Skip to main content
NCBI home page
The Texas Heart Institute Journal logoLink to The Texas Heart Institute Journal
. 1989;16(3):150–157.

System Design Considerations for Laser Angioplasty

Lawrence I Deckelbaum 1
PMCID: PMC324874  PMID: 15227199

Abstract

Laser angioplasty, or the use of laser radiation to vaporize or remove obstructure atherosclerotic plaque, has been an active area of research for the past several years. This article reviews current design considerations for developing a safe, effective clinical laser angioplasty system. The choice of laser, fiber, and catheter determines the performance characteristics of such a system. The laser provides the power source for ablative radiation, the fiber furnishes a means of transmitting the laser radiation, and the catheter provides a way of directing the fiber at the target tissue. Other considerations, such as the need for feedback control of laser ablation and the planned application of the system in the coronary or peripheral circulation, also determine the ultimate design. (Texas Heart Institute Journal 1989;16:150-7)

Keywords: Angioplasty, laser-assisted

Keywords: arterial occlusive diseases

Keywords: catheterization, peripheral arterial

Keywords: fiber optics

Keywords: heart catheterization

Keywords: vaporization, laser

Full text

PDF
150

Images in this article

156Image
on p.156

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abela G. S., Normann S., Cohen D., Feldman R. L., Geiser E. A., Conti C. R. Effects of carbon dioxide, Nd-YAG, and argon laser radiation on coronary atheromatous plaques. Am J Cardiol. 1982 Dec;50(6):1199–1205. doi: 10.1016/0002-9149(82)90448-9. [DOI] [PubMed] [Google Scholar]
  2. Abela G. S., Seeger J. M., Barbieri E., Franzini D., Fenech A., Pepine C. J., Conti C. R. Laser angioplasty with angioscopic guidance in humans. J Am Coll Cardiol. 1986 Jul;8(1):184–192. doi: 10.1016/s0735-1097(86)80111-5. [DOI] [PubMed] [Google Scholar]
  3. Choy D. S., Stertzer S. H., Myler R. K., Marco J., Fournial G. Human coronary laser recanalization. Clin Cardiol. 1984 Jul;7(7):377–381. doi: 10.1002/clc.4960070701. [DOI] [PubMed] [Google Scholar]
  4. Crea F., Davies G., McKenna W., Pashazade M., Taylor K., Maseri A. Percutaneous laser recanalisation of coronary arteries. Lancet. 1986 Jul 26;2(8500):214–215. doi: 10.1016/s0140-6736(86)92507-9. [DOI] [PubMed] [Google Scholar]
  5. Cumberland D. C., Sanborn T. A., Tayler D. I., Moore D. J., Welsh C. L., Greenfield A. J., Guben J. K., Ryan T. J. Percutaneous laser thermal angioplasty: initial clinical results with a laser probe in total peripheral artery occlusions. Lancet. 1986 Jun 28;1(8496):1457–1459. doi: 10.1016/s0140-6736(86)91498-4. [DOI] [PubMed] [Google Scholar]
  6. Deckelbaum L. I., Isner J. M., Donaldson R. F., Clarke R. H., Laliberte S., Aharon A. S., Bernstein J. S. Reduction of laser-induced pathologic tissue injury using pulsed energy delivery. Am J Cardiol. 1985 Oct 1;56(10):662–667. doi: 10.1016/0002-9149(85)91031-8. [DOI] [PubMed] [Google Scholar]
