Endovenous laser coagulation: asymmetrical heat transfer and coagulation (modeling in blood plasma)

The objective of this study was to describe the dynamics of blood plasma heating and coagulation processes carried out by continuous laser radiation with wavelengths 1.55 and 1.94 μm through bare-tip fibers and fibers with radial output (radial fibers) used for endovenous laser coagulation (EVLC). The study was performed in previously thawed frozen donor blood plasma using high-speed shooting of the heating process through the shadow optical method. It has been shown that in the case of highly water-absorbed laser radiations, convection, explosive, and small-bubble boiling play a major role in the process of heat transfer and coagulation. It has been shown that in the case of radiation with wavelength λ = 1.94 μm, effective heat transfer begins at significantly lower levels of power compared to radiations with λ = 1.55 μm. It has been established that heat transfer is sharply asymmetrical and is directed mainly upwards and forwards (bare-tip fiber) or upwards (radial fibers). For a wavelength of 1.94 μm, the effect of self-cleaning of the fiber surface from coagulated plasma fragments was found. Except for short-term acts of explosive boiling, the heat transfer is asymmetrical and directed mainly upwards. This effect should lead to uneven heating and thermal damage to the vein wall with the maximum at its upper part. For EVLC, the use of radiation with a wavelength of 1.94 μm is more efficient and safer.