The Effects of Laser Energy on the Arterial Wall

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      Laser energy has been proposed as a method of resecting atherosclerotic plaque since the mid 1960s. However, only over the past several years have we come to understand some of the unique Interactions of the laser with cardiovascular tissue. In laser angioplasty a major challenge has been choosing the optimal laser and duration of laser exposure to achieve adequate resection of plaque, while minimizing such complications as thrombosis, perforation, embolization, aneurysm formation, and accelerated atherosclerosis. Ultimately we must develop a more selective laser that resects plaque while leaving adjacent arterial wall uninjured. This review describes the physics of laser energy, the different lasers available for use in the cardiovascular system, laser-arterial wall Interactions, and some of the limitations of laser angioplasty.

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        • McGuff PE
        • Bushnell D
        Studies of the surgical applications of the laser.
        Surg Forum. 1963; 14: 143-145
        • White RA
        Technical frontiers for the vascular surgeon: laser anastomotic welding and angioscopy-assisted intraluminal instrumentation.
        J Vasc Surg. 1987; 5: 673-680
        • Litvack F
        • Grundfest WS
        • Goldenberg T
        • et al.
        Pulsed laser angioplasty: wavelength, power, and energy dependencies relevant to clinical application.
        Lasers Surg Med. 1988; 8: 60-65
        • Sliney DH
        Laser-tissue interactions.
        Cl Chest Med. 1985; 2: 203-208
        • Puliafito CA
        • Steinert RF
        Short-pulsed Nd:YAG laser microsurgery of the eye: biophysical considerations.
        IEEE J Quantum Electron. 1984; 20: 1442
        • Ronn A
        User chemistry.
        Sci Am. 1979; 240: 114-130
        • Grundfest WS
        • Litvack F
        • Forrester JS
        • et al.
        Laser ablation of human atherosclerotic plaque without adjacent tissue injury.
        JAAC. 1985; 5: 929-933
        • Isner JM
        • Donaldson RF
        • Deckelbaum LI
        • et al.
        The Excimer Laser: Gross, light microscopic and ultrastructural analysis of potential advantages for use in laser therapy of cardiovascular disease.
        JACC. 1985; 6: 1102-1109
        • Grundfest WS
        • Litvack F
        • Hickey A
        The current status of angioscopy and laser angioplasty.
        J Vasc Surg. 1987; 5: 667-672
        • Murphy-Chutorian D
        • Kosek J
        • Mok W
        • et al.
        Selective absorption of ultraviolet laser energy by human atherosclerotic plaque treated with tetracycline.
        Am J Cardiol. 1985; 55: 1293-1297
        • Spears JR
        • Serur J
        • Shropshire D
        • et al.
        Fluorescence of experimental atheromatous plaques with hematoporphyrin derivative.
        J Clin Invest. 1983; 71: 395-399
      1. Straight RC, Vincent GM, Hammond EH, et al. Porphyrin retention and photodynamic treatment of diet induced atherosclerotic lesions in pigs: photodynamic therapy of tumors and other disease. Padova, Italy, Libreria Progetto, 1985, pp. 350–352.

        • Litvack F
        • Grundfest WS
        • Forrester JS
        • et al.
        Effects of hematoporphyrin derivative and photodynamic therapy on atherosclerotic rabbits.
        Am J Cardiol. 1985; 56: 667-671
        • Prince MR
        • Deutsch TF
        • Mathews-Roth MM
        • et al.
        Preferential light absorption in atheromas in vitro: implications for laser angioplasty.
        Clin Res. 1985; 33: 218A
      2. Orme EC. Personal communication, 1989.