  7. Deckelbaum L. I., Isner J. M., Donaldson R. F., Laliberte S. M., Clarke R. H., Salem D. N. Use of pulsed energy delivery to minimize tissue injury resulting from carbon dioxide laser irradiation of cardiovascular tissues. J Am Coll Cardiol. 1986 Apr;7(4):898–908. doi: 10.1016/s0735-1097(86)80355-2. [DOI] [PubMed] [Google Scholar]
  8. Deckelbaum L. I., Lam J. K., Cabin H. S., Clubb K. S., Long M. B. Discrimination of normal and atherosclerotic aorta by laser-induced fluorescence. Lasers Surg Med. 1987;7(4):330–335. doi: 10.1002/lsm.1900070406. [DOI] [PubMed] [Google Scholar]
  9. Deckelbaum L. I. Laser angioplasty. Cardiol Clin. 1988 Aug;6(3):345–356. [PubMed] [Google Scholar]
  10. Eldar M., Battler A., Neufeld H. N., Gaton E., Arieli R., Akselrod S., Levite A., Katzir A. Transluminal carbon dioxide-laser catheter angioplasty for dissolution of atherosclerotic plaques. J Am Coll Cardiol. 1984 Jan;3(1):135–137. doi: 10.1016/s0735-1097(84)80439-8. [DOI] [PubMed] [Google Scholar]
  11. Fourrier J. L., Brunetaud J. M., Prat A., Marache P., Lablanche J. M., Bertrand M. E. Percutaneous laser angioplasty with sapphire tip. Lancet. 1987 Jan 10;1(8524):105–105. doi: 10.1016/s0140-6736(87)91944-1. [DOI] [PubMed] [Google Scholar]
  12. Gal D., Steg P. G., Dejesus S. T., Rongione A. J., Clarke R. H., Isner J. M. Failure of angiography to diagnose thermal perforation complicating laser angioplasty in a rabbit. Am J Cardiol. 1987 Sep 15;60(8):751–752. doi: 10.1016/0002-9149(87)90404-8. [DOI] [PubMed] [Google Scholar]
  13. Geschwind H. J., Kern M. J., Vandormael M. G., Blair J. D., Deligonul U., Kennedy H. L. Efficiency and safety of optically modified fiber tips for laser angioplasty. J Am Coll Cardiol. 1987 Sep;10(3):655–661. doi: 10.1016/s0735-1097(87)80210-3. [DOI] [PubMed] [Google Scholar]
  14. Ginsburg R., Wexler L., Mitchell R. S., Profitt D. Percutaneous transluminal laser angioplasty for treatment of peripheral vascular disease. Clinical experience with 16 patients. Radiology. 1985 Sep;156(3):619–624. doi: 10.1148/radiology.156.3.3161118. [DOI] [PubMed] [Google Scholar]
  15. Grundfest W. S., Litvack F., Forrester J. S., Goldenberg T., Swan H. J., Morgenstern L., Fishbein M., McDermid I. S., Rider D. M., Pacala T. J. Laser ablation of human atherosclerotic plaque without adjacent tissue injury. J Am Coll Cardiol. 1985 Apr;5(4):929–933. doi: 10.1016/s0735-1097(85)80435-6. [DOI] [PubMed] [Google Scholar]
  16. Grundfest W. S., Litvack F., Hickey A., Doyle L., Glick D., Lee M., Chaux A., Treiman R., Cohen L., Foran R. The current status of angioscopy and laser angioplasty. J Vasc Surg. 1987 Apr;5(4):667–673. [PubMed] [Google Scholar]
  17. Isner J. M., Donaldson R. F., Deckelbaum L. I., Clarke R. H., Laliberte S. M., Ucci A. A., Salem D. N., Konstam M. A. The excimer laser: gross, light microscopic and ultrastructural analysis of potential advantages for use in laser therapy of cardiovascular disease. J Am Coll Cardiol. 1985 Nov;6(5):1102–1109. doi: 10.1016/s0735-1097(85)80316-8. [DOI] [PubMed] [Google Scholar]
