低出力使用KTPレーザーの脳動脈瘤術中利用の可能性

Abstract

(Objectives) In clipping operations for cerebral aneurysms, intraoperative rupture of aneurysms is the most serious problem. We evaluated the use of low power KTP (Potassium Titanyl Phosphate)/532TM. laser on cerebral aneurysms during clipping operations and examined the arterial wall affected by this laser histologically. (Methods) Ligh and electron microscopic studies were done on rat common carotid arteries and human superficial temporal arteries irradiated by a 0.05W KTP laser irradiation for 5-30 seconds. In 5 out of 10 clipping operations, the 0.05W KTP laser irradiation was given to the broad neck portion of aneurysms for shrinkage before clipping. Also, all 10 aneurysms were irradiated by the same power laser at the dome portion for coagulation after clipping. (Results) In the light microscopic study, the laser irradiated portion of artery became shrinken without perforation in all materials.Electron microscopic study revealed the vacuolas in the endothelial cells and smooth muscle cells, adhesion or invasion of neutrophils and monocytes to not only the intima but also to the media, and deprivation of endothelial cells in a high dose irradiation. In all clipping operations, the low power KTP laser was effective for shinkage and coagulation of aneurysms. (Conclusions) The low power KTP/532532TM laser was useful in safe and steady clipping operations for cerebral aneurysms.