Keisuke Hashimura

Coagulation and ablation of biological soft tissue by quantum cascade laser with peak wavelength of 5.7 μm

Molecules such as water, proteins and lipids that are contained in biological tissue absorb mid-infrared (MIR) light, which allows such light to be used in laser surgical treatment. Esters, amides and water exhibit strong absorption bands in the 5–7 μm wavelength range, but at present there are no lasers in clinical use that can emit in this range. Therefore, the present study focused on the quantum cascade laser (QCL), which is a new type of semiconductor laser that can emit at MIR wavelengths and has recently achieved high output power. A high-power QCL with a peak wavelength of 5.7 μm was evaluated for use as a laser scalpel for ablating biological soft tissue. The interaction of the laser beam with chicken breast tissue was compared to a conventional CO2 laser, based on surface and cross-sectional images. The QCL was found to have sufficient power to ablate soft tissue, and its coagulation, carbonization and ablation effects were similar to those for the CO2 laser. The QCL also induced comparable photothermal effects because it acted as a pseudo-continuous wave laser due to its low peak power. A QCL can therefore be used as an effective laser scalpel, and also offers the possibility of less invasive treatment by targeting specific absorption bands in the MIR region.

Selective removal of atherosclerotic plaque with a quantum cascade laser in the 5.7 µm wavelength range

Atherosclerotic plaques consist mainly of cholesteryl esters, and the C=O stretching vibration mode of cholesteryl esters strongly absorbs radiation at a wavelength of 5.75 µm. For clinical application of less-invasive laser angioplasty with 5.75 µm, a compact laser is required. Quantum cascade lasers (QCLs) are semiconductor lasers that can emit radiation in the mid-IR range. In this study, the potential of the QCL for less-invasive laser angioplasty was evaluated. At the average power density of 180 W/cm2, the atherosclerotic aorta was ablated for the irradiation time of 1 s or more, whereas the normal aorta was ablated for more than 10 s. This demonstrates that selective ablation of the atherosclerotic aorta was achieved. However, strong coagulation and carbonization were observed. For reducing thermal effects, improving the pulse structure is required. In conclusion, the QCL achieved the selective ablation of the atherosclerotic lesions, which indicates the potential of the QCL.

Improvement of thermal effects to rabbit atherosclerotic aortas by macro pulse irradiation of a quantum cascade laser in the 5.7 μm wavelength range

Atherosclerotic plaques mainly consist of cholesteryl esters. Cholesteryl esters have an absorption peak at the wavelength of 5.75 μm originated from C=O stretching vibration mode of ester bond. Our group achieved making cutting difference between atherosclerotic lesions and normal vessels using a quantum cascade laser (QCL) in the 5.7 μm wavelength range. QCLs are relatively new types of semiconductor lasers that can emit mid-infrared range. They are sufficiently compact and have recently achieved their high-power emission. However, large thermal damage was observed because the QCL worked as a quasi-continuous wave laser due to its short pulse interval. To realize less invasive ablation by the QCL, reducing thermal effects to normal vessels is needed. In this study, we tried improving the thermal effects by changing the pulse structure. First, irradiation effects to rabbit atherosclerotic aortas by macro pulse irradiation (irradiation of pulses at intervals) and conventional continuous pulse irradiation were compared. The macro pulse width and the macro pulse interval were set to 0.54 and 12 ms, respectively, because the thermal relaxation time of rabbit normal and atherosclerotic aortas in the oscillation wavelength was 0.54-12 ms. As a result, ablation depth became longer and coagulation width became shorter by the macro pulse irradiation. In addition, cutting difference between rabbit normal and atherosclerotic aortas was observed by the macro pulse irradiation. Therefore, the macro pulse irradiation achieved the improvement of thermal effects by the QCL in the 5.7 μm wavelength range. The QCL has the potential of realizing less-invasive laser angioplasty.

