A new concept for a realtime feedback system in angioplasty with a flashlamp pumped dye laser

The feasibility of using a pulsed dye laser in angioplasty for detection and disintegration of calcified plaques was studied in vitro. A flashlamp-pumped dye laser (495 nm, 2 microseconds) was used as the exciting source for laser-induced-fluorescence (LIF) signals. Spectral data in the 520 nm to 800 nm region of normal intima, calcified plaque and fibro-fatty plaques were analyzed with an optical multichannel analyzer, using the same fiber for energy delivery and fluorescence diagnostic. Good signal to noise ratio and different spectra for different specimens were obtained within only 2 microseconds. The spectral difference is caused by selective reabsorption of oxyhemoglobin in the vessel wall. Time resolved LIF-spectroscopy shows that the fluorescence intensity reaches its maximum value before the maximum laser intensity is delivered. Fluorescence analysis can be performed in less than 300 ns and therefore the laser can be controlled before plasma threshold is reached. The described in vitro results can lead to a clinical useful feedbacksystem for energy control of microseconds lasers in angioplasty if the blood interference effects can be minimized by changing the laser excitation wavelength or staining the tissue.