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Smooth excimer laser coronary angioplasty (SELCA) and conventional excimer laser angioplasty: Comparison of vascular injury and smooth muscle cell proliferation

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Abstract

Although the excimer laser, which utilizes ‘non-thermal ablation effects’, has achieved encouraging results in early clinical trials, the long-term results have failed to show any advantage over conventional percutaneous transluminal coronary angioplasty (PTCA).

A new system, Smooth Excimer Laser Coronary Angioplasty (SELCA), has been developed to reduce the tissue damage in the vessel wall caused by shock waves and vapour bubbles.SELCA (wavelength 308 nm, pulse duration 115 ns, repetition rate 150 Hz and energy density 50 mJ mm-2) lowers the amount of shock wave formation and pressure peak amplitude in the surrounding tissue by about eight times when compared to the conventional 308 nm excimer laser (ELCA). In this preclinical evaluation, this new system was compared to ELCA. Fifty New Zealand White rabbits were stimulated by repeated weak DC impulses for a period of 28 days in order to form an atherosclerotic plaque in the right carotid artery. The vessels were excised 3, 7,14 and 28 days after laser irradiation for immunohistochemical analysis.

SELCA and ELCA laser treatment lead to a decrease in maximal intimal wall thickness 3 days after intervention (control: 177±4 µm; SELCA: 131±22µm; ELCA: 120 ±33µm). In the period between 3 and 28 days, a moderate increase in intimal wall thickness was observed after SELCA treatment compared to a significant increase after ELCA (28 days after intervention: SELCA: 157±22µm; ELCA: 274 ±28µm). Bromodeoxyuridine (BrdU) was applied 18 and 12 h before excision of the vessels in order to determine the percent of cells undergoing DNA synthesis. The percent of BrdU labelled SMC in the intima (control: 13 ± 2 cells mm-2) increased in both groups after 3 days (SELCA: 248 ± 107 cells mm-2; ELCA: 162 ± 41 cells mm-2) and 7 days (SELCA: 162± 55 cells mm-2; ELCA: 279 ± 119 cells mm-2).

The present results demonstrate that vascular wall injury and increase in intimal wall thickness following SELCA are reduced in comparison to the results achieved with the conventional technique. Further trials are necessary to assess whether these improvements will lead to more favourable long-term results after excimer laser angioplasty.

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References

  1. Srinivasan R. Ablation of polymers and biological tissue by ultraviolet lasers.Science 1986,234:559–65

    Article  CAS  PubMed  Google Scholar 

  2. Cross FW, Bowker TJ, Langley A et al. Excimer laser angioplasty: Evidence for non thermal ablation from emission spectroscopy of photoproducts.Circulation 1986,74 (Suppl. 11):1439A

    Google Scholar 

  3. Grundfest WS, Litvack F, Forrester JS et al. Laser ablation of human atherosclerotic plaque without adjacent tissue injury.J Am Coll Cardiol 1985,5:929–33

    Article  CAS  PubMed  Google Scholar 

  4. Bowker TJ, Cross FW, Rumsby PT et al. Excimer laser angioplasty: Quantitative comparison in vitro of three ultraviolet wavelength on tissue ablation and haemolysis.Lasers in Medical Science 1986,1:91–9

    Article  Google Scholar 

  5. Isner JM, Donaldson RF, Deckelbaum LI et al. The excimer laser: Gross, light microscopic and ultrastructural analysis of potential advantages for use in laser therapy of cardiovascular diseases.J Am Coll Cardiol 1985,5:1102–9

    Article  Google Scholar 

  6. Grundfest WS, Litvack IK, Goldenberg T et al. Pulsed ultraviolet lasers and the potential for safe laser angioplasty.Am J Surg 1985,150:220–6

    Article  CAS  PubMed  Google Scholar 

  7. Mohr FW, Lenz W, Kusserow SV et al. Excimer laser for angioplasty and cardiac valve repair.Laser in Medicine and Surgery 1987,3:93–7

    Google Scholar 

  8. Singelton DL, Paraskevopoulos G, Taylor RS et al. Excimer laser angioplasty: Tissue ablation arterial response and fibre optic delivery.IEEE J Quant Electr 1987; QE-23,10:1772–81

    Article  Google Scholar 

  9. Frazier OH, Diethrich EB, Johansson B et al. Preliminary results of intraoperative excimer laser angioplasty. Phase 1: An adjunct to coronary artery bypass surgery.Lasers Surg Med 1992,12:7–12

    Article  CAS  PubMed  Google Scholar 

  10. Prevosti LG, Leon MB, Smith PD et al. Early and late healing responses of normal canine artery to excimer laser irradiation.J Thorac Cardiovasc Surg 1988,96:150–6

    CAS  PubMed  Google Scholar 

  11. Farrell EM, Higginson LAJ, Nip WS et al. Pulsed excimer laser angioplasty of human cadaveric arteries.J Vase Surg 1986,3:284–7

    Article  CAS  Google Scholar 

  12. Karsch KR, Haase KK, Mauser M et al. Percutaneous coronary excimer laser angioplasty: Initial clinical results.Lancet 1989,2:647–50

    Article  CAS  PubMed  Google Scholar 

  13. Sanborn TA, Torre SR, Aharma SK et al. Percutaneous coronary excimer laser-assisted balloon angioplastyInitial clinical and quantitative angiographic results in 50 patients.J Am Coll Cardiol 1991,17:94–9

    Article  CAS  PubMed  Google Scholar 

  14. Cook SL, Eigler NL, Shefer A et al. Percutaneous excimer laser coronary angioplasty of lesions not ideal for balloon angioplasty.Circulation 1991,84:632–43

