An Evaluation of Prostaglandin Activity and Pathologic Changes Following Carbon Dioxide Laser Endarterectomy

Laser endarterectomy has been proposed as a method to recanalize narrowed or occluded arteries, especially coronarles. Since a substantial number of patients with anterior cerebral circulation ischemic symptoms have evidence of obstructive carotid lesions, laser angioplasty may perhaps be a useful technigue for the treatment of cerebrovascular disease. Most of the endarterectomy studies performed to date have been performed using argon lasers (1). Alterations in clotting have been associated with argon laser angioplasty (2,3). Such alterations would have considerable impact on cerebro-vascular circulation where thrombosis and embolism are poorly tolerated. Very little basic science data has been published regarding carbon dioxide laser irradiation of vessel surfaces. CO₂ lasers generally induce more superficial lesions in tissue than argon or YAG so as to make them perhaps more useful in the performance of laser angioplasty. McVicker et al have recently published results from CO₂ laser treatments of canine carotid and femoral vessels studying the acute thrombotic conseguences of laser irradiation (4). The current study set out to attempt to reproduce those data as well as to evaluate the delayed effects, observed after several hours of recirculation of CO₂ laser endarterectomy.