DEVELOPMENT OF THE ENDOVASCULAR THROMBOLYSIS SYSTEM WITH SHOCK WAVE

冲击波血管内溶栓系统的研制

• 批准号: 12307028
• 负责人: YOSHIMOTO Takashi
• 金额: $ 11.9万
• 依托单位: TOHOKU UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (A)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12307028/
• 关键词: ENDOVASCULAR INFRARED MONITOR; CEREBRAL EMBOLISM; ENDOVASCULAR THERAPY; SHOCK WAVE ENGINEERING; THROMBOLYSIS; LASER-INDUCED LIQUID JET; LASER MEDICINE; VASCULAR ENDOSCOPY; 閉塞性脳血管障害; 衝撃波医療

Background and ObjectiveThere are several problems inherent in the treatment of cerebral embolisms, such as the narrow therapeutic time window and the severe side effects of fibrinolytic drugs. It is thusnecessary to develop a new method of removing a cerebral thrombus more rapidly using smaller amounts of fibrinolytics. In the present, we investigated a liquid jet induced by holmium (Ho) : YAG laser irradiation in water.Materials and MethodsIn this study, a pulsed Ho : YAG laser whose wavelength, pulse duration, and energy were 2.1 μm, 350 μs, and 350 mJ/pulse, respectively. Behavior of Ho : YAG laser induced bubble in a capillary tube filled with pure water was observed at various stand-off distances (L ; distance between the optical fiber end and the capillary exit). After that, a liquid-jet generator was made by insertion of an optical fiber (diameter : 0.6 mm) into a catheter (6Fr) filled with pure water. The maximum penetration depth of a liquid jet generated with this device int … More o a gelatin artificial thrombus was measured at various stand-off distances (L ; destance between the optical fiber end and catheter exit). Moreover, the phenomenon and the pressure around the catheter were observed with a shadowgraph and PVDF needle hydrophon, respectively. Based on these results, a stand-off distance of 13 mm was chosen to investigate the enhancement of urokinase (UK) efficacy by only a single operation of the liquid-jet device in artificial thrombi made of human blood.ResultsA laser-induced bubble in a capillary tube rapidly grew forward and generated a liquid jet. Maximum penetration depth with the liquid-jet generating catheter increased in proportion to L and reached a maximum value (9 mm) when L was around 13 mm. A shock wave whose overpressure at a point several mm away from the catheter exit was over 12MPa was captured with shadowgraph Fabrinolysis rates (%) after incubation with a small amount of UK for 10 min and 30 min were predominantly raised by a single use of the laser-induced liquid jet (5.4 ± 2.4 vs. 22.6 ± 6.1 and 7.3 ± 3.8 vs. 38.3 ± 5.6, respectively (mean ± SD, p<0.001)).ConclusionsHo : YAG laser irradiation within a capillary tube filled with water caused liquid jet formation, which promoted the effect of fibrinolytics. Moreover, this jet was accompanied with shock waves, which might enable to facilitate endovascular balloon angioplasty by cracking subintimal calcified lesions. The liquid jet generation system is so simple that will be applied to an endovascular system for cerebral fibrinolysis in the near future. Less

背景和客观性是治疗脑栓栓塞的几个问题，例如狭窄的治疗时间窗口和纤维蛋白水解药物的严重副作用。因此，它是一种新的方法，即使用较少量的纤维蛋白剂更快地去除脑血栓。目前，我们研究了由Holmium（HO）诱导的液体射流：水中的YAG激光照射。材料和方法中的这项研究，一种脉冲HO：YAG激光器，其波长，脉冲持续时间和能量分别为2.1μm，350μm和350 MJ/Pulse。 HO：YAG激光的行为在毛细管中诱导气泡，该毛细管在各种隔离距离（L;光纤末端和毛细管出口之间的距离）下观察到的纯净水。之后，通过将光纤（直径：0.6 mm）插入到充满纯水的导管（6FR）中进行液体喷射器。使用该设备INT产生的液体射流的最大渗透深度……在各种隔离距离（L;光纤端和导管出口之间的目的地）下测量了明胶人造血栓。此外，分别用阴影图和PVDF针疏水观察到了导管周围的现象和压力。基于这些结果，选择了13毫米的隔离距离，以研究液体射流器件在由人类血液制成的人造血栓中的单个操作中提高尿激酶（UK）的效率。毛细管中的毛细管引起的毛细管中的气泡快速生长并向前生长并产生了液体喷射。随着液体射流导管的最大穿透深度与L成比例增加，并在L约为13 mm时达到最大值（9 mm）。冲击波在距导管出口几毫米距离距离超过12MPA的点上的过度压力被捕获，并在少量英国孵育10分钟和30分钟后用阴影图（％）捕获，主要是通过一次激光诱导的液体喷射（5.4±2.4 vs.22.6 vs.6±6.6±6.1±3.3±3.3±3.3±3.3±3.3;） ±SD，p <0.001））。结论：毛细管中充满水的毛细管激光照射，导致液体喷射形成，从而促进了纤维蛋白分解的作用。此外，这款喷射伴随着冲击波，这可能可以通过破裂的微小钙化病变来促进血管内气囊血管成形术。液体喷射系统非常简单，将在不久的将来应用于脑纤维蛋白溶解的血管内系统。较少的

项目成果

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Hirano T、Komatsu M、Saeki T、Uenohara H、Takahashi A、Takayama K、Yoshimoto T：“激光诱导液体射流伴随冲击波发生；用于治疗脑栓塞的新型药物输送系统”第 23 届会议论文集。

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