ABSTRACT
Thermal and mechanical events during continuous wave (CW) laser ablation of biological and phantom media were investigated. Porcine aortae, collagen fibers, and polyacrylamide control samples were subjected to argon laser irradiation while infrared and high-speed (240 images/s) video cameras were used to monitor their surfaces. Subsequent analysis of simultaneous changes in surface temperature and physical features correlated thermal and mechanical events. Video images recorded prior to ablation onset of tissue slabs clearly revealed two distinct phases: 1) progressive growth of a surface dehydration zone, and 2) surface deformation, implying subsurface bubble formation. Surface temperature recordings and video imaging revealed that the onset of CW ablation of soft biological media often initiated with a violent explosion, surface tearing, and tissue ejection. Histological inspection revealed intense coagulation in superficial layers near the irradiation site, whereas chiefly mechanical disruption was noted at the base of the crater. Ablation characteristics were consistent with theoretical calculations which indicate subsurface temperature peaks that increase in magnitude and surface proximity as energy deposition rates are increased. Results also suggested that mechanical properties of target media strongly influenced the extent of pressure built up, the nature of ablation onset, and the characteristics of the overall ablation pathway.
Subject(s)
Acrylic Resins , Aorta/surgery , Collagen , Laser Therapy , Thermodynamics , Animals , Aorta/anatomy & histology , Aorta/physiology , Biomechanical Phenomena , Evaluation Studies as Topic , Surface Properties , Swine , Temperature , Videotape RecordingABSTRACT
The effect of laser irradiation on the thrombogenicity of thrombus was evaluated by treating thrombi, formed in-vitro from canine blood, with two different doses of cw Nd:YAG laser energy at 1064 nm. The thrombi were then incubated with whole blood, and the plasma levels of fibrinogen and thrombin-antithrombin III-complexes were measured. A statistically significant decrease (p < 0.05) in the thrombogenicity was indicated by a reduction in both fibrinogen consumption and levels of thrombin-antithrombin III-complexes in the high dose group (600 joules, 100 degrees C peak temperature) in comparison to the low dose group (300 joules, 70 degrees C peak temperature) and the untreated thrombi. These findings suggest that laser irradiation of thrombus at an appropriate dose may substantially reduce its thrombogenicity and ability to modulate hemostasis.
Subject(s)
Antithrombin III/radiation effects , Fibrinogen/radiation effects , Lasers , Peptide Hydrolases/radiation effects , Thrombosis/physiopathology , Animals , Antithrombin III/metabolism , Dogs , Fibrinogen/metabolism , In Vitro Techniques , Peptide Hydrolases/metabolism , Thrombosis/bloodABSTRACT
Mitigation of adverse biologic reactivity after balloon angioplasty is necessary before the incidence of restenosis can be appreciably reduced. A brief review of experimental evidence supports the hypothesis that the thrombogenicity of the injured arterial wall can be reduced by a suitable level of thermal denaturation or cross-linking of thrombogenic proteins. In addition, the concept of local pharmacologic therapy, which can be provided with laser balloon angioplasty at the site of arterial injury, is introduced. Preliminary in vitro and in vivo data suggest that guide catheter-injected albumin-heparin conjugates fabricated as water-insoluble microspheres remain adherent to the injured luminal surface and deeper arterial layers after physical trapping by the inflated balloon and subsequent laser/thermal exposure. The combination of initially adequate luminal morphology, reduction of the thrombogenicity of the injured arterial wall and application of local pharmacologic therapy with laser balloon angioplasty may eventually prove helpful in reducing the incidence of restenosis.
