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Laser ablation on vascular diseases: mechanisms and influencing factors

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Abstract

Vascular diseases, such as venous insufficiency and coronary artery diseases, have been threatening the health of people. Efficient treatment with proper postoperative care is required to relieve the pain of the patients. Traditionally, venous insufficiency is treated with ligation and stripping, an open surgery whose complication rate cannot be ignored. Coronary artery disease is often treated with balloon angioplasty during which undilatable lesions may be encountered, limiting the efficacy of this approach. With advances in laser photonics and percutaneous coronary intervention procedure, laser ablation is emerging as an alternative and adjunctive therapy for these diseases. Endovenous laser ablation has the advantages of high success rate, low complication risk, and fast postoperative recovery. Laser ablation in arteries can handle uncrossable or undilatable lesions with a low incidence of serious complications. In this review, previously published research concerning vascular diseases and their therapies are analyzed in order to provide a clear explanation of the mechanisms and merits of laser ablation. For endovenous laser ablation, the main mechanisms are steam bubbles, heat conduction, and heat pipe, and three main influencing factors are wavelength, fiber types, and laser energy density. For excimer laser coronary atherectomy, the main mechanisms are photochemical, photothermal, and photomechanical effects, and three main influencing factors are catheter, medium, and laser parameters.

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Funding

This work was funded by National Natural Science Foundation of China (62071016, 92049201, 82350003), College Students’ Innovative Entrepreneurial Training Plan Program, and Fundamental Research Funds for the Central Universities.

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Author notes

  1. Chenghong Zhang and Wenhao Lyu contributed equally to this work.

Authors and Affiliations

  1. School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, China

    Chenghong Zhang, Wenhao Lyu, Pengtianyu Qiu, Congyu Zhang, Xiaoli Zhao & Bo Fu

  2. Key Laboratory of Big Data-Based Precision Medicine Ministry of Industry and Information Technology, School of Engineering Medicine, Beihang University, Beijing, China

    Xiaogang Wang, Boqu He & Bo Fu

  3. Neurosurgery Department of Xuanwu Hospital, Capital Medical University, Beijing, China

    Xunming Ji

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  1. Chenghong Zhang
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Contributions

Boqu He and Bo Fu conceived and designed the review. Boqu He and Pengtianyu Qiu analyzed and interpreted the relevant data. Boqu He, Chenghong Zhang, Wenhao Lyu, and Congyu Zhang did manuscript writing. Bo Fu, Chenghong Zhang, Wenhao Lyu, Pengtianyu Qiu, Congyu Zhang, Xiaoli Zhao, Xiaogang Wang, Boqu He, and Xunming Ji did critical revision of the article. Boqu He and Xunming Ji have the overall responsibility. All authors read and approved the final manuscript.

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Correspondence to Bo Fu or Xunming Ji.

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Zhang, C., Lyu, W., Qiu, P. et al. Laser ablation on vascular diseases: mechanisms and influencing factors. Lasers Med Sci 39, 18 (2024). https://doi.org/10.1007/s10103-023-03964-2

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