What have We Learned about the Atherosclerotic Plaque Using Laser Radiation?
The development of percutaneous transluminal angioplasty has been a milestone in the treatment of peripheral vascular disease (1). Nevertheless the procedure has some major limitations: 1) Inability to cross severe occlusion; 2) a 25%–50% restenosis rate at two years (2); 3) scant success in diffuse atherosclerotic arteries. The ability to ablate atherosclerotic plaques without damaging the vessel wall was the “dream” of the first pioneers who first used laser radiation in the cardiovascular field. Extensive experimental and human clinical studies have been performed in the last ten years to evaluate the effect of laser radiation on the plaque. As a consequence our knowledge of the optical, thermal and several other properties of the normal and diseased vessel wall has increased greatly. Some of these new developments are considered in order to understand better the behavior of atherosclerotic plaque during laser application and to begin to evaluate the possible uses of this powerful tool to alter and to measure components of the artery wall lesions using exogenous fluorescence.
Unable to display preview. Download preview PDF.
- 5.J. W. Valvano, L. Hayes, A. J. Welch, S. Bajekal, D. Colvin, H. Hussein, Thermal properties of plaque and vessel wall, Lasers Surg Med 3:318 (1984).Google Scholar
- 13.J. R. Spears, J. Serur, D. Shropshir, S. Paulin, Fluorescence of experimental atheromathous plaques with hematoporphyrin derivate, J Clin Invest 78:395 (1986).Google Scholar
- 15.G. M. Vincent, G. S. Abela and E. Barbieri, Photosensitizer -enhanced laser angioplasty. In Lasers in cardiovascular medicine and surgery: fundamentals and techniques, G S Abela ed., Kluwer Academic Press, Boston (1990).Google Scholar
- 21.A. Perbellini, E. Barbieri G. Taddei, A. Scuro, G. Mazzilli, S. Imperio, M. Lino, G. Destro, L. Lucchese, Recanalization of occluded peripheral arteries by “Hot tip” laser system. Vase Surg 23:371 (1989).Google Scholar
- 22.E. Barbieri, G S. Abela, A. I. Khoury, C R. Conti, Temperature characteristics of laser thermal probes in the coronary circulation of dogs. Circulation 76:IV-47 (1987).Google Scholar
- 23.E. Barbieri, A. Perbellini, A. Scuro, G Taddei, G. Mansueto, G. Bau, P. Ghini, G. Destro, Excimer laser in the treatment of peripheral artery disease: acute and short term results, 37th Meeting American College of Angiology 20, Atlanta (1990).Google Scholar
- 24.G. Biamino, G. Stefan, H. Böttcher, U. Flesch, U. Kar, K. Dorschel, P. Skarabis, M. Gross, H. Witt, G. Muller, Excimer laser revascularization: clinical results. Cardiovascular and Interventional Radiological Society of Europe, Annual Meeting 182, Brussel (1990).Google Scholar