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To determine the effects of laser irradiation upon human coronary atherosclerotic disease, coronary plaques were extracted from fresh human cadaver hearts. Seventy-four diseased artery samples were sectioned either transversely or longitudinally and subjected to laser treatment from argon-ion and carbon dioxide sources. The laser beam affected vaporization and patency in fibrous, lipoid, and calcified plaques as observed histologically. Calcified blockage showed greater extent of charred remnants following controlled thermal injury than did fibrous or lipoid obstructions. The area and depth of penetration varied directly with intensity and duration of photoirradiation and inversely with the density of the atherosclerotic tissue. This study supports further research work on the use of lasers to effect relief of atherosclerotic obstructions.

Reprint requests: Garrett 1,~. M.D., Cardiovascular Medicine, Suite 202. LICD Professional Bldg.. 4301 S St., Sacramento, CA 95817. therapy” of heart and circulatory disorders is virtually unexplored. To determine the in vivo feasibility of transmitting laser energy intravascularly for the purposes of visualizing and treating peripheral artery pathoanatomy, a flexible fiberopticscope (Trimedyne, Inc., Arlington Heights, Ill.), equipped with a quartz fiber, was inserted via the left subclavian artery to the aortoiliac bifurcation in open-chest dogs (Fig. 1, A). For improved viewing, blood was diverted by normal saline infusion through the flushing channel of t,he fiberopticscope (Fig. 2, A). In addition, an area within the origin of the right iliac artery was then photoirradiated by a neodymium-YAG laser (five 2 to 3 second bursts of 60 W) (Fig. 2, B). Following these studies, the intervened vessels were removed, thereby verifying that the photoirradiation had indeed produced a lesion of coagulation necrosis (Fig. 1, A and B). Thus this investigation provides the initial demonstration of the practicality of conducting laser energy into living blood vessels and related structures as a new modality in the management of cardiovascular diseases.