Dumitru Adrian DRĂGHICI, Ileana PANTEA, Nadinne ROMAN, Daniela DRUGUȘ, Angela REPANOVICI


Thrombolytic therapy is the key in the treatment of acute, cardiogenic cerebral embolism caused by coagulated blood carries some risk of hemorrhagic complications, and it is necessary to develop new safer and more reliable treatment methods. Laser thrombolysis treatