Development of a new technique for reducing pressure pulse generation during 308‐nm excimer laser coronary angioplasty
- 1 January 1995
- journal article
- research article
- Published by Wiley in Catheterization and Cardiovascular Diagnosis
- Vol. 34 (1), 15-22
- https://doi.org/10.1002/ccd.1810340306
Abstract
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 unto-ward 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 laserrelated 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.Keywords
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