Occurrence and magnitude of pressure waves during Er:YAG laser ablation of atherosclerotic tissue: comparison to XeCl excimer laser ablation.
OBJECTIVE
Since excimer laser ablation has not shown advantages in comparison to conventional balloon angioplasty, the search for other laser light sources came up with the Er:YAG laser, operating at a wavelength of 2.94 microns.


METHODS
Normal and atherosclerotic human vessel segments were irradiated in vitro, using pulsed Er:YAG laser systems. The laser beam was either focused onto the tissue in air or delivered via a fibre system onto the tissue being immersed in saline. Needle-type hydrophones were used for pressure pulse detection.


RESULTS
Er:YAG laser irradiation results in effective tissue ablation of normal and calcified atherosclerotic vessel segments. In comparison to excimer lasers, ablation rates can be increased by a factor of 5 to 10 at least. Er:YAG laser ablation is also associated with a generation of pressure waves. On calcified plaque, the acoustic signals differ significantly from those on normal tissue. Histological tissue analysis reveals small zones of discoloration and tissue fissures that are found 100-200 microns lateral to the crater edge, depending on the energy density used.


CONCLUSIONS
Er:YAG lasers generate pressure waves that are comparable to excimer laser ablation. Er:YAG lasers, however, show a markedly improved ablation efficiency, which may favour these systems as effectively cutting, less traumatic tools for removal of atherosclerotic plaque.
Rose
C H
CH
Department of Cardiology, Tübingen University, Germany.
Haase
K K
KK
Wehrmann
M
M
Karsch
K R
KR
D001018:Aortic Diseases / Q000473:pathology / Q000601:surgery*; D001161:Arteriosclerosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D066298:In Vitro Techniques; D053685:Laser Therapy / Q000295:instrumentation; D011312:Pressure