Lead extraction by selective operation of a nanosecond-pulsed 355nm laser

Amir Herzog, Stefan Bogdan, Michael Glikson, Amiel A. Ishaaya, Charles Love

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Lead extraction (LE) is necessary for patients who are suffering from a related infection, or in opening venous occlusions that prevent the insertion of additional lead. In severe cases of fibrous encapsulation of the lead within a vein, laser-based cardiac LE has become one of the foremost methods of removal. In cases where the laser radiation (typically at 308 nm wavelength) interacts with the vein wall rather than with the fibrotic lesion, severe injury and subsequent bleeding may occur. Selective tissue ablation was previously demonstrated by a laser operating in the UV regime; however, it requires the use of sensitizers (e.g.: tetracycline). In this study, we present a preliminary examination of efficacy and safety aspects in the use of a nanosecond-pulsed solid-state laser radiation, at 355 nm wavelength, guided in a catheter consisting of optical fibers, in LE. Specifically, we demonstrate a correlation between the tissue elasticity and the catheter advancement rate, in ex-vivo experiments. Our results indicate a selectivity property for specific parameters of the laser radiation and catheter design. The selectivity is attributed to differences in the mechanical properties of the fibrotic tissue and a normal vein wall, leading to a different photomechanical response of the tissue's extracellular matrix. Furthermore, we performed successful in-vivo animal trials, providing a basic proof of concept for using the suggested scheme in LE. Selective operation using a 355 nm laser may reduce the risk of blood vessel perforation as well as the incidence of major adverse events.

Original languageEnglish (US)
Title of host publicationOptical Interactions with Tissue and Cells XXVII
PublisherSPIE
Volume9706
ISBN (Electronic)9781628419405
DOIs
StatePublished - Jan 1 2016
Externally publishedYes
EventOptical Interactions with Tissue and Cells XXVII - San Francisco, United States
Duration: Feb 14 2016Feb 17 2016

Other

OtherOptical Interactions with Tissue and Cells XXVII
CountryUnited States
CitySan Francisco
Period2/14/162/17/16

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Atomic and Molecular Physics, and Optics
  • Biomaterials
  • Radiology Nuclear Medicine and imaging

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  • Cite this

    Herzog, A., Bogdan, S., Glikson, M., Ishaaya, A. A., & Love, C. (2016). Lead extraction by selective operation of a nanosecond-pulsed 355nm laser. In Optical Interactions with Tissue and Cells XXVII (Vol. 9706). [97060T] SPIE. https://doi.org/10.1117/12.2212613