Effects of pulsed lasers on agar model simulation of the arterial wall.

Coronary laser angioplasty is limited by a high rate of dissection and the occurrence of abrupt closure and perforation. The aim of this study was to visualize the mechanical effects of pulsed lasers on two chamber in vitro models. These models consisted of 1 or 2 agar layers and calcium carbonate inclusions (1-layer model) or lipid (2-layer model) simulating lipid or calcified tissue. The inclusions were irradiated with a holmium-yttrium-aluminum-garnet (Ho-YAG) laser or a xenon chloride excimer laser. The Ho-YAG laser demonstrated dissection-like expansions of the target and perforation-like cracks. The size of dissection was obtained using an the empirical formula of energy (E) and the maximal expansion distance (Dmax) of the targets, Dmax = 0.15E0,87-1,17. The excimer laser showed rare and short perforation-like cracks and little dissection-like expansion of the gaseous products originating from the ablation of material. Ho-YAG laser ablation is likely to induce target tissue dissections and/or perforations. Excimer laser-ablates targets with less traumatic effects than Ho-YAG laser.