    CAS  PubMed  Google Scholar 

  15. Karsch KR, Haase KK, Voelker W et al. Percutaneous coronary excimer laser angioplasty in patients with stable and unstable angina pectoris: Acute results and incidence of restenosis during 6-month follow-up.Circulation 1990,81:1849–59

    CAS  PubMed  Google Scholar 

  16. Litvack F, Eigler NI, Margolis JR et al. Percutaneous excimer laser coronary angioplasty.Am J Cardiol 1990,66:1027–32

    Article  CAS  PubMed  Google Scholar 

  17. Appelmann YEA, Piek JJ, Strikwerda S et al. Randomised trial of excimer laser angioplasty versus balloon angioplasty for treatment of obstructive coronary artery disease.Lancet 1996,347:79–84

    Article  Google Scholar 

  18. Strikwerda S, Swijndregt EM, Foley DP et al. Immediate and late outcome of excimer laser and balloon coronary angioplasty: A quantitative angiographic comparison based on matched lesions.J Am Coll Cardiol 1995,26:939–46

    Article  CAS  PubMed  Google Scholar 

  19. Van Leeuwen TG, Van Erven L, Meetens JH et al. Origin of arterial wall dissections induced by pulsed excimer and mid-infrared laser ablation in the pig.J Am Coll Cardiol 1992,19:1610–8

    Article  PubMed  Google Scholar 

  20. Xie DY, Hassenstein S, Oberhoff M et al. In vitro evaluation of ablation parameters of normal and fibrous aorta using smooth excimer laser coronary angioplasty.Lasers Surg Med 1994,13:618–24

    Article  Google Scholar 

  21. Hanke H, Strohschneider T, Oberhoff M et al. Time course of smooth muscle cell proliferation in the intima and media of arteries following experimental angioplasty.Circ Res 1990,67:651–9

    CAS  PubMed  Google Scholar 

  22. Hanke H, Haase KK, Hanke S et al. Morphological changes and smooth muscle cell proliferation after experimental excimer laser treatment.Circulation 1991,83:1380–9

    CAS  PubMed  Google Scholar 

  23. Hassenstein S, Hanke H, Kamenz J et al. Vascular injury and time course of smooth muscle cell proliferation following experimental holmium laser angioplasty.Circulation 1992,86:1575–83

    CAS  PubMed  Google Scholar 

  24. Position of the American Heart Association on Research Animal Use.Circulation 1985,71:849

    Google Scholar 

  25. Sachs L: Angewandte Statistik: 5. Auflage. Berlin, Springer Verlag, 1978

    Google Scholar 

  26. Van Leeuwen TG, van der Veen MJ, Verdaasdonk RM, Borst C. Noncontact tissue ablation by holmium: YSGG laser pulses in blood.Lasers Surg Med 1991,11:26–34

    Article  PubMed  Google Scholar 

  27. Van Leeuwen TG, Van Erven L, Meertens JH et al. Origin of arterial wall dissections induced by pulsed excimer and mid-infrared laser ablation in the pig.J Am Coll Cardiol 1992,19:1610–8

    Article  PubMed  Google Scholar 

  28. Haase KK, Hanke H, Baumbach A et al. Occurrence, extent, and implications of pressure waves during excimer laser ablation of normal arterial wall and atherosclerotic plaque.Lasers Surg Med 1993,13:263–70

    Article  CAS  PubMed  Google Scholar 

  29. Tomaru T, Geschwind HJ, Boussignac G et al. Characteristics of shock waves induced by pulsed lasers and their effects on arterial tissue: Comparison of excimer, pulse dye, and holmium YAG lasers.Am Heart J 1992,123:896–904

    Article  CAS  PubMed  Google Scholar 

  30. Tomaru T, Geschwind HJ, Boussignac G et al. Comparison of ablation efficacy of excimer, pulsed-dye, and holmium-YAG lasers relevant to shock waves.Am Heart J 1992,123:886–95

    Article  CAS  PubMed  Google Scholar 

  31. Litvack F, Doyle L, Grundfest W et al. In vivo excimer laser ablation: Acute and chronic effects on canine aorta.Circulation 1986, 74-IL1438A

  32. Marmur JD, Sanborn TA, Kahn H et al. Acute biologic response to excimer versus thermal laser angioplasty in experimental atherosclerosis.J Am Coll Cardiol 1991,17(4):978–84

    Article  CAS  PubMed  Google Scholar 

  33. Badimon L, Badimon JJ, Galvez A et al. Influence of arterial damage and wall shear rate on platelet deposition.Arteriosclerosis 1986,6:312–20

    CAS  PubMed  Google Scholar 

  34. Isner JM, Rosenfield K, White CJ et al. In vivo assessment of vascular pathology resulting from laser irradiation.Circulation 1992,85:2185–96

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Division of Cardiology, Otfried Müller Str. 10, D-72076, Tübingen, Germany

    M. Oberhoff, A. Baumbach, C. Herdeg, S. Hassenstein, D. Y. Xie, E. Blessing, H. Hanke, K. K. Haase & K. R. Karsch

  2. Department of Physiology, University of Tübingen, Germany

    E. Betz

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  1. M. Oberhoff
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  2. A. Baumbach
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  3. C. Herdeg
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  4. S. Hassenstein
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  5. D. Y. Xie
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  6. E. Blessing
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  7. H. Hanke
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  8. K. K. Haase
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  9. E. Betz
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  10. K. R. Karsch
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Oberhoff, M., Baumbach, A., Herdeg, C. et al. Smooth excimer laser coronary angioplasty (SELCA) and conventional excimer laser angioplasty: Comparison of vascular injury and smooth muscle cell proliferation. Laser Med Sci 12, 328–335 (1997). https://doi.org/10.1007/BF02767155

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  • DOI: https://doi.org/10.1007/BF02767155

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