Laser Catheter for Dethrombosis of Arterial Occlusion

描述(由申请人提供)： 这项建议的主要目标是构建一种基于导管的介入设备，该设备包含紫外线(UV)导光玻璃光纤，将被用于从大鼠的颈总动脉(CCA)去除闭塞性血栓(血栓)，特别是展示该设备对仅含有血小板或含有纤维蛋白、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)激光促进的血栓解除过程(美国6,539,944号)，其定义是在不使用溶栓剂的情况下将血小板聚集体溶解到单个血小板中。血栓的分离是通过内窥镜下紫外线激光照射血栓近端动脉段的内表面来启动的。这有助于平滑肌松弛，从而扩张动脉段，最不寻常的是，血栓也是如此。这使得血液可以有效地渗透到血栓中和整个血栓中，并预示着动脉的再通。随着一段又一段的血栓再通，紫外线激光照射会顺序地穿过血栓。我们将首先构建一个单腔导管的原型，它可以通过不同的通道进入一根光纤来传导紫外线激光，也可以输入溶液，如生理盐水、X射线造影液或药物。然后我们将在X射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颈总动脉的有效性，然后使用这些实验参数开始解除纯血小板(PP)或血小板纤维蛋白红细胞(FPE)闭塞血栓的血栓。由于X射线造影液对紫外光只有适度的吸收，即使在紫外线照射期间，也可以通过透视观察血栓解除的进展。对于PP和FPE血栓，我们将确定内窥镜紫外线治疗后再通CCA所需的时间，并将这些溶解时间与紫外线治疗与特殊溶栓(TPA)药物瑞替普酶联合应用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的处理部分是否有残留的血栓物质。

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.