Endovascular Treatment Using Low-Power Ultraviolet Laser for Delayed Vasospasm in the Rabbit Carotid Artery Model
Kanji Nakaia,
Yuji Numaguchia,
Thomas H. Fostera,
Katsuji Shimab and
Makoto Kikuchic
a Department of Radiology, University of Rochester Medical Center, Rochester, NY
b Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan
c Department of Medical Engineering, National Defense Medical College, Tokorozawa, Saitama, Japan
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FIG 1. Specially developed equipment used in this study.
A, Photograph of optic fiber. The fiber can deliver laser energy and diffuse UV or visible light in a cylindrical pattern from a diffusing section. The diameter of the optical fiber is 0.49 mm (0.019 in). Scale bar, 5 mm.
B, Illustration of endovascular UV irradiation. The blood was hand-flushed with saline to irradiate the entire arterial wall homogeneously with UV or visible light.
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FIG 2. Bar graph shows the preventive effect of UV on the development of vasospasm for different irradiation time periods. Four groups are shown, for which the irradiation time was 0, 5, 10, or 20 seconds. UV irradiation with durations of 10 and 20 seconds significantly prevented the development of vasospasm (P < .001). Values represent the ratio of the relative diameter in each group on day 2 to that on day 0. The preventive effect seems to be close to maximum at an irradiation period of 10 seconds. Bars represent mean ± SD. *, P < .05 compared with no irradiation.
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FIG 3. Bar graph shows values that represent the ratio of the RD in each group on each point to that on day 0 and represent mean ± SD.
A, Preventive effect of UV on the development of vasospasm among different treatment groups on day 2. UV treatment significantly inhibited vasospasm (P < .001 compared with the VS + fiber group). Bar graph shows that the preventive effect on vasospasm was not due to manipulation (VS + fiber group) but to UV irradiation (VS + UV group). *, P < .05 compared with the VS + fiber group.
B, Time course of %RD among different treatment groups.
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FIG 4. Bar graph shows the preventive effect of UV or visible light on the development of vasospasm. Values represent the ratio of the RD in each group on each point to that on day 0 and represent mean ± SD. Although visible light significantly prevented vasospasm (P = .045), UV light was more effective. *, P < .05; **, P < .01 compared with the no irradiation (VS + fiber) group.
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FIG 5. Photomicrographs show cross sections of rabbit CCAs on day 2. Hematoxylin and eosin stain was used. Placement of autologous blood around CCAs induced folding of the endothelial surface, the corrugation of the internal elastic lamina, contraction of smooth muscle cells, and thickening of the arterial wall compared with no blood placement. In the UV-treated vessel, there is less folding of the internal elastic lamina and the smooth muscle cells appear relaxed. Scale bar, 100 µm.
A, VS group.
B, VS + fiber group.
C, Wrap group.
D, Wrap + UV group.
E, VS + UV group.
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