Development of a new technique for reducing pressure pulse generation during 308-nm excimer laser coronary angioplasty
✍ Scribed by Tcheng, James E. ;Wells, Lisa D. ;Phillips, Harry R. ;Deckelbaum, Lawrence I. ;Golobic, Robert A.
- Publisher
- John Wiley and Sons
- Year
- 1995
- Tongue
- English
- Weight
- 729 KB
- Volume
- 34
- Category
- Article
- ISSN
- 0098-6569
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✦ Synopsis
Despite expectations that excimer laser ablation would result in a low incidence of coronary dissection, studies have documented a 15-20% incidence of dissection (including a 4-67'0 incidence of clinically significant dissection) during excimer interventions. This investigation sought to determine if pressure pulses produced by the exposure of fluid phase media (blood and contrast) to 308-nm excimer radiation might contribute to untoward outcomes. Pressure pulses generated in these media were quantitated to be >I00 atm. In vitro ablation of porcine aorta in the presence of blood or contrast resulted in tissue dissection, while ablation in pure crystalloid did not. Next, a "flush and bathe" technique designed to replace all blood and contrast with crystalloid was applied to a pilot population of 57 consecutive patients. There were no rhythm disturbances or laserrelated clinically significant dissections in this group, and the clinical success rate was 95%. In summary, this report quantitates a potential etiology for excimer dissection and suggests that replacement of blood and contrast with crystalloid might improve procedural and clinical success rates. o 1995 Wiley-Liss, Inc.