Selective ablation of rabbit atherosclerotic plaque with less thermal effect by the control of pulse structure of a quantum cascade laser in the 5.7 μm wavelength range

Cholesteryl esters are main components of atherosclerotic plaques and have an absorption peak at the wavelength of 5.75 μm originated from C=O stretching vibration mode of ester bond. Our group achieved the selective ablation of atherosclerotic lesions using a quantum cascade laser (QCL) in the 5.7 μm wavelength range. QCLs are relatively new types of semiconductor lasers that can emit mid-infrared range. They are sufficiently compact and considered to be useful for clinical application. However, large thermal effects were observed because the QCL worked as quasicontinuous wave (CW) lasers due to its short pulse interval. Then we tried macro pulse irradiation (irradiation of pulses at intervals) of the QCL and achieved effective ablation with less-thermal effects than conventional quasi-CW irradiation. However, lesion selectivity might be changed by changing pulse structure. Therefore, in this study, irradiation effects of the macro pulse irradiation to rabbit atherosclerotic plaque and normal vessel were compared. The macro pulse width and the macro pulse interval were set to 0.5 and 12 ms, respectively, because the thermal relaxation time of rabbit normal and atherosclerotic aortas in the oscillation wavelength of the QCL was 0.5–12 ms. As a result, cutting difference was achieved between rabbit atherosclerotic and normal aortas by the macro pulse irradiation. Therefore, macro pulse irradiation of a QCL in the 5.7 μm wavelength range is effective for reducing thermal effects and selective ablation of the atherosclerotic plaque. QCLs have the potential of realizing less-invasive laser angioplasty.

Thermal ablation of WHHLMI rabbit atherosclerotic plaque by quantum cascade laser in the 5.7-μm wavelength range

We evaluated the utility of a compact and high-power quantum cascade laser (QCL) in the 5.7 μm wavelength range for less-invasive laser angioplasty. Atherosclerotic plaques mainly consist of cholesteryl esters. The wavelength of 5.75 μm is well absorbed in C=O stretching vibration mode of cholesteryl esters. Our previous study achieved to make cutting differences between a normal tunica intima of an artery and an atherosclerotic lesions using a nanosecond pulsed laser by difference-frequency generation (DFG laser) at the wavelength of 5.75 μm. For realizing a clinical application of this technique, a compact laser device is required. In this study, QCL irradiation effects to a porcine normal aorta were compared with DFG laser. In addition QCL irradiation effects to an atherosclerotic aorta of myocardial infarction-prone Watanabe heritable hyperlipidemic rabbit (WHHLMI rabbit) and a normal aorta were observed. As a result, the QCL could make cutting difference between the rabbit atherosclerotic aorta and the normal aorta. On the other hand, the QCL induced more thermal damage to porcine normal aorta than the DFG laser at the irradiation condition of comparable ablation depth. In conclusion, the possibility of less-invasive and selective treatment of atherosclerotic plaques using the QCL in the 5.7 μm wavelength range was revealed, although improvement of QCL was required to prevent the thermal damage of a normal artery.

Selective ablation of WHHLMI rabbit atherosclerotic plaque by quantum cascade laser in the 5.7 μm wavelength range for less-invasive laser angioplasty

We investigated the potential of a compact and high-power quantum cascade laser (QCL) in the 5.7 μm wavelength range for less-invasive laser angioplasty. Atherosclerotic plaques consist mainly of cholesteryl esters. Radiation at a wavelength of 5.75 μm is strongly absorbed in C=O stretching vibration mode of cholesteryl esters. Our previous study achieved to make cutting differences between a normal artery and an atherosclerotic lesions using nanosecond pulsed laser by difference-frequency generation (DFG laser) at the wavelength of 5.75 μm. For applying this technique to clinical treatment, a compact laser device is required. In this study, QCL irradiation effects to a porcine normal aorta were compared with DFG laser. Subsequently, QCL irradiation effects on an atherosclerotic aorta of myocardial infarction-prone Watanabe heritable hyperlipidemic rabbit (WHHLMI rabbit) and a normal rabbit aorta were observed. As a result, the QCL could make cutting differences between the rabbit atherosclerotic and normal aortas. On the other hand, the QCL induced more thermal damage to porcine normal aorta than the DFG laser at the irradiation condition of comparable ablation depths. In conclusion, the possibility of less-invasive and selective treatment of atherosclerotic plaques using the QCL in the 5.7 μm wavelength range was revealed, although improvement of QCL was required to prevent the thermal damage of a normal artery.