Excimer, Ho:YAG, and Q-switched Ho:YAG ablation of aorta: a comparison of temperatures and tissue damage in vitro

Relationships of skin depths and temperatures when varying pulse repetition frequencies from 2.0-microm laser light incident on pig skin

Human perception of 2.0-microm infrared laser irradiation has become significant in such disparate fields as law enforcement, neuroscience, and pain research. Several recent studies have found damage thresholds for single-pulse and continuous wave irradiations at this wavelength. However, the only publication using multiple-pulse irradiations was investigating the cornea rather than skin. Literature has claimed that the 2.0-microm light characteristic thermal diffusion time was as long as 300-ms. Irradiating the skin with 2.0-microm lasers to produce sensation should follow published recommendations to use pulses on the order of 10 to 100 ms, which approach the theoretical thermal diffusion time. Therefore, investigation of the heating of skin for a variety of laser pulse combinations was undertaken. Temperatures of ex vivo pig skin were measured at the surface and at three depths from pulse sequences of six different duty factors. Differences were found in temperature rise per unit exposure that did not follow a linear relation to duty factor. The differences can be explained by significant heat conduction during the pulses. Therefore, the common heat modeling assumption of thermal confinement during a pulse may need to be experimentally verified if the pulse approaches the theoretical thermal confinement time.

Beam-profile modulation of thulium laser radiation applied with multimode fibers and its effect on the threshold fluence to vaporize water

The threshold fluences at which vaporization is initiated at the tip of a multimode fiber that is submerged in water were investigated when free-running and Q-switched thulium laser pulses (lambda = 2.01 microm) were applied with different pulse energies. We focused on the quantification of temporal and spatial fluence modulations of the beam profile at the tip of a 400-microm fiber. The spatial and the temporal fluence peaks over the average fluence were measured to as high as 1.5 and 4 in the Q-switched mode, respectively, and 2.5 and 40 in the free-running mode, respectively. The fluence peaks significantly influence the vaporization process. An increase in the threshold fluence with increasing pulse energy was found for the Q-switched mode, but there was a decrease for the free-running mode. Pressure transients of the order of 1 kbar and temperatures higher than 200 degrees C were calculated for a 30-mJ Q-switched laser pulse at the onset of vaporization. Collecting all the data allowed us to trace the thermodynamic path of rapid heating and vaporization in a phase diagram of water.

Modelling infrared temperature measurements: implications for laser irradiation and cryogen cooling studies

The use of thermographic techniques has increased as infrared detector technology has evolved and improved. For laser-tissue interactions, thermal cameras have been used to monitor the thermal response of tissue to pulsed and continuous wave irradiation. It is important to note that the temperature indicated by the thermal camera may not be equal to the actual surface temperature. It is crucial to understand the limitations of using thermal cameras to measure temperature during laser irradiation of tissue. The goal of this study was to demonstrate the potential difference between measured and actual surface temperatures in a quantitative fashion using a ID finite difference model. Three ablation models and one cryogen spray cooling simulation were adapted from the literature, and predictions of radiometric temperature measurements were calculated. In general, (a) steep superficial temperature gradients, with a surface peak, resulted in an underestimation of the actual surface temperature, (b) steep superficial temperature gradients, with a subsurface peak, resulted in an overestimation, and (c) small gradients led to a relatively accurate temperature estimate.

Tissue ablation and gas formation of two excimer laser systems: an in vitro evaluation on porcine aorta

BACKGROUND AND OBJECTIVE

The relationship between tissue ablation volume and the formation of insoluble gas of the currently available excimer laser systems is unknown. This aspect was evaluated in two excimer laser systems.

STUDY DESIGN/MATERIALS AND METHODS

We measured tissue ablation volume and gas production of two excimer laser systems (308 nm) on porcine aortic tissue immersed in saline (the CVX-300 using 1.4 and 1.7 mm laser catheters and the Dymer 200 + using 1.3, 1.3z and 1.6 mm laser catheters).

RESULTS

Tissue ablation volume and gas production increased proportionally with the applied energy fluence, ranging from 30-60 mJ/mm2. The gas production per unit of ablated tissue volume of the 1.4 mm laser catheter was significantly higher than the 1.3 mm laser catheter (mean difference +117%, 95% CI from +64% till +188%, P<0.001). The gas production of the 1.7 mm laser catheter was higher than the 1.6 mm laser catheter (mean difference +70%, 95% CI from +28% till +126%, P<0.001). The 1.3z mm laser catheter demonstrated more gas production than the 1.3 mm laser catheter (mean difference +123%, 95% CI from +68% till +196%, P<0.001).

CONCLUSION

The results of our study indicate that excimer laser with the use of the CVX-300 laser system results in significantly higher gas production than the Dymer 200+ laser system, which can be markedly reduced by lowering the applied energy fluence. The 1.3z laser catheter constitutes an exception, showing similar characteristics as the CVX-300 laser catheters.

