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In vitro analysis of mechanism of pulsed-laser thrombolysis

Thrombolytic therapy in the treatment of cardiogenic acute cerebral embolism caused by coagulated blood carries the risk of hemorrhagic complications, and there is a need to develop safer and more reliable treatment methods. Laser thrombolysis therapy, which utilizes the difference in energy absorpt...

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Autores principales: Yamashita, Daisuke, Matsumoto, Yuji, Tamaoki, Yoshinori, Ueda, Yukio, Okada, Hiroyuki, Kawashima, Toshiyuki, Yamashita, Yutaka, Nakayama, Teiji, Umemura, Kazuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794104/
https://www.ncbi.nlm.nih.gov/pubmed/35085324
http://dx.doi.org/10.1371/journal.pone.0262991
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author Yamashita, Daisuke
Matsumoto, Yuji
Tamaoki, Yoshinori
Ueda, Yukio
Okada, Hiroyuki
Kawashima, Toshiyuki
Yamashita, Yutaka
Nakayama, Teiji
Umemura, Kazuo
author_facet Yamashita, Daisuke
Matsumoto, Yuji
Tamaoki, Yoshinori
Ueda, Yukio
Okada, Hiroyuki
Kawashima, Toshiyuki
Yamashita, Yutaka
Nakayama, Teiji
Umemura, Kazuo
author_sort Yamashita, Daisuke
collection PubMed
description Thrombolytic therapy in the treatment of cardiogenic acute cerebral embolism caused by coagulated blood carries the risk of hemorrhagic complications, and there is a need to develop safer and more reliable treatment methods. Laser thrombolysis therapy, which utilizes the difference in energy absorption between the thrombus and the arterial wall, has shown promise as a new treatment method because it can selectively act only on the thrombus. It has not been applied clinically, however, and one of the main reasons for this is that its underlying mechanism has not been elucidated. We developed a pulse laser thrombolysis system for treating cerebral blood vessels that consists of a diode-pumped solid-state neodymium-yttrium aluminum garnet laser, which has excellent stability and maintainability and is suitable for clinical applications coupled to a small-diameter optical fiber. Moreover, we analyzed the mechanisms that occur during pulsed laser irradiation of transparent glass tubes and gelatin phantoms. We found that bubbles form as a thermal effect in addition to ablation of the pulsed laser irradiation. Furthermore, we detected no shock waves or water jets associated with the bubbles. We analyzed the bubbles’ dynamics and growth rate, and their effect on a rabbit blood clot phantom. We concluded that the bubbles generated by the laser irradiation physically cut the thrombus and thereby had a thrombectomy effect. We believe that this study will clarify the mechanism of laser thrombolysis therapy and contribute greatly to the realization of its clinical application.
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spelling pubmed-87941042022-01-28 In vitro analysis of mechanism of pulsed-laser thrombolysis Yamashita, Daisuke Matsumoto, Yuji Tamaoki, Yoshinori Ueda, Yukio Okada, Hiroyuki Kawashima, Toshiyuki Yamashita, Yutaka Nakayama, Teiji Umemura, Kazuo PLoS One Research Article Thrombolytic therapy in the treatment of cardiogenic acute cerebral embolism caused by coagulated blood carries the risk of hemorrhagic complications, and there is a need to develop safer and more reliable treatment methods. Laser thrombolysis therapy, which utilizes the difference in energy absorption between the thrombus and the arterial wall, has shown promise as a new treatment method because it can selectively act only on the thrombus. It has not been applied clinically, however, and one of the main reasons for this is that its underlying mechanism has not been elucidated. We developed a pulse laser thrombolysis system for treating cerebral blood vessels that consists of a diode-pumped solid-state neodymium-yttrium aluminum garnet laser, which has excellent stability and maintainability and is suitable for clinical applications coupled to a small-diameter optical fiber. Moreover, we analyzed the mechanisms that occur during pulsed laser irradiation of transparent glass tubes and gelatin phantoms. We found that bubbles form as a thermal effect in addition to ablation of the pulsed laser irradiation. Furthermore, we detected no shock waves or water jets associated with the bubbles. We analyzed the bubbles’ dynamics and growth rate, and their effect on a rabbit blood clot phantom. We concluded that the bubbles generated by the laser irradiation physically cut the thrombus and thereby had a thrombectomy effect. We believe that this study will clarify the mechanism of laser thrombolysis therapy and contribute greatly to the realization of its clinical application. Public Library of Science 2022-01-27 /pmc/articles/PMC8794104/ /pubmed/35085324 http://dx.doi.org/10.1371/journal.pone.0262991 Text en © 2022 Yamashita et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Yamashita, Daisuke
Matsumoto, Yuji
Tamaoki, Yoshinori
Ueda, Yukio
Okada, Hiroyuki
Kawashima, Toshiyuki
Yamashita, Yutaka
Nakayama, Teiji
Umemura, Kazuo
In vitro analysis of mechanism of pulsed-laser thrombolysis
title In vitro analysis of mechanism of pulsed-laser thrombolysis
title_full In vitro analysis of mechanism of pulsed-laser thrombolysis
title_fullStr In vitro analysis of mechanism of pulsed-laser thrombolysis
title_full_unstemmed In vitro analysis of mechanism of pulsed-laser thrombolysis
title_short In vitro analysis of mechanism of pulsed-laser thrombolysis
title_sort in vitro analysis of mechanism of pulsed-laser thrombolysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8794104/
https://www.ncbi.nlm.nih.gov/pubmed/35085324
http://dx.doi.org/10.1371/journal.pone.0262991
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