Abstract
Important causes of suboptimal angiographic results following percutaneous transluminal coronary angioplasty (PTCA) include elastic recoil, arterial dissection, and the presence of thrombus. Although increased vasomotor tone may contribute to a reduction of luminal diameter improvement, passive recoil probably accounts for most of the latter. Typically, in most clinical series [1–4] a mean residual diameter of acute stenosis of approximately 30%, which roughly corresponds to a 50% luminal cross-sectional area stenosis, is found after successful PTCA, presumably as a result of such recoil. Intimal tears may further compromise an apparently successful PTCA procedure, even without propagation of a dissection, by local disruption of laminar flow patterns. When thrombus is associated with a lesion treated with PTCA, a poor result is frequently encountered, perhaps as a result of the difficulty in attempting to remodel this tissue with pressure and the possibility that spreading the thrombus along the luminal surface may increase the number of sites of potential propagation of the thrombus.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Gruentzig AR, Schlumpf M, Siegenthaler W (1984). Long-term results after coronary angioplasty (abstr). Circulation 70 (Suppl 11): 11–323.
Cowley MJ, Vetrovec GW, Wolfgang TC (1984). Emergency coronary bypass surgery after coronary angioplasty: The National Heart, Lung, and Blood Institute’s Percutaneous Transluminal Coronary Angioplasty Registry Experience. Am J Cardiol 53: 22C–26C.
Serruys PW, Luijten HE, Beatt KJ, Gueskens R, et al. (1988). Incidence of restenosis after successful coronary angioplasty: A time-related phenomenon. A quantitative angiographic study in 342 patients at 1, 2, 3, and 4 months. Circulation 77: 361.
Nobuyoshi M, Kimura T, Nosaka H, Moika S, et al. (1988). Restenosis after successful percutaneous transluminal coronary angioplasty: Serial angiographic follow-up of 229 patients. J Am Coll Cardiol 12: 616.
Hiehle JF, Bourgelais DBC, Shapshay S, Schoen FJ, et al. (1985). Nd:YAG laser fusion of human atheromatous plaque-arterial wall separations in vitro. Am J Cardiol 56: 953–957.
Spears JR (1987). PTCA restenosis: Potential prevention with laser balloon angioplasty (LBA). Am J Cardiol 60: 61B–64B.
Spears JR (1989). Sealing. In Cardiovascular Laser Therapy, JM Isner, RH Clarke, eds. New York: Raven Press, pp 177–199.
Serur JR, Sinclair IN, Spokojny AM, Paulin S, et al. (1985). Laser balloon angioplasty (LBA): Effect on the carotid lumen in the dog. Circulation 72: 111–457.
Jenkins RD, Sinclair IN, Leonard BM, Sandor T, et al. (1989). Laser balloon angioplasty in normal rabbit iliac arteries. Lasers Surg Med, in press.
Welch AJ, Valvano JW, Pearce JA, Hayes LJ, et al. (1985). Effect of laser radiation on tissue during laser angioplasty. Lasers Surg Med 5: 251.
Gorisch W, Boergen KP (1979). Thermal shrinkage of collagen fibers during occlusion in laser surgery. In Laser Surgery, Vol III, I. Kaplan, ed. Jerusalem: Academic Press, pp 202–207.
Kaltenbach M, Beyer J, Walter S, Klepzig H, et al. (1984). Prolonged application of pressure in transluminal coronary angioplasty. Cath Cardiovasc Diagn 10: 213.
1’3. Peterson LH, Jensen RE, Parnell J (I960). Mechanical properties of arteries in vivo. Circ Res 8: 622.
Gow BS (1970). Viscoelastic properties of conduit arteries. Circ Res 26(Suppl II):II — 113.
Spears JR, Sandor T, Als AV, Malagold M, et al. (1983). Computerized image analysis for quantitative measurement of vessel diameter from cineangiograms. Circulation 68:453– 461.
Sandor T, D’Adamo A, Hanlon WB, Spears JR. (1987). High precision quantitative angiography. IEEE Trans Med Imaging MI-6:258– 265.
Spears JR, Sandor T (1986). Quantitation of coronary artery stenosis severity: Limitations of angiography and computerized information ex–traction. In State of the Art in Quantitative Coronary Arteriography, J HC Reiber, PW Serrys, eds. Amsterdam: Martinus Nijhoff Publishers, pp 103–124.
Steele PM, Chesebro JH, Stanson AW, Holmes DR Jr, et al. (1985). Balloon angioplasty. Natural history of the pathological response to injury in a pig model. Circ Res 57: 105.
Lee G, Ikeda RM, Theis JH, Chan MC, et al. (1984). Acute and chronic complications of laser angioplasty: Vascular wall damage and formation of aneurysms in the atherosclerotic rabbit. Am J Cardiol 53: 290–293.
Cumberland DC, Storkey IR, Oakley GDG, et al. (1986). Percutaneous laser-assisted coronary angioplasty. Lancet 11: 214.
Sinclair IN, Jenkins RD, James LM, Sinofsky EL, et al. (1988). Effect of laser balloon angioplasty on normal dog coronary arteries in vivo (abstr). J Am Coll Cardiol II (Suppl): 108A.
