Dalupang JJ, Shanks TG, Colt HG. Nd-YAG laser damage to metal and silicone endobronchial stents: delineation of margins of safety using an in vitro experimental model.
Chest 2001;
120:934-40. [PMID:
11555532 DOI:
10.1378/chest.120.3.934]
[Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
STUDY OBJECTIVE
To identify margins of safety within which bronchoscopic Nd-YAG laser resection can be performed without damaging indwelling tracheobronchial stents.
DESIGN
Experimental in vitro study simulating a patient-care environment.
METHODS
Uncovered and covered metal Wallstent (Schneider; Zurich, Switzerland) and Dumon (Bryan Corporation; Woburn, MA) silicone stents were deployed in the tracheobronchial tree of a ventilated and oxygenated (fraction of inspired oxygen, 40%) heart-lung block of a dead canine. Rigid bronchoscopic Nd-YAG (1,064 nm) laser procedures were performed in order to deliver laser energy using fiber-to-target distances of 10 mm and 20 mm, and noncontact, continuous-mode, 1-s pulses at power settings of 10 W, 30 W, and 40 W. The major outcome measure was laser-induced stent damage, defined as discoloration, ignition, or breakage. This was assessed using six power densities: 75 W/cm(2), 172 W/cm(2), 225 W/cm(2), 300 W/cm(2), 518 W/cm(2), and 690 W/cm(2).
RESULTS
The uncovered Wallstent and the silicone stent remained intact at power densities of 75 W/cm(2) (10 W, 20 mm) and 172 W/cm(2) (10 W, 10 mm), but were damaged at power densities > 225 W/cm(2) (30 W, 20 mm). The covered Wallstent was damaged at all power densities tested.
CONCLUSION
Uncovered Wallstent and silicone stents are not damaged when Nd-YAG laser energy is delivered using power densities < or = 72 W/cm(2) (10 W, 10 mm). Covered Wallstents, however, had a high likelihood of ignition at all power densities studied.
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