title: Laser scoop desobliteration: a method for minimally invasive remote recanalization of chronically occluded superficial femoral arteries.
abstract: Stenosis and occlusion of the superficial femoral artery (SFA) are most common in arterial occlusive disease. There are numerous interventional, surgical, and combined approaches to reconstitute maximum blood supply to the lower limb; however, despite intense clinical research, the long-term success rates are still poor. We present the first results with a catheter prototype for laser-based minimal invasive endarterectomy, called laser scoop desobliteration (LSD). The tip of a glass fiber containing a catheter was modified with a spatula head design and connected to an ultraviolet laser. It was tested in cadavers fixed with the Thiel embalming technique preserving tissue consistency, flexibility, and plasticity. After longitudinal arteriotomy of the SFA, a circular dissection between media and adventitia was performed. Then the LSD catheter was inserted and propagated with a progress of 1 mm∕s. Afterward, the atheroma core, which showed a plain surface without substantial attaching tissue debris, was removed. Histological examination of the vessel wall showed that the dissection was performed at the media/adventitia interface. In summary, the constructed LSD catheter allowed a rapid and easy way to perform an endarterectomy, thereby offering an innovative approach in the treatment of chronic occluded SFA.
authors.affiliation: University Medical Center Schleswig-Holstein, Clinic of Radiology and Neuroradiology, Arnold-Heller-Street 3, 24105 Kiel, Germany.
authors.forename: Carola
authors.initials: C
authors.lastname: Heneweer
authors.affiliation: University Medical Center Schleswig-Holstein, Clinic of Cardiovascular Surgery, Arnold-Heller-Street 3, 24105 Kiel, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Siggelkow
authors.affiliation: University Medical Center Schleswig-Holstein, Clinic of Radiology and Neuroradiology, Arnold-Heller-Street 3, 24105 Kiel, GermanycPhilips GmbH Innovative Technologies, Research Laboratories, Roentgenstr. 24-26, 22335 Hamburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Helle
authors.affiliation: University Medical Center Schleswig-Holstein, Clinic of Cardiovascular Surgery, Arnold-Heller-Street 3, 24105 Kiel, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Petzina
authors.affiliation: University Medical Center Schleswig-Holstein, Clinic of Radiology and Neuroradiology, Arnold-Heller-Street 3, 24105 Kiel, Germany.
authors.forename: Asmus
authors.initials: A
authors.lastname: Wulff
authors.affiliation: University Medical Center Schleswig-Holstein, Clinic of Radiology and Neuroradiology, Arnold-Heller-Street 3, 24105 Kiel, Germany.
authors.forename: Joost P
authors.initials: JP
authors.lastname: Schaefer
authors.affiliation: University Medical Center Schleswig-Holstein, Clinic of Cardiovascular Surgery, Arnold-Heller-Street 3, 24105 Kiel, Germany.
authors.forename: Rouven
authors.initials: R
authors.lastname: Berndt
authors.affiliation: University Medical Center Schleswig-Holstein, Clinic of Cardiovascular Surgery, Arnold-Heller-Street 3, 24105 Kiel, Germany.
authors.forename: Rene
authors.initials: R
authors.lastname: Rusch
authors.affiliation: Christian-Albrechts-Universitaet zu Kiel, Institute of Anatomy, Otto-Hahn Platz 8, 24118 Kiel, Germany.
authors.forename: Thilo
authors.initials: T
authors.lastname: Wedel
authors.affiliation: Christian-Albrechts-Universitaet zu Kiel, Institute of Anatomy, Otto-Hahn Platz 8, 24118 Kiel, Germany.
authors.forename: Guenther
authors.initials: G
authors.lastname: Klaws
authors.affiliation: University of Basel, Department of Biomedicine, Pestalozzistr. 20, 4056 Basel, Switzerland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Müller-Gerbl
authors.affiliation: University Medical Center Schleswig-Holstein, Institute of Pathology, Arnold-Heller-Str. 3, 24105 Kiel, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Röcken
authors.affiliation: University Medical Center Schleswig-Holstein, Clinic of Radiology and Neuroradiology, Arnold-Heller-Street 3, 24105 Kiel, Germany.
authors.forename: Olav
authors.initials: O
authors.lastname: Jansen
authors.affiliation: University Medical Center Schleswig-Holstein, Clinic of Cardiovascular Surgery, Arnold-Heller-Street 3, 24105 Kiel, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Lutter
authors.affiliation: University Medical Center Schleswig-Holstein, Clinic of Cardiovascular Surgery, Arnold-Heller-Street 3, 24105 Kiel, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Cremer
authors.affiliation: University Medical Center Schleswig-Holstein, Clinic of Cardiovascular Surgery, Arnold-Heller-Street 3, 24105 Kiel, Germany.
authors.forename: Justus
authors.initials: J
authors.lastname: Groß
mesh_terms: D004691:Endarterectomy / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D058729:Peripheral Arterial Disease / Q000601:surgery*; D062666:Vascular Access Devices