| Project/Area Number |
60570481
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Radiation science
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| Research Institution | Dokkyo University School of Medicine, Koshigaya Hospital |
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Principal Investigator |
TAKEKAWA Shoichi D. Dokkyo University School of Medicine, 医学部, 教授 (80171627)
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| Co-Investigator(Kenkyū-buntansha) |
MORI Yoshiomi Dokkyo University School of Medicine, 病理部, 教授 (30059886)
YAMADA Takashi Dokkyo University School of Medicine, 心臓血管外科, 教授 (50014022)
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| Project Period (FY) |
1985 – 1986
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| Project Status |
Completed (Fiscal Year 1986)
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| Budget Amount *help |
¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 1986: ¥300,000 (Direct Cost: ¥300,000)
Fiscal Year 1985: ¥1,600,000 (Direct Cost: ¥1,600,000)
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| Keywords | PTA / Laser / Laser angioplasty / Vascular endoscopy / Arteriosclerosis / 動脈閉塞 / 動脈硬化症 / 間欠性跛行 |
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| Research Abstract |
Application of laser energy in conjunction with PTA (laser angioplasty) has been investigated to improve the prognosis of PTA and to enable angioplasty in cases with total occlusion of arteries.
Fundamental studies on the effect of laser on normal aortic and arterial wall, atheroma and thrombus showed the necessity of high power(about 80 W)and short time exposure to perform non-contact laser irradiation in normal saline; low power(about 10 - 20 W)for contact irradiation with a new ceramic tip or a bare laser fiber tip.
Laser angioplasty was performed 16 times in 13 cases. The procedure was repeated at a different segment in two cases and at the same segment in a case of popliteal artery entrapment syndrome followed by surgical intervention to relieve the entrapment only.
The following conclusions were obtained.
(1) It is strongly suggested that laser angioplasty improved the prognosis of angioplasty because no recurrence was noted in 8 successful laser angioplasty on for arteriosclerotic s
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tenosis. The longest follow-up period is 24 months.
(2) It was possible to recanalize both marked stenosis and occlusion of tibial and fibular arteries by laser angioplasty, using a bare laser fiber and a Van Andel dilating catheter.
(3) The risk of vessel perforation is very low, if we are cautious about coaxiality of laser beam with the artery. We have not encountered vessel perforation in 16 treatments.
(4) It seemed to be a good method to irradiate laser at several different points in an occluded artery, using a bare laser fiber.
(5) Problems are left to be solved for recanalization of a long segment occlusion, since increased permeability of the arterial wall, weakening of the arterial wall and formation of small aneurysms were noted when treated with a new ceramic tip. It seems to be necessary to improve the shape of the ceramic tip and technique of applying laser. The safe technique to irradiate laser to a tortuous artery is yet to be developed in future.
(6) A new laser vascular endoscope was developed in cooperation of Olympus Optical Co., Ltd. It is now possible to irradiate laser under direct vision. We treated one case with stenosis in the external iliac artery under direct vision, using a bare laser fiber, with satisfactory results. Less
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