Transvenous and intra-arterial ultrasound monitoring of laser-assisted angioplasty.
To evaluate the effects of peripheral laser angioplasty in vivo, two new applications of intravascular ultrasound have been tested. Sonography of iliac and femoropopliteal arteries using 6.2-French/20-MHz transducers via a transvenous approach was technical feasible, however, spatial resolution of images was not equivalent to intra-arterial sonography. Catheters and guide wires could be observed in normal and moderate stenotic segments but not in occlusions. Using a combined 9-French multifiber-laser-ultrasound-catheter sonographic analysis of arterial stenoses revealed a reduction of the degree of stenoses from 84 +/- 8% before to 47 +/- 10% after laser angioplasty. Both imaging modalities detected bright echoes during pulsed laser energy delivery with a focal appearance within the occlusion material and a diffuse pattern involving the distal arterial lumen. Probably these effects are caused by optico-mechanical plaque disruptions and ejections of gaseous products during the laser ablation. Further development of combined catheter devices to guide energy delivery by continuous imaging might improve the results of laser angioplasty.
Huppert
P E
PE
Abteilung für Radiologische Diagnostik, Universität Tübingen.
Duda
S H
SH
Kreis
A
A
Claussen
C D
CD
D000368:Aged; D016342:Angioplasty, Laser / Q000295:instrumentation*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D014159:Transducers; D018084:Ultrasonography, Interventional / Q000295:instrumentation*