Plaque ablation by excimer laser irradiation using a movable energy-transmitting device

Area of Science:

• Cardiovascular Surgery
• Medical Devices
• Laser Technology

Background:

• Excimer laser energy is suitable for atherosclerotic plaque ablation, particularly in small vessels like coronary and crural arteries.
• A significant challenge has been the efficient transmission of far-ultraviolet pulsed laser power in clinical settings.
• Existing methods face limitations in delivering consistent and effective laser energy for intraoperative plaque removal.

Purpose of the Study:

• To develop and evaluate an energy-transmitting device for excimer laser plaque ablation.
• To assess the device's capability to deliver sufficient energy for intraoperative atherosclerotic plaque removal.
• To ensure minimal energy loss and high energy density at the distal end for effective treatment.

Main Methods:

• Construction of a novel energy-transmitting device housed in a rigid, articulated arm for an excimer laser.
• Testing the device using fresh human cadaver coronary arteries with and without atherosclerotic disease.
• Irradiation of arteries vertically and coaxially, with energy delivery measured by a power meter at the distal end.

Main Results:

• The device achieved energy densities up to 3 J/cm(2)/pulse due to energy focusing.
• Efficient tissue ablation of approximately 20 micrometers per pulse at 5 Hertz was observed.
• Normal vascular tissue and plaque components (fibrohyalinous, lipid) were promptly ablated with well-circumscribed, carbonization-free margins.
• Light microscopy confirmed no thermal damage to surrounding tissues.

Conclusions:

• The developed energy-transmitting device facilitates intraoperative excimer laser irradiation for atherosclerotic plaque ablation.
• The system demonstrates minimal energy loss between the laser generator and the delivery tip.
• Sufficient energy densities are achievable for effective plaque removal, offering a promising solution for vascular interventions.