Fiberoptic

Laser
Systems
By GEETHA S
There are fi ve types of Fiberoptic and Laser Methods
used in Cardiology

1. Guidance
2. Imaging
3. Diagnosis
4. Therapy
5. Other endoscopic techniques
 Diagnosis
• Optical fi ber sensors can be inserted into blood vessels or the heart via
thin catheters or thin endoscopes.

• Fiber lasers provide high resolution, high contrast, and deep penetration
for applications that aid in medical evaluation.
Therapy
• Laser angioplasty has been performed to recanalize blockages in the
coronary or peripheral arteries in thousands of patients.

• Lasers can also be used for endarterectomy (the removal of plaque) or

for tissue welding in the cardiovascular system.
 Other endoscopic techniques

• Thin endoscopes can be used for many of the therapeutic methods.

• Some therapeutic methods are injection of drugs or dyes into

atherosclerotic blockages or insertion of ultrasonic imaging devices.

• These therapeutic methods are used to measure the thickness of the

blood vessel wall.

• These are still under investigation.

 Fig: Laser endoscope system in cardiology

A complete laser endoscopic system is shown in the Fig.

Mechanical
Devices
 Introduction
o Mechanical devices means any tool or device which enhances the actions
possible by the hands that is within the scope of practice.

o Several mechanical devices were proposed for atherectomy. Each of the

devices is based on an atherectomy catheter which has to be guided and
positioned.

o An atherectomy is a procedure to remove plaque from an artery (blood

vessel). Removing plaque makes the artery wider, so blood can fl ow
more freely to the heart muscles.
Coronary Atherectomy
There are three types of Mechanical Devices

1. Directional atherectomy devices

2. Rotational atherectomy devices

3. Transluminal extraction devices

 Directional atherectomy devices

• The directional atherectomy devices consists of a cutting blade that

is directed towards the arterial wall allowing plaque to be removed
where the side cutter is in contact with the arterial wall.
• These devices are based on a probe with a rotary cutter of diameter 1.5-
2.5 mm at its end.
• This atherectomy catheter is introduced through a guiding catheter and
its tip is placed near the stenosis.
• The atheroma is excised using the rotary cutter and collected in a nose
cone. It is then removed from the artery when the cutter is withdrawn.
(A) cutter driver , (B) nosecone and (C) blade Directional
 Rotational atherectomy devices

• The rotational atherectomy device consists of a long catheter with an oval-

shaped burr that is encrusted with microscopic diamond embedded surface
tip.

• These devices are based on a rotating abrasive burr of diameter 1.5-3.5

mm that is advanced over a thin guide wire.

• Through the catheter, a lubricious fl uid is pumped in to reduce

heat production and burr entrapment during the procedure.

• The abrasive tip is then rotated at about 150,000 rpm while it

is being advanced through the atherosclerotic blockage.
Rotational
 Transluminal extraction devices

• The transluminal extraction devices has been used in treating vein graft
disease because of its ability to aspirate thrombus and friable material
present in diseased vein grafts.

• These devices are based on the excision of small segments of

the atheroma and extraction of the atheromatous debris
through the atherectomy catheter.

• These methods were used successfully to treat blocked peripheral

arteries.

• More than 2000 patients have had coronary atherectomy using

mechanical devices, with a high rate of success. Yet all are limited by
the catheter diameter which is larger than that of a laser catheter.
 Translumi

Transluminal
Thank You