        • Welch AJ
        • Valvano JW
        • Pearce JA
        • et al.
        Effect of laser radiation on tissue during laser angioplasty.
        Lasers Surg Med. 1985; 5: 251-264
        • Lawrence PF
        • Dries DJ
        • Moatamed F
        • et al.
        Acute effects of argon laser on human atherosclerotic plaque.
        J Vasc Surg. 1984; 1: 852-859
        • Farrell EM
        • Higginson AJ
        • NIP WS
        • et al.
        Pulsed excimer laser angioplasty of human cadaveric arteries.
        J Vasc Surg. 1986; 3: 284-287
        • Deckelbaum LI
        • Isner JM
        • Donaldson RF
        • et al.
        Use of pulsed energy delivery to minimize tissue injury resulting from carbon dioxide laser irradiation of cardiovascular tissues.
        JACC. 1986; 7: 898-908
        • Grundfest WS
        • Litvack IF
        • Goldenberg T
        • et al.
        Pulsed ultraviolet lasers and the potential for safe laser angioplasty.
        Am J Surg. 1985; 150: 220-226
        • Sanborn TA
        The use of thermal-tip laser probe in occluded arteries. In arterial surgery: New diagnostic and operative techniques.
        in: Grune and St rat ton, Orlando, FL1988: 69-77
        • Abela GS
        • Fenech A
        • Crea F
        • et al.
        “Hot-Tip”: Another method of laser vascular recanalization.
        Lasers Surg Med. 1985; 5: 327-335
        • Geschwind HJ
        • Blair JD
        • Mongkolsmai D
        • et al.
        Development and experimental application of contact probe catheter for laser angioplasty.
        JACC. 1987; 9: 101-107
        • Lammer J
        • Karnel F
        Percutaneous transluminal laser angioplasty with contact probes.
        Radiology. 1988; 168: 733-737
        • Abela GS
        • Seeger JM
        • Barbieri E
        • et al.
        Laser angioplasty with angioscopic guidance in humans.
        J Am Coll Cardiol. 1986; 8: 184-192
        • Pollack ME
        • Eugene J
        • Hammer-Wilson M
        • et al.
        The thrombogenic potential of argon ion laser endarterectomy.
        J Surg Research. 1987; 42: 153-158
        • Ragimov SE
        • Belyaeu AA
        • Vertepa IA
        • et al.
        Comparison of different lasers in terms of thrombogenicity of the laser treated vascular wall.
        Lasers Surg Med. 1988; 5: 77-82
        • Choy DSJ
        • Startzer S
        • Loubeau JM
        • et al.
        Embolization and vessel wall perforation in argon laser recanalization.
        Lasers Surg Med. 1985; 5: 297-308
        • Labs JD
        • White RI
        • Anderson JH
        • et al.
        Thermodynamic correlates of hot tip laser angioplasty.
        Investigative Radiology. 1987; 22: 954-959
        • Case RB
        • Choy DS
        • Dwyer EM
        • et al.
        Absence of distal emboli during in vivo laser recanalization.
        Lasers Surg Med. 1985; 5: 281-289
        • Labs JD
        • Merillat JC
        • Williams GM
        Analysis of solid phase debris from laser angioplasty. Potential risks of atheroembolism.
        J Vasc Surg. 1988; 7: 326-335
        • Lee G
        • Ikeda RM
        • Theis JH
        • et al.
        Acute and chronic complications of laser angioplasty: vascular wall damage and formation of aneurysms in the atherosclerotic rabbit.
        Am J Cardiol. 1984; 53: 290-293
        • Abela GS
        • Crea F
        • Seeger JM
        • et al.
        The healing process in normal canine arteries and in atherosclerotic monkey arteries after transluminal laser irradiation.
        Am J Cardiol. 1985; 56: 983-988
        • Treat MR
        • Weld FM
        • White JV
        • et al.
        Effect of CO2 laser on the luminal surface of blood vessels in vivo.
        Lasers Surg Med. 1983; 3: 247-254
        • Theis JH
        • Lee G
        • Chun MC
        • et al.
        Effects of simultaneous viewing and vaporization of plaques using the steer-able laser-heated metal cap in the atherosclerotic money model.
        Lasers Surg Med. 1987; 7: 414-420
        • Sanborn TA
        • Haudenschild CC
        • Garber GR
        • et al.
        Angiographic and histologic consequences of laser thermal angioplasty: comparison with balloon angioplasty.
        Circulation. 1987; 75: 1281-1286