Formation of pressure waves during in vitro excimer laser irradiation in whole blood and the effect of dilution with contrast media and saline

Abstract

Pressure waves during excimer laser ablation of vascular tissue may be responsible for complications of coronary excimer laser angioplasty. In this experimental study, pressure waves were measured during excimer laser irradiation in blood and contrast media using a polyvinilidenefluoride hydrophone. At a distance of 4 mm lateral to the tip of a 1.7 mm multifiber laser catheter, excimer laser irradiation in blood resulted in a linear increase of peak pressures from 1,365 +/- 165 kPa at 30 mJ/mm2 to 2,866 +/- 404 kPa at 60 mJ/mm2. In contrast media, peak pressure increased from 3,172 +/- 573 kPa (30 mJ/mm2) to 5,763 +/- 467 kPa (60 mJ/mm2). Contrast media and saline were added to blood. At a concentration of 60% contrast in blood, a 3.4 fold increase of peak pressures was documented as compared to pure blood. Further increase of the concentration did not result in higher pressure waves. Concentrations of saline in blood of 90% and 96% reduced the peak pressures by 16% and > 50%, respectively, as compared to pure blood.