A New Nd: YAG Laser-Bearing Angioscope is Useful for Visualizing and Treating Lesions of the Superior Vena Cava and the Right-Sided Chambers of the Heart

Abstract

The utility of a prototype Nd:YAG laser-bearing angioscope was evaluated for the diagnosis and treatment of neoplastic lesions of superior vena cava (SVC) and right-sided chambers of the heart in dogs.

The angioscope had a balloon tightly fixed to the tip with heat shrink tubing and suture ligation. Approximately 96% of the Nd:YAG laser energy penetrated the balloon without rupture when the balloon was inflated with saline solution and was in direct contact with the target.

The internal surfaces of the SVC, inferior vena cava, right atrium, tricuspid valve, right ventricle, and main pulmonary artery were visualized clearly by this angioscopic technique. The Nd:YAG laser was guided successfully under direct vision and a surgically transplanted neoplasm in the SVC was irradiated. Tumor coagulation was confirmed macroscopically and microscopically.

This new angioscope requires further improvement, specifically, to decrease its diameter and improve the durability of the balloon.

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References

1. Abela GS , Seeger JM , Barbieri E , et al: Laser angioplasty with angioscopic guidance in humans. J Am Coll Cardiol 8:184-192, 1986.

2. Grundfest WS , Litvak F , Hickey A , et al: The current status of angioscopy and laser angioplasty. J Vasc Surg 5:667-673, 1987.

3. Tanabe T , Yokota A , Sugie S : Cardiovascular fiberoptic endoscopy: Development and clinical application. Surgery 87:375-379, 1980.

4. Cumberlands DC , Taylor DI , Proctor AE : Use of laser in percutaneous peripheral angioplasty, early clinical experience. Semin Int Radiol 3:65-68, 1986.

5. Takekawa SD , Kawashima M : Laser vascular endoscopy. In: Nd:YAG Laser in Medicine and Surgery, ed. by Oguro Y , Atsumi K , Joffe SN . Tokyo: Professional Postgraduate Service, 1986, pp 343-347.

6. Gisburg R , Wexler L , Profitt D : Percutaneous transluminal laser angioplasty for treatment of peripheral vascular disease. Clinical experience with 16 patients. Radiol 156:619-624, 1985.

7. Siegel RJ , Chae JS , Forrester JS , et al: Angiography, angioscopy, and ultrasound imaging before and after percutaneous balloon angioplasty. Am Heart J 120: 1086-1090, 1990.

8. Rosenthal D , Pesa FA , Gottsegen WL , et al: Thermal laser-assisted balloon angioplasty of the superficial femoral artery: A multicenter review of 602 cases. J Vasc Surg 14:152-159, 1991.

9. Tomaru T , Abela GS , Gonzalez J , et al: Laser recanalization of thrombosed arteries using thermal and/or modified optical probes: Angiographic and angioscopic study. Angiology 43:412-420, 1992.

10.

10. Froelich JJ , Barth KH , Lossef SV , et al: Evaluation of a prototype steerable angioscopic laser catheter in a canine model: A feasiblity study. Cardiovasc Intervent Radiol 16:235-238, 1993.

11.

11. Rocchini AP , Cho KJ , Byrum C , et al: Transluminal angioplasty of superior vena cava obstruction in a 15-month-old child. Chest 82:506-508, 1982.