Dehiscence of portions of atheromatous plaques fractured during percutaneous transluminal coronary angioplasty may contribute to both abrupt reclosure and gradual restenosis. Laser balloon angioplasty has been shown to be effective in welding human plaque-arterial wall s e p arations in vitro by hea
Laser balloon angioplasty: Effect of exposure duration on shear strength of welded layers of postmortem human aorta
โ Scribed by Ronald D. Jenkins; I. Nigel Sinclair; Raj K. Anand; Leslie M. James; Dr. J. Richard Spears
- Publisher
- John Wiley and Sons
- Year
- 1988
- Tongue
- English
- Weight
- 418 KB
- Volume
- 8
- Category
- Article
- ISSN
- 0196-8092
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โฆ Synopsis
Laser Balloon Angioplasty (LBA) is a technique that may improve the results of balloon angioplasty by thermally sealing arterial dissections and reducing elastic recoil. To define the relationship between laserexposure duration and the strength of thermal welds made between separated layers of arterial wall, 360 1-cm discs of human postmortem aorta were lased for six different exposure intervals at three different temperature ranges, comparing shear strength of thermal welds in the different groups. Twenty discs were lased to achieve plateau adventitial temperatures of 95"C-l04"C (group A), 105"C-l14"C (group B), or 115ยฐC-124ยฐC (group C) at each of the exposure periods (5,10, 15,20,25, and 30 sec). A 400-pm fiberoptic coupled to a 1.06 pm continuous wave neodymium:YAG laser was placed perpendicularly 8 mm above the luminal surface of each disc, which had been split midway between the intimal and adventitial surface and reapposed. Mean laser energy ranged 78- 378 J delivered in a decremental stepwise fashion to achieve quickly and maintain the target plateau tissue temperature. Mean weld strength increased in relation to both achieved tissue temperature and laserexposure duration, with at least 10 sec necessary, at temperatures greater than 95"C, for reliable thermal welding. Laser exposure for greater than 20 sec provided no statistical increment in weld strength. In the anticipated clinical performance of LBA, these data suggest that when thermal fusion of disrupted arterial tissues is desired, a laserexposure duration of 10-20 sec is optimal.
๐ SIMILAR VOLUMES
Thermal fusion of intimal plaque with the arterial wall during coronary balloon angioplasty may significantly reduce the incidence of abrupt closure and may reduce the occurrence of delayed restenosis by improvement of luminal size and shape. Although Nd:YAG laser energy has been shown to be effecti