Comparison of different lasers in terms of thrombogenicity of the laser-treated vascular wall.

The thrombogenic properties of the laser-treated vascular wall are reported as quantitatively assessed on the basis of 33 experiments with peripheral canine vessel segments. Three types of surfaces, namely, 1) intact, 2) mechanically de-endothelized, and 3) postlaser, have been simultaneously exposed to platelet-enriched plasma in a sequentially organized artificial circulation system. Then the adherent platelets have been counted on the treated surfaces, and the relative thrombogenicity index has been calculated according to the equation T = (A1 - Aint)/(Ad - Aint), where Aint, Ad, A1 = the adherent platelet counts on intact, mechanically de-endothelized, and laser-treated surfaces, respectively. The following lasers have been evaluated: 1) Nd-YAG, 1,060 nm, continuous wave, 4W; 2) argon-ion, 480 and 514 nm and argon-ion, 350 nm, continuous-wave, 1 W and 400 mW [corrected], respectively; 3) excimer XeCl, 308 nm, pulsed, 30 mJ per pulse, repetition rate 10 Hz [corrected]; and also 4) the laser-heated metal probe (2 mm diameter, Trimedyne, Nd-YAG) 1,060 nm, 8 W. The thrombogenicity index values obtained were 83 +/- 7, 72 +/- 8, 57 +/- 9, 63 +/- 7, and 82 +/- 9%, respectively. The differences between these values were statistically insignificant. The data are suggestive of the essential requirement of, at least, anticoagulant therapy after laser angioplasty irrespective of the laser type.