  18. Leon M. B., Lu D. Y., Prevosti L. G., Macy W. W., Jr, Smith P. D., Granovsky M., Bonner R. F., Balaban R. S. Human arterial surface fluorescence: atherosclerotic plaque identification and effects of laser atheroma ablation. J Am Coll Cardiol. 1988 Jul;12(1):94–102. doi: 10.1016/0735-1097(88)90361-0. [DOI] [PubMed] [Google Scholar]
  19. Livesay J. J., Cooley D. A. Laser coronary endarterectomy: proposed treatment for diffuse coronary atherosclerosis. Tex Heart Inst J. 1984 Sep;11(3):276–279. [PMC free article] [PubMed] [Google Scholar]
  20. MCGUFF P. E., BUSHNELL D., SOROFF H. S., DETERLING R. A., Jr STUDIES OF THE SURGICAL APPLICATIONS OF LASER (LIGHT AMPLIFICATION BY STIMULATED EMISSION OF RADIATION). Surg Forum. 1963;14:143–145. [PubMed] [Google Scholar]
  21. Murphy-Chutorian D., Kosek J., Mok W., Quay S., Huestis W., Mehigan J., Profitt D., Ginsburg R. Selective absorption of ultraviolet laser energy by human atherosclerotic plaque treated with tetracycline. Am J Cardiol. 1985 May 1;55(11):1293–1297. doi: 10.1016/0002-9149(85)90491-6. [DOI] [PubMed] [Google Scholar]
  22. Pandian N. G., Kreis A., Brockway B., Isner J. M., Sacharoff A., Boleza E., Caro R., Muller D. Ultrasound angioscopy: real-time, two-dimensional, intraluminal ultrasound imaging of blood vessels. Am J Cardiol. 1988 Sep 1;62(7):493–494. doi: 10.1016/0002-9149(88)90992-7. [DOI] [PubMed] [Google Scholar]
  23. Polanyi T. G. Laser physics. Otolaryngol Clin North Am. 1983 Nov;16(4):753–774. [PubMed] [Google Scholar]
  24. Prince M. R., Deutsch T. F., Mathews-Roth M. M., Margolis R., Parrish J. A., Oseroff A. R. Preferential light absorption in atheromas in vitro. Implications for laser angioplasty. J Clin Invest. 1986 Jul;78(1):295–302. doi: 10.1172/JCI112564. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Prince M. R., LaMuraglia G. M., MacNichol E. F., Jr Increased preferential absorption in human atherosclerotic plaque with oral beta carotene. Implications for laser endarterectomy. Circulation. 1988 Aug;78(2):338–344. doi: 10.1161/01.cir.78.2.338. [DOI] [PubMed] [Google Scholar]
  26. Puliafito C. A., Steinert R. F., Deutsch T. F., Hillenkamp F., Dehm E. J., Adler C. M. Excimer laser ablation of the cornea and lens. Experimental studies. Ophthalmology. 1985 Jun;92(6):741–748. doi: 10.1016/s0161-6420(85)33962-3. [DOI] [PubMed] [Google Scholar]
  27. Sanborn T. A., Faxon D. P., Haudenschild C. C., Ryan T. J. Experimental angioplasty: circumferential distribution of laser thermal energy with a laser probe. J Am Coll Cardiol. 1985 Apr;5(4):934–938. doi: 10.1016/s0735-1097(85)80436-8. [DOI] [PubMed] [Google Scholar]
  28. Spears J. R., Marais H. J., Serur J., Pomerantzeff O., Geyer R. P., Sipzener R. S., Weintraub R., Thurer R., Paulin S., Gerstin R. In vivo coronary angioscopy. J Am Coll Cardiol. 1983 May;1(5):1311–1314. doi: 10.1016/s0735-1097(83)80145-4. [DOI] [PubMed] [Google Scholar]
  29. Spokojny A. M., Serur J. R., Skillman J., Spears J. R. Uptake of hematoporphyrin derivative by atheromatous plaques: studies in human in vitro and rabbit in vivo. J Am Coll Cardiol. 1986 Dec;8(6):1387–1392. doi: 10.1016/s0735-1097(86)80312-6. [DOI] [PubMed] [Google Scholar]

Articles from Texas Heart Institute Journal are provided here courtesy of Texas Heart Institute

RESOURCES