NDLI: The risk and benefits of experimental cardiovascular therapies

Content Provider	IEEE Xplore Digital Library
Author	Grundfest, W.S.
Copyright Year	1999
Abstract	308 nm XeCl excimer lasers have been developed to permit long pulse operation. The 135 to 200 ns pulse duration permits effective fiberoptic transmission which makes this wavelength practical for percutaneous (interventional) medical applications. Defining optical operating parameters in part depends on the desired procedure. In general, ablation of cardiovascular tissues (muscle, atheroma and fibrous tissue can be performed effectively at 35 to 50 mJ/mm/sup 2/. However, ablation of calcified tissue requires energies of 80 to 100 mJ/mm/sup 2/ and higher repetition rates (40 to 80 Hz). At these higher energies and repetition rates more thermal damage is observed. For clinical applications the fiberoptic delivery system plays a major role in the feasibility, safety and efficacy of procedures. Lack of beam homogeneity produces both hot spots and dead space within the ablative field. Hot spots can lead to tissue tearing and unwanted thermal damage. Tissue tearing is produced by a combination of the gas generated during ablation, the shockwaves produced during bubble collapse and the shape of and force applied to the delivery system. At 308 nm the intensity of the shockwaves is a function of the fluence, the environment, pressure within the bubble and tissue characteristics. Using PDVF transducers we have measured these shockwaves at 7-10 Atm in albumen solutions to as high as 70-80 Atm in solutions containing X-ray contrast agents during ablation of vascular tissue or myocardium. Thermal damage can result from multiple factors including irradiation at subablative thresholds, repetition rates and fluences which exceed the thermal relaxation time of the tissue and fiberoptic configurations which confine ablation products to a cavity in front of the fiberoptics.
Starting Page	362
Ending Page	363
File Size	103700
Page Count	2
File Format	PDF
ISBN	0780356349
ISSN	10928081
DOI	10.1109/LEOS.1999.813633
Language	English
Publisher	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Publisher Date	1999-11-08
Publisher Place	USA
Access Restriction	Subscribed
Rights Holder	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Subject Keyword	Cardiology Medical treatment Optical pulses Thermal factors Fiber lasers Laser ablation Medical services Biomedical equipment Biomedical optical imaging Muscles
Content Type	Text
Resource Type	Article
Subject	Electronic, Optical and Magnetic Materials Electrical and Electronic Engineering

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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