Laser ablation of atherosclerotic blood vessel tissue under various irradiation conditions

Steering light in fiber-optic medical devices: a patent review

INTRODUCTION

Steering light is relevant to many medical applications that require tissue illumination, sensing, or modification. To control the propagation direction of light beams, a great variety of innovative fiber-optic medical devices have been designed.

AREAS COVERED

This review provides a comprehensive overview of the patent literature on light beam control in fiber-optic medical devices. The Web of Science Derwent Innovation Index database was scanned, and 81 patents on fiber-optic devices published in the last 20 years (2001-2021) were retrieved and categorized based on the working principle to steer light (refraction/reflection, scattering, diffraction) and the design strategy that was employed (within fiber, at fiber end, outside fiber).

EXPERT OPINION

Patents describing medical devices were found for all categories, except for generating diffraction at the fiber end surface. The insight in the different designs reveals that there are still several opportunities to design innovative devices that can collect light at an angle off-axis, reduce the angular distribution of light, or split light into multiple beams.

Thermodynamic response of soft biological tissues to pulsed infrared-laser irradiation

The physical mechanisms that achieve tissue removal through the delivery of short pulses of high-intensity infrared laser radiation, in a process known as laser ablation, remain obscure. The thermodynamic response of biological tissue to pulsed infrared laser irradiation was investigated by measuring and analyzing the stress transients generated by Q-sw Er:YSGG (lambda = 2.79 microns) and TEA CO2 (lambda = 10.6 microns) laser irradiation of porcine dermis using thin-film piezoelectric transducers. For radiant exposures that do not produce material removal, the stress transients are consistent with thermal expansion of the tissue samples. The temporal structure of the stress transients generated at the threshold radiant exposure for ablation indicates that the onset of material removal is delayed with respect to irradiation. Once material removal is achieved, the magnitude of the peak compressive stress and its variation with radiant exposure are consistent with a model that considers this process as an explosive event occurring after the laser pulse. This mechanism is different from ArF- and KrF-excimer laser ablation where absorption of ultraviolet radiation by the collagenous tissue matrix leads to tissue decomposition during irradiation and results in material removal via rapid surface vaporization. It appears that under the conditions examined in this study, explosive boiling of tissue water is the process that mediates the ablation event. This study provides evidence that the dynamics and mechanism of tissue ablation processes can be altered by targeting tissue water rather than the tissue structural matrix.

Studies of acoustical and shock waves in the pulsed laser ablation of biotissue

Quantitative studies are conducted into the absolute pressure values of the acoustical and shock waves generated and propagating in a biotissue under pulsed (tau p = 50 ns) UV (lambda = 308 nm) laser irradiation (below and above the ablation threshold). Powerful (several hundreds of bars in pressure) high-frequency (f approximately 10(7) Hz) acoustic compression and rarefaction pulses are found to be generated in the biotissue. The amplitudes and profiles of the acoustic pulses developing in atherosclerotic human aorta tissues and an aqueous CuCl2 solution under laser irradiation are investigated as a function of the laser pulse energy fluence. The results obtained point to the absence of the cold spallation of the objects of study by rarefaction waves. Based on experimental data, the rise rates, pressure gradients, and propagation velocities of shock waves in the biotissue are calculated. The experimental data are found to agree well with the theoretical estimates.

XeCl laser ablation of atherosclerotic aorta: luminescence spectroscopy of ablation products

XeCl laser ablation of atherosclerotic aorta tissue was investigated. Luminescence spectra of ablation products were measured for soft and hard arterial tissues. A pronounced difference observed between plume luminescence for various plaques and normal vessel wall correlates with the chemical composition of the tissue. The mechanism of plume luminescence appeared to be thermochemical excitation ablation products (particles, atoms, molecules, etc.) in the air. The process of soft tissue ablation was delayed with respect to the exciting laser pulse at relatively low laser fluences close to the ablation threshold. The kinetics of the ablation process as a function of laser-pulse energy fluence is reported. The data indicate that tissue ejection mechanism, which involves vapor bubbles formation, expansion and explosion, is suitable for the description of the XeCl excimer laser ablation of soft tissues.

XeCl laser ablation of atherosclerotic aorta: optical properties and energy pathways

The energetics of 308-nm excimer laser irradiation of human aorta were studied. The heat generation that occurred during laser irradiation of atherosclerotic aorta equaled the absorbed laser energy minus the fraction of energy for escaping fluorescence (0.8-1.6%) and photochemical decomposition (2%). The absorbed laser energy is equal to the total delivered light energy minus the energy lost as specular reflectance (2.4%, air/tissue) and diffuse reflectance (11.5-15.5%). Overall, about 79-83.5% of the delivered light energy was converted to heat. We conclude that the mechanism of XeCl laser ablation of soft tissue involves thermal overheating of the irradiated volume with subsequent explosive vaporization. The optical properties of normal wall of human aorta and fibrous plaque, both native and denatured were determined. The light scattering was significant and sufficient to cause a subsurface fluence (J/cm2) in native aorta that equaled 1.8 times the broad-beam radiant exposure, phi o (2.7 phi o for denatured aorta). An optical fiber must have a diameter of at least 800 microns to achieve a maximum light penetration (approximately 200 microns for phi o/e) in the aorta along the central axis of the beam.