title: Atherectomy using a solid-state laser at 355 nm wavelength.
abstract: Peripheral arterial disease (PAD), caused by atherosclerotic processes, is allied with an increased risk of ischemic events, limb loss, and death. Recently, the use of a solid-state laser at 355 nm within a hybrid catheter was suggested for that purpose. In this work, short nanosecond pulses of a solid-state laser at 355 nm delivered through a hybrid catheter, composed of optical fibers and a blunt mechanical blade, are used to conduct a pre-clinical study and two clinical cases. The pre-clinical study consisted of an atherosclerotic calcified cadaveric leg and a porcine in vivo trial within the iliac artery, respectively. The clinical cases include chronic total occlusions with a calcified lesion. The occluded cadaveric leg is recanalized successfully and no evidence of thermal necrosis is indicated in the histopathology analysis of the porcine study. No arterial wall damage is demonstrated on the animals' treated arteries and no significant impact on blood count and biochemistry analysis is noted in the animal trial. Successful recanalization of the occluded arteries followed by balloon angioplasty is obtained in both clinical cases. Our work constitutes a proof of concept for using a solid-state pulsed laser at 355 nm in atherectomy.
authors.affiliation: Department of Electrical and Computer Engineering, Ben-Gurion University, Beer-Sheva, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Herzog
authors.affiliation: Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Oszkinis
authors.affiliation: Department of Cardiology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Planer
authors.affiliation: Department of General and Vascular Surgery, Silesian Medical University, Katowice, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Ziaja
authors.affiliation: Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Kruszyna
authors.affiliation: Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Michał Goran
authors.initials: MG
authors.lastname: Stanisić
authors.affiliation: Department of General and Vascular Surgery, Silesian Medical University, Katowice, Poland.
authors.forename: Damian
authors.initials: D
authors.lastname: Ziaja
authors.affiliation: Department of Electrical and Computer Engineering, Ben-Gurion University, Beer-Sheva, Israel.
authors.forename: Amiel A
authors.initials: AA
authors.lastname: Ishaaya
authors.affiliation: Department of General and Vascular Surgery, Silesian Medical University, Katowice, Poland.
authors.forename: Wacław
authors.initials: W
authors.lastname: Kuczmik
mesh_terms: D000818:Animals; D001157:Arterial Occlusive Diseases / Q000601:surgery; D017073:Atherectomy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007717:Knee / Q000098:blood supply; D053844:Lasers, Solid-State; D013552:Swine
keywords: 355 nm; Peripheral arterial disease; atherectomy; laser ablation; recanalization