Review on Laser Technology in Intravascular Imaging and Treatment

Application of the Magnet-Cre optogenetic system in the chicken model

Chickens serve as an excellent model organism for developmental biology, offering unique opportunities for precise spatiotemporal access to embryos within eggs. Optogenes are light-activated proteins that regulate gene expression, offering a non-invasive method to activate genes at specific locations and developmental stages, advancing developmental biology research. This study employed the Magnet-Cre optogenetic system to control gene expression in developing chicken embryos. Magnet-Cre consists of two light-sensitive protein domains that dimerize upon light activation, each attached to an inactive half of the Cre recombinase enzyme, which becomes active upon dimerization. We developed an all-in-one plasmid containing a green fluorescent protein marker, the Magnet-Cre system, and a light-activated red fluorescent protein gene. This plasmid was electroporated into the neural tube of Hamburger and Hamilton (H&H) stage 14 chicken embryos. Embryo samples were cleared using the CUBIC protocol and imaged with a light sheet microscope to analyze optogenetic activity via red-fluorescent cells. We established a pipeline for Magnet-Cre activation in chicken embryos, demonstrating that a single 3-min exposure to blue light following incubation at 28 °C was sufficient to trigger gene activity within the neural tube, with increased activity upon additional light exposure. Finally, we showed a spatiotemporal control of gene activity using a localized laser light induction. This research lays the groundwork for further advancements in avian developmental biology and poultry research, enabling spatiotemporal control of genes in both embryos and transgenic chickens.

Knowledge, attitude, and practice of orthopedic, vascular surgery, and anesthesiology doctors regarding postoperative deep vein thrombosis prevention in surgical patients

Orthopedic and vascular surgeries carry a high risk of postoperative deep vein thrombosis (DVT). This cross-sectional study assessed the knowledge, attitude, and practice (KAP) of orthopedists, vascular surgeons, and anesthesiologists regarding postoperative DVT prevention in surgical patients. The study was performed at two hospitals in China from November 22 to December 13, 2023. Demographic information and KAP data were collected using a self-administered questionnaire. Among 294 doctors, 187 (63.61%) were male, and 248 (84.35%) had prior experience in orthopedic surgeries. Mean scores for knowledge, attitude, and practice were 9.94 ± 1.91, 37.12 ± 2.94, and 23.02 ± 3.64, respectively. Knowledge was correlated to attitude (r = 0.182, P = 0.002), knowledge to practice (r = 0.234, P < 0.001), and attitude to practice (r = 0.281, P < 0.001). Attitude score (OR = 1.249, 95% CI: [1.127-1.385], P < 0.001) and anesthesiology work (OR = 0.309, 95% CI: [0.158-0.603], P = 0.001) were independently associated with proactive practice. Structural equation modeling confirmed direct impacts of knowledge on attitude (β = 0.894, P < 0.001) and practice (β = 1.786, P < 0.001) and of attitude on practice (β = 0.338, P = 0.017). In conclusion, orthopedists, vascular surgeons, and anesthesiologists showed good knowledge, attitude, and practice toward DVT prevention in surgical patients in two hospitals in China.

Unraveling the Enigma of Aortic Dissection: From Genetics to Innovative Therapies

Aortic dissection (AD) presents a critical medical emergency characterized by a tear in the aortic wall, necessitating prompt recognition and management to mitigate catastrophic complications. Despite advancements in medical technology and therapeutic interventions, AD remains a formidable challenge, often resulting in severe morbidity and mortality. This narrative review provides a comprehensive overview of AD, encompassing its clinical presentation, diagnostic modalities, and management strategies, while also exploring emerging trends and innovations in its management. Genetic predispositions significantly influence AD pathogenesis, with over 30 contributory genes identified, emphasizing the importance of genetic screening and counseling. Classification systems such as Stanford and DeBakey, alongside their revised counterparts, aid in categorizing AD and guiding treatment decisions. Advancements in diagnostic imaging, including transesophageal echocardiography and computed tomography angiography, have enhanced diagnostic precision, augmented by artificial intelligence and machine learning algorithms. Pharmacological innovations focus on optimizing medical therapy, while surgical and endovascular approaches offer minimally invasive treatment options. Hybrid procedures and aortic valve-sparing techniques broaden treatment avenues, while bioresorbable stent grafts hold promise for tissue regeneration. Collaborative efforts and ongoing research are essential to address remaining challenges and improve outcomes in managing AD. This review contributes to the understanding of AD's complexity and facilitates informed decision-making in clinical practice, underscoring the imperative for continued innovation and research in AD management.

