功率脉冲紫翠宝石激光烧蚀 (波长378 nm倍频)； 4)评估外源性注射荧光是否 化合物(四环素血卟啉衍生物，或 组织学染色)定位于动脉粥样硬化斑块 增强光纤的诊断能力 荧光法； 5)计算机光纤荧光检测能力评价 指导实现选择性斑块消融而无需 体外激光对下动脉壁的损伤 血管成形术模型。 希望目前动脉穿孔的高风险 在激光血管成形术中可以通过光纤消除 荧光导引。此外，荧光制导激光 消融术在其他医学领域可能有广泛的应用 实现选择性组织消融任何肿块的潜力 可以通过荧光特性来区分。

Currently the major impediment to safe and effective laser angioplasty is the high incidence of arterial perforation. The aim of this research project is to evaluate the hypothesis that fiberoptic fluorimetry can distinguish atherosclerotic from normal artery and thereby guide the delivery of laser energy for plaque ablation. Preliminary investigation has shown that characteristic fluorescence can be induced in human atheromas by low power laser radiation. A fiberoptic catheter could there transmit low power radiation forfluorescence analysis and if correctly targeted, subsequently transmit high power laser radiation for plaque ablation. This proposal will evaluate fiberoptic fluorimetry of normal and atherosclerotic human cadaveric aorta, iliofemoral and coronary arteries using a helium cadmium laser (wavelength 325 nm) for fluorescence induction, and a microcomputer based optical multichannel analyzer for fluorescence analysis. The specific aims are to: 1) derive a discriminant function to differentiate atherosclerotic from normal arterial tissue histology based on laser-induced fluorescence characteristics; 2) evaluate fiberoptic laser-induce fluorescence spectroscopy in a fluid environment (saline, blood, or Fluosol); 3) evaluate the arterial fluorescence changes as plaque ablation proceeds using fiberoptic fluorimetry in conjunction with high peak power pulsed Alexandrite laser ablation (wavelength 378 nm frequency doubled); 4) evaluate whether exogenously administered fluorescent compounds (tetracycline hematoporphyrin derivative, or histologic dyes) localize to atherosclerotic plaque and enhance the diagnostic capabilities of fiberoptic fluorimetry; 5) evaluate the ability of computerized fiberoptic fluorimetry guidance to achieve selective plaque ablation without damage to the underlying arterial wall in an in vitro laser angioplasty model. It is hoped that the currently high risk of arterial perforation during laser angioplasty can be eliminated by fiberoptic fluorimetry guidance. In addition, fluorimetry guided laser ablation may have broad application in other areas of medicine by the potential to achieve selective tissue ablation of any mass that is distinguishable by fluorescence properties.