Lasers in Medical Science

, Volume 6, Issue 2, pp 141–146 | Cite as

Improved criteria for the recognition of atherosclerotic plaque using fluorescence spectroscopy

  • Paul N. Casale
  • Norman S. Nishioka
  • James F. Southern
  • Peter C. Block
  • R. Rox Anderson
Article
  • 22 Downloads

Abstract

To determine the fluorescence pattern for distinguishing normal (N) from calcified and fibrous plaque (P), fluorescence spectra of cadaveric aorta were measured with a spectrofluorometer. Emission (Em) and excitation (Ex) spectra corrected for instrumental response were obtained from 200 to 1000 nm. Specimens from 50 patients were measured less than 24 h after autopsy and then examined histologically. Spectra from 25 specimens demonstrated that the ratio of fluorescence intensity 460 nm/385 nm with Ex=337 nm provided separation of N from P (1.53±29 vs 0.82±0.25,p<0.01) and that a ratio of 1.25 correctly identified all N and P. A prospective test of this ratio on an additional 25 specimens yielded a significant difference between N and P (1.70±0.37 vs 0.87±0.23,p<0.0001) with a value of 1.25 correctly identifying all (10/10) N and 93% (14/15) P. Prospective analysis of previously proposed fluorescence ratios (600 nm/580 nm at Ex=480 nm; 530 nm/550 nm at Ex=459 nm; 448 nm/514 nm and 538 nm/514 nm at Ex=337 nm) all resulted in poor separation of N from P. The ratio of 460 nm/385 nm with Ex=337 nm is superior to previously reported criteria for distinguishing N from P and may be useful for guiding laser angioplasty systems.

Key words

Laser angioplasty Coronary artery disease Nitrogen laser Tissue fluorescence 

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References

  1. 1.
    Lee G, Ikada RM, Theis JH et al. Acute and chronic complications of laser angioplasty: vascular wall damage and formation of aneurysms in the atherosclerotic rabbit.Am J Cardiol 1984,53:290–3CrossRefPubMedGoogle Scholar
  2. 2.
    Choy DSJ, Stertzer SH, Myler RK et al. Human coronary laser recanalization.Clin Cardiol 1984,7:377–81PubMedGoogle Scholar
  3. 3.
    Ginsburg R, Wexler L, Mitchell RS, Profitt D. Percutaneous transluminal laser angioplasty for treatment of peripheral vascular disease: clinical experience with sixteen patients.Radiology 1985,156:619–24PubMedGoogle Scholar
  4. 4.
    Abela GS, Seeger JM, Barbieri E et al. Laser angioplasty with angioscopic guidance in humans.JACC 1986,8:184–92PubMedGoogle Scholar
  5. 5.
    Abela GS, Normann SJ, Cohen DM et al. Laser recanalization of occluded atherosclerotic arteries in vivo and in vitro.Circulation 1985,71:403–11PubMedGoogle Scholar
  6. 6.
    Crea F, Fenech A, Smith W et al. Laser recanalization of acutely thrombosed coronary arteries in live dogs: early results.JACC 1985,6:1052–6PubMedGoogle Scholar
  7. 7.
    Crea F, Abela GS, Fenech A et al. Transluminal laser irradiation of coronary arteries in live dogs: an angiographic and morphologic study of acute effects.Am J Cardiol 1986,57:171–4CrossRefPubMedGoogle Scholar
  8. 8.
    Abela GS, Seeger JM, Barbieri E et al. Angioscopy for guidance of laser recanalization in man.JACC 1986,7:153AGoogle Scholar
  9. 9.
    Sanborn TR, Faxon DP, Haudenschild CC et al. Angiographic and histopathologic consequences of in vivo laser irradiation of atherosclerotic lesions.Circulation 1983,68:111–45Google Scholar
  10. 10.
    Funai JT, Pandian NG, Isner JM et al. Utility of high frequency two-dimensional echocardiography in the performance of laser coronary angioplasty. Experimental studies.Clin Res 1984,32:672AGoogle Scholar
  11. 11.
    Kittrell C, Willett RL, Santos-Pacheo C et al. Diagnosis of fibrous arterial atherosclerosis using fluorescence.Appl Optics 1985,24:2280–1Google Scholar
  12. 12.
    Deckelbaum LI, Lam JK, Cabin HS et al. Discrimination of normal and atherosclerotic aorta by laser-induced fluorescence.Lasers Surg Med 1987,7:330–5PubMedGoogle Scholar
  13. 13.
    Sartori MP, Boassaller C, Weilbacher D et al. Detection of atherosclerotic plaques and characterization of arterial wall structure by laser induced fluorescence.Circulation 1986,74:11–7Google Scholar
  14. 14.
    Leon MB, Lu DY, Prevosti LG et al. Human arterial surface fluorescence: atherosclerotic plaque identification and effects of laser atheroma ablation.JACC 1988,12:94–102PubMedGoogle Scholar
  15. 15.
    Spokojny AM, Serur JR, Skillman J, Spears JR. Uptake of hematoporphyrin derivative by atheromatous plaques: studies in human in vitro and rabbit in vivo.JACC 1986,8:1387–92PubMedGoogle Scholar
  16. 16.
    Litvack F, Grundfest WS, Forrester JS et al. Effects of hematoporphyrin derivative and photodynamic therapy on atherosclerotic rabbits.Am J Cardiol 1985,56:667–71CrossRefPubMedGoogle Scholar
  17. 17.
    Banga I, Bihari-Varga M. Investigations of free and elastin-bound fluorescent substances present in the atherosclerotic lipid and calcium plaques.Connective Tissue Res 1974,2:237–41Google Scholar
  18. 18.
    Tinker DH, Rucker RB, Tappel AL. Variation of elastin fluorescence with method of preparation: determination of the major flurophore of fibrillar elastin.Connective Tissue Res 1983,2:299–308Google Scholar
  19. 19.
    Blomfield J, Farrar JF. Fluorescence spectra of arterial elastin.Biochem Biophys Res Comm 1967,28:346–51CrossRefPubMedGoogle Scholar
  20. 20.
    MacFarlane TWR, Petrowski S, Rigutto L, Roach MR. Computer-based video analysis of cerebral arterial geometry using the natural fluorescence of the arterial wall and contrast enhancement techniques.Blood Vessels 1983,20:161–71PubMedGoogle Scholar
  21. 21.
    Blankenhorn DH, Braunstein H. Carotenoids in man. III. The microscopic pattern of fluorescence in atheroma and its relation to their growth.J Clin Invest 1958,37:160–5PubMedGoogle Scholar
  22. 22.
    Blankenhorn DH, Freiman DG, Knowles HC. Carotenoids in man. The distribution of epiphasic carotenoids in atherosclerotic lesions.J Clin Invest 1956,35:1243–7PubMedGoogle Scholar
  23. 23.
    Prince MR, Deutsch TF, Mathews-Roth MM et al. Preferential light absorption in atheromas in vitro. Implications for laser angioplasty.J Clin Invest 1986,78:295–302PubMedGoogle Scholar
  24. 24.
    Leon MB, Prevosti LG, Smith PD et al. In vivo laser-induced fluorescence plaque detection: preliminary results in patients.Circulation 1987,76:IV-408Google Scholar

Copyright information

© Baillière Tindall 1991

Authors and Affiliations

  • Paul N. Casale
    • 1
  • Norman S. Nishioka
    • 1
  • James F. Southern
    • 1
  • Peter C. Block
    • 1
  • R. Rox Anderson
    • 1
  1. 1.Cardiac Unit and Wellman LaboratoryMassachusetts General Hospital, Harvard Medical SchoolBostonUSA

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