Jenkins RD, Sinclair IN, Anand R, Kalil AG, et al. (1988). Laser balloon angioplasty: Effect of tissue temperature on weld strength of human postmortem intima-media separations. Lasers Surg Med 8: 30–39.
Anand RK, Sinclair IN, Jenkins RD, Hiehle JF Jr, et al. (1988). Laser balloon angioplasty: Effect of constant temperature versus constant power on tissue weld strength. Lasers Surg Med 8: 40–44.
Jenkins RD, Sinclair IN, Anand RK, James LM, et al. (1988). Laser balloon angioplasty: Effect of exposure duration on shear strength of welded layers of postmortem human aorta. Lasers Surg Med 8: 392–396.
Spears JR, James LM, Leonard BM, Sinclair IN, et al. (1988). Plaque-media rewelding with reversible tissue optical property changes during repetitive CW Nd: YAG laser exposure. Lasers Surg Med 8: 477–485.
Sinclair IN, Anand RK, Kalil AG, Jr., Schoen FJ, et al. (1986). Laser balloon angioplasty: Factors affecting plaque–arterial wall thermal “weld” strength. Circulation 74: 11–203.
Klink F, Grosspietzch R, von Klitzing L, Endeil W, et al. (1978). Animal in-vivo studies and in–vitro experiments with human tubes for end–to–end anastomotic operation by a C02 laser technique. Fertil Stgeril 30: 100.
Jain KK, Gorisch W (1979). Repair of small blood vessels with the Neodymium-YAG laser: A preliminary report. Surgery 85: 684.
Gomes OM, Macruz R, Armelin E, Ribeiro MP, et al. (1983). Vascular anastomosis by argon laser beam. Texas Heart Inst J 10: 145.
Frazier OH, Painvin A, Morris JR, Thomsen S, et al. (1985). Laser-assisted microvascular anastomoses: Angiographic and anatomopathologic studies on growing microvascular anastomoses: Preliminary report. Surgery 97: 585.
White RA, Kopchok G, Donayre C, Abergel RP, et al. (1986). Comparison of laser-welded and sutured arteriotomies. Arch Surg 121: 1133.
Sauer JS, Rogers DW, Hinshaw JR (1986). Bursting pressures of C02 laser-welded rabbit ileum. Lasers Surg Med 6: 106.
Higgins T (1987). Computer control helps Nd: YAG laser fuse tissue. Lasers & Applications 6: 22.
Schober R, Ulrich F, Sander T, Durselen H, et al. (1986). Laser-induced alteration of collagen substructure allows microsurgical tissue welding. Science 232: 1421.
Sigel B, Dunn MR. (1965). The mechanism of blood vessel closure by high frequency electrocoagulation. Surg Gynecol Obstet 121: 823.
Sigel B, Acevedo FJ (1963). Electrocoaptive union of blood vessels: A preliminary experimental study. J Surg Res 111: 90.
Marchesini R, Andreola, Emanuelli H, Melloni E, et al. (1985). Temperature rise in biological tissue during Nd: YAG laser irradiation. Lasers Surg Med 5: 75.
Sanborn TA, Sinclair IN, Serur JR, Spokojny AM, et al. (1985). In vivo laser thermal seal of neointimal dissection after balloon angioplasty in rabbit atherosclerosis. Circulation 72: 111–469.
Jenkins RD, Sinclair IN, McCall PE, Schoen FJ, et al. (1989). Thermal sealing of arterial dissections and perforations in atherosclerotic rabbits with laser balloon angioplasty. Lasers in Life Sciences 3: 18.
Fields CD, Gal D, Rongione AJ, ErBin L, et al. (1988). Acute effect of laser-thermal enhancement of neoluminal intima—“G-lasing” —following balloon angioplasty. Circulation 78 (Suppl II): II–503.
Wood GC (1963). Spectral changes accompanying the thermal denaturation of collagen. Biochem Biophys Res Commun 13: 95–99.
Ansevin AT, Vizard DL, Brown BW, McConathy J (1976). High-resolution thermal denaturation of DNA. I. Theoretical and practical considerations for the resolution of thermal subtransitions. Biopolymers 15: 153–174.
Marcos NC, Berns M, Henry WL (1988). Effect of laser–heated tip angioplasty on human athero-sclerotic coronary arteries. Lasers Surg Med 8: 22–29.
Spears JR, Reyes VP, James LM, Sinofsky EL (1988). Laser balloon angioplasty: Initial clinical percutaneous coronary results. Circulation 78 (Suppl II): II–296.
Spears JR, Reyes VP, Sinclair IN, Hopkins, B, et al. (1989). Percutaneous coronary laser balloon angioplasty: Preliminary results of a multi-center trial (abstr). J Am Col Cardiol, in press.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1990 Kluwer Academic Publishers
About this chapter
Cite this chapter
Spears, J.R., Sinclair, I.N., Jenkins, R.D. (1990). Laser Balloon Angioplasty: Experimental In-Vivo and In-Vitro Studies. In: Abela, G.S. (eds) Lasers in Cardiovascular Medicine and Surgery: Fundamentals and Techniques. Developments in Cardiovascular Medicine, vol 103. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-1489-9_12
Download citation
DOI: https://doi.org/10.1007/978-1-4613-1489-9_12
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-8801-5
Online ISBN: 978-1-4613-1489-9
eBook Packages: Springer Book Archive