In-Stent Restenosis Overview: From Intravascular Imaging to Optimal Percutaneous Coronary Intervention Management

Despite ongoing progress in stent technology and deployment techniques, in-stent restenosis (ISR) still remains a major issue following percutaneous coronary intervention (PCI) and accounts for 10.6% of all interventions in the United States. With the continuous rise in ISR risk factors such as obesity and diabetes, along with an increase in the treatment of complex lesions with high-risk percutaneous coronary intervention (CHIP), a substantial growth in ISR burden is expected. This review aims to provide insight into the mechanisms, classification, and management of ISR, with a focus on exploring innovative approaches to tackle this complication comprehensively, along with a special section addressing the approach to complex calcified lesions.

The safe use of lasers in biomedicine: Principles of laser-matter interaction

Optical radiation sources, and in particular lasers, find an ever-increasing number of applications in the medical field. It is essential that personnel who are in the presence of an optical radiation source, whether operator, patient or researcher, know precisely the risks inherent in the exposure of the human body to radiation. In order to reduce the risk of biological damage, beyond the provisions of the law on safety regulations, the precise information and accurate preparation of personnel are the main guarantee for the correct use of these sources. In all the application fields, the possibility of a biological damage cannot be completely eliminated, assuming the connotation of occupational risks. In order to understand the risks and operate their effective mitigation, the basic knowledge of the fundamental concepts at the basis of laser-matter interaction will be presented and discussed, with a focus on the physical parameters needed to efficiently estimate and mitigate the related occupational risks, in both a laboratory and clinical context.

Ablation of porcine subcutaneous fat and porcine aorta tissues by a burst-mode nanosecond-pulsed laser at 355 nm

High-energy laser pulses used in laser angioplasty are challenging the laser cost, delivery system damage, efficiency, and laser catheter operating time. 355 nm nanosecond-pulsed laser in burst mode has shown potentials in reducing the system complexity and selective ablation of tissues. In this paper, burst mode laser ablation of porcine subcutaneous fat and porcine aorta is investigated. A histopathological analysis demonstrates that porcine subcutaneous fat can be ablated at a rate of greater than 0.2 mm/s when the number of pulses per burst is 1500 (corresponding to a fluence of 0.12 mJ/mm² per pulse and 180 mJ/mm² per burst), and the temperature of tissue during lasing is lower than 45°C. The porcine aorta remains nearly unaffected at the same laser parameter, and the tissue temperature during lasing is lower than 35°C. It shows the feasibility of using a burst-mode laser for selective ablation of tissue.

Advances in the development of biodegradable coronary stents: A translational perspective

Implantation of cardiovascular stents is an important therapeutic method to treat coronary artery diseases. Bare-metal and drug-eluting stents show promising clinical outcomes, however, their permanent presence may create complications. In recent years, numerous preclinical and clinical trials have evaluated the properties of bioresorbable stents, including polymer and magnesium-based stents. Three-dimensional (3D) printed-shape-memory polymeric materials enable the self-deployment of stents and provide a novel approach for individualized treatment. Novel bioresorbable metallic stents such as iron- and zinc-based stents have also been investigated and refined. However, the development of novel bioresorbable stents accompanied by clinical translation remains time-consuming and challenging. This review comprehensively summarizes the development of bioresorbable stents based on their preclinical/clinical trials and highlights translational research as well as novel technologies for stents (e.g., bioresorbable electronic stents integrated with biosensors). These findings are expected to inspire the design of novel stents and optimization approaches to improve the efficacy of treatments for cardiovascular diseases.

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Bioresorbable stents can overcome the limitations of non-degradable stents.

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3D printing of shape-memory polymeric stents can lead to better clinical outcomes.

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Advances in Mg-, Fe- and Zn-based stents from a translational perspective.

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Electronic stents integrated with biosensors can covey stent status in real time.

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Development in the assessment of stent performance in vivo.