Laser induced fluorescence attenuation spectroscopy: detection of hypoxia.

The development of a new laser-induced fluorescence (LIF) spectroscopy technique for the measurement of the attenuation spectrum of tissue is described. The technique, termed laser-induced fluorescence attenuation spectroscopy (LIFAS), has been applied to study the effects of hypoxia on the in vivo optical properties of renal and myocardial tissue in the 350-600-nm band. Excimer laser (Xe-Cl) is used to excite a small volume of the tissue (rabbit model, N = 20) and induce autofluorescence. The emitted LIF is monitored fiberoptically at two locations that are unevenly displaced about the fluorescing volume. The optical attenuation of the tissue is calculated from the dual LIF measurements by assuming an exponential decay of the fluorescence with distance. The results indicate that hypoxia modulates the attenuation spectrum leading to characteristic changes in its shape. Primarily, the spectral profile becomes more concave between 455 nm and 505 nm and two spectral peaks at about 540 and 580 nm disappear leaving in their place a single peak at about 555 nm. The attenuation spectra of normoxic and hypoxic tissue are used to train partial least squares multivariate model for spectral classification. The model detected acute renal and myocardial hypoxia with an accuracy greater than 90% (range: 90%-96%) and 74% (range: 74%-90%), respectively.

Laser tissue interaction in direct myocardial revascularization.

This investigation examines the various laser choices used for transmyocardial laser revascularization (TMLR) with emphasis on the laser-tissue interaction. A series of in vivo (porcine model, n=27) and in vitro experiments were performed to study the effects of CO(2), holmium:YAG, and XeCl excimer lasers on the histological outcome of TMR channels. Computerized histopathological analysis has revealed that the CO(2) and holmium:YAG lasers produce substantial unpredictable thermal damage and differ predominantly in the amount of the mechanical injury or tissue shredding. In comparison, the excimer laser appears to produce the most uniform tissue ablation with the least thermal and shockwave damage.

Excimer laser (308 nm) based transmyocardial laser revascularization: effects of the lasing parameters on myocardial histology.

BACKGROUND AND OBJECTIVE: The effect of the excimer laser (308 nm) parameters on transmyocardial revascularization (TMR) channels is not well defined. This study investigates the influence of the pulse repetition rate, the size of the delivery catheter and its advancement speed on the morphology of TMR channels in vivo. STUDY DESIGN/MATERIALS AND METHODS: Myocardial ablation was performed in a porcine model (N = 27) using multifiber catheters of 1.0 and 1.4 mm in diameter. The catheters were advanced into the myocardium at different speeds (1.27 and 2.54 mm/sec) while ablating at various repetition rates (10-80 Hz). The radiant exposure was kept at 35 mJ/mm(2) throughout the experiments. The channel histology was quantified by digital microscopy. RESULTS: The channel cross-sectional area and the extent of the thermal damage decrease as the catheter advancement speed exceeds the ablation speed and vice versa. Within the parameters tested, advancement speed of about 1.3 mm/sec and pulse repetition rates of 40 Hz produce channels of size comparable to the catheter's diameter with moderate thermomechanical damage. CONCLUSIONS: The repetition rate, catheter size, and catheter advancement speed are closely intertwined and crucial to the histological outcome of excimer laser based TMR.