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The paradox of thermal ablation without thermal injury

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However it is done, it is certain that a beam of heat is the essence of the matter. H.G. WellsThe War of the Worlds (1)

Abstract

Previous investigations have demonstrated in vitro that the excimer laser may be used to accomplish cardiovascular tissue ablation without causing thermal injury to boundary sites. Initial investigations suggested that results achieved with the excimer laser were related to photochemical breaking of molecular bonds, rather than thermal degradation.

More recent investigations, however, have suggested that the mechanism of excimer tissue ablation may not be unique. Results indistiguishable from those accomplished with the excimer laser have been reproduced using both visible and infrared wavelengths. Experiments utilizing gas chromatography have indicated that the vapour-phase photoproducts liberated during excimer laser tissue ablation are indistinguishable from those observed following continuous wave laser irradiation or flame torching of cardiovascular tissue. While photoemission spectroscopic analysis has identified free radicals released in gas phase during excimer laser ablation, electron paramagnetic resonance spectroscopy has similarly identified free radicals released in solution during continuous wave laser ablation; while these two techniques may detect different types of radicals with different kinetic behaviour, these results indicate, that the finding of free radical photoproducts per se during laser ablation does not necessarily exclude a non-thermal mechanism. Finally, plasma-mediated photodisruption represents a third alternative to explain pulsed laser ablation; experiments are required, however, to define whether plasma generated during pulsed laser irradiation is central to the ablation process, or represents an epiphenomenon.

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Authors and Affiliations

  1. Departments of Medicine (Cardiology) and Pathology, New England Medical/Tufts Medical School, Boston, MA, USA

    Jeffrey M. Isner & Richard H. Clarke

  2. the Department of Chemistry, Boston University, Boston, MA, USA

    Jeffrey M. Isner & Richard H. Clarke

Authors
  1. Jeffrey M. Isner
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  2. Richard H. Clarke
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Isner, J.M., Clarke, R.H. The paradox of thermal ablation without thermal injury. Laser Med Sci 2, 165–173 (1987). https://doi.org/10.1007/BF02594155

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  • DOI: https://doi.org/10.1007/BF02594155

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