Development of a new technique for reducing pressure pulse generation during 308-nm excimer laser coronary angioplasty.

Published

Journal Article

Despite expectations that excimer laser ablation would result in a low incidence of coronary dissection, studies have documented a 15-20% incidence of dissection (including a 4-6% incidence of clinically significant dissection) during excimer interventions. This investigation sought to determine if pressure pulses produced by the exposure of fluid phase media (blood and contrast) to 308-nm excimer radiation might contribute to untoward outcomes. Pressure pulses generated in these media were quantitated to be > 100 atm. In vitro ablation of porcine aorta in the presence of blood or contrast resulted in tissue dissection, while ablation in pure crystalloid did not. Next, a "flush and bathe" technique designed to replace all blood and contrast with crystalloid was applied to a pilot population of 57 consecutive patients. There were no rhythm disturbances or laser-related clinically significant dissections in this group, and the clinical success rate was 95%. In summary, this report quantitates a potential etiology for excimer dissection and suggests that replacement of blood and contrast with crystalloid might improve procedural and clinical success rates.

Full Text

Duke Authors

Cited Authors

  • Tcheng, JE; Wells, LD; Phillips, HR; Deckelbaum, LI; Golobic, RA

Published Date

  • January 1995

Published In

Volume / Issue

  • 34 / 1

Start / End Page

  • 15 - 22

PubMed ID

  • 7728846

Pubmed Central ID

  • 7728846

International Standard Serial Number (ISSN)

  • 0098-6569

Digital Object Identifier (DOI)

  • 10.1002/ccd.1810340306

Language

  • eng

Conference Location

  • United States