Threshold and ablation efficiency studies of microsecond ablation of gelatin under water

BACKGROUND AND OBJECTIVE

Laser thrombolysis is the selective ablation of thrombus occluding vessels by microsecond pulsed laser irradiation. To achieve efficient ablation of thrombus, the optimal wavelength, spot size, and pulse energy need to be determined.

STUDY DESIGN/MATERIALS AND METHODS

A gelatin-based thrombus model confined in 3 mm inner diameter tubes was ablated under water using a 1 microsecond pulsed dye laser. Wavelength studies were conducted by varying the absorption of the gelatin between 10-2000 cm-1 corresponding to the waveband between 400-600 nm on the absorption spectrum of thrombus. A unique spectrophotometric method was developed to measure the ablated mass. An acoustic method was used to measure ablation thresholds under water as a function of absorption.

RESULTS

The mass removed per pulse per unit energy was nearly equal over an absorption range of 100-1000 cm-1 at pulse energies above threshold. Mass removal increased linearly with pulse energy but did not have a direct relationship with radiant exposure. Ablation thresholds indicate that the gelatin needed to be heated only to 100 degrees C for ablation to commence. Ablation masses measured were an order of magnitude higher than those predicted by thermal ablation models.

CONCLUSION

The results suggest that any wavelength between 410-590 nm can be used for effective thrombolysis. The ablation efficiency depends on the total energy delivered rather than the radiant exposure. The high ablation efficiencies suggest a dominance of the mechanical action of vapor bubbles over thermal ablation in the ablation process.

Pulsed laser ablation of soft tissues, gels, and aqueous solutions at temperatures below 100 degrees C

BACKGROUND AND OBJECTIVE

It is desirable for laser microsurgical procedures to remove tissue accurately and with minimal thermal and mechanical damage to adjacent non-irradiated tissues. Pulsed laser ablation can potentially remove biological tissue with microprecision if appropriate irradiation conditions are applied. The major goal of this study was to determine whether laser ablation is possible at temperatures below 100 degrees C. Another aim was to test thermoelastic and recoil stress magnitudes and to estimate their effects on phantom and biological tissue.

STUDY DESIGN/MATERIALS AND METHODS

Pulsed laser ablation of water (aqueous solution of potassium chromate) and water containing soft tissues (collagen gel and pig liver) irradiated under confined stress conditions was studied. The ablation mechanism and stages of the ablation process were determined based on time-resolved measurements of laser-induced acoustic waves with simultaneous imaging of the ablation process by laser-flash photography.

RESULTS

This study reveals the important role of tensile thermoelastic stress, which produces efficient cavitation that drives material ejection at temperatures substantially below 100 degrees C. Ablation thresholds for the aqueous solution, collagen gel, and liver were 20, 38, and 55 J/cm3, respectively, which correspond to temperature jumps of 5, 10, and 15 degrees C. Two distinct stages of material ejection were observed: (1) initial removal of small volumes of material due to the rupture of single subsurface bubbles, (2) bulk material ablation in the form of jets produced by intense hydrodynamic motions formed upon collapse of large bubbles after coalescence of smaller bubbles. The duration of material ejection upon short-pulse ablation may vary from microseconds to submilliseconds, and depended on the mechanical properties of materials and the incident laser fluence.

CONCLUSION

Nanosecond laser ablation of water, gels, and soft tissue under confined-stress conditions of irradiation may occur at temperatures below 100 degrees C. This ablation regime minimizes thermal injury to adjacent tissues and involves thermoelastic stress and recoil pressure magnitudes, which may be tolerated by tissues adjacent to an ablated crater.

Temperature dependence of the absorption coefficient of water for midinfrared laser radiation

The dynamics of the water absorption peak around 1.94 microns was examined. This peak is important for the absorption of holmium and thulium laser radiation. To examine the effect of temperature on the absorption coefficient, the transmission of pulsed Ho:YAG, Ho:YAG, Ho:YSGG, and Tm:YAG laser radiation through water of 22 degrees C, 49 degrees C, and 70 degrees C was measured as a function of the thickness of the water layer. From these data the absorption coefficients were determined at the three wavelengths. We found that at all three wavelengths, the absorption coefficients decreased when increasing the temperature. Second, the absorption spectrum of water was measured from 1,850-2,150 nm with a spectrophotometer. It was found that the absorption peak at 1.94 microns (at 22 degrees C) shifts to shorter wavelengths with increasing temperatures, to 1.92 microns at 70 degrees C. A model was developed to predict the temperature distribution incorporating the dynamic change in absorption coefficient. The temperature distributions are compared to the predictions of a model assuming constant optical properties. It is shown in this study that the dynamics of the absorption coefficient has a significant influence on the expected zone of damage and ablation parameters in the 2-microns wavelength range.