Document Detail


Treatment of vasospasm with a 480-nm pulsed-dye laser.
MedLine Citation:
PMID:  1885979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Laser energy at a wavelength of 480 nm was applied in 1-microseconds pulses of 3 to 10 mJ to two models of vasospasm. Rabbit common carotid arteries (CCA's) were constricted chronically by the application of human blood within a silicone sheath. Peak vasospasm developed 24 to 48 hours later, and persisted for up to 6 days. Endovascular laser treatment was delivered to 40 CCA's via a 200-microns diameter silica quartz fiber introduced through the femoral artery. The CCA caliber increased from 60% of the pre-vasospasm control diameter to a minimum post-laser diameter of 83% of control. No instances of laser-induced perforation or of arterial thrombosis were observed for up to 60 days after treatment. Prophylactic laser application to nine normal vessels was able to attenuate the development of vasospasm if blood was applied immediately thereafter (88% vs. 59% of control diameter, p less than 0.02), but not if blood was applied 7 days later. Studies in 16 normal CCA's established that there was a considerable margin between the laser energy required to induce dilatation and that which caused perforation, providing that the fiber remained relatively central within the artery. Morphological examination demonstrated focal loss of endothelial cells immediately after laser application, followed approximately 7 days later by the development of areas of intimal hyperplasia. Only minimal changes were observed in the medial or adventitial layers. In a second study, the basilar artery of seven dogs was constricted chronically by two intracisternal injections of autologous blood 3 days apart. Five dogs received endovascular laser treatment 7 or 10 days after the first injection, when basilar artery diameter was reduced to a mean of 61% and 77% of control, respectively. Immediately following treatment, basilar artery diameter increased to 104% and 102% of resting diameter, respectively. Both untreated and laser-treated arteries were smaller than the control diameter at 30 days (80% and 82%, respectively), but in each group the vasodilatory response to hypercapnia was preserved. These findings indicate that 1-microsecond laser pulses are well tolerated by systemic and cerebral arteries in two different animal models, and suggest that the 480-nm pulsed-dye laser may have an application for the treatment or prophylaxis of cerebral vasospasm.
Authors:
R Macfarlane; A Teramura; C J Owen; S Chase; R de la Torre; K W Gregory; J W Peterson; R Birngruber; J A Parrish; N T Zervas
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  75     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  1991 Oct 
Date Detail:
Created Date:  1991-10-10     Completed Date:  1991-10-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  613-22     Citation Subset:  AIM; IM    
Affiliation:
Neurosurgical Service, Massachusetts General Hospital, Harvard Medical School, Boston.
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MeSH Terms
Descriptor/Qualifier:
Animals
Basilar Artery / surgery
Carotid Arteries / surgery,  ultrastructure
Carotid Artery Diseases / pathology,  surgery*
Chronic Disease
Constriction, Pathologic / surgery
Dogs
Ischemic Attack, Transient / pathology,  surgery*
Laser Therapy*
Light Coagulation
Rabbits
Spasm / pathology,  surgery*
Grant Support
ID/Acronym/Agency:
HL22573/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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