Acoustic and plasma-guided laser angioplasty

The feasibility of using acoustic and plasma-guided laser (APGL) for angioplasty was studied in vitro. A flashlamp-pumped tunable dye laser operating at a wavelength of 504 nm (coumarin green) was used as the laser source. Acoustic signals were recorded with a hydrophone, which has a useful frequency response of up to 350 kHz. Plasma optical emissions were transmitted retrograde along the laser fiber and reflected through a beam splitter to an optical detection system consisting of a series of spectral filters (to transmit plasma radiation from 380 nm to 440 nm and block any 504 nm laser light) and a photomultiplier tube. Measurements of the acoustic and the plasma optical signals were obtained from blood, atheromatous plaque, and normal arterial wall. Results of monitoring show that it is possible to know without direct vision whether the laser energy is being discharged in the lumen (blood), on the normal arterial wall, or on the atheromatous plaque. Blood produced strong acoustic signals but no plasma signals; plaque produced strong plasma and strong acoustic signals. Neither plasma nor significant acoustic signals were produced by the normal arterial wall. These distinctions may allow clinical laser ablation of plaque to be performed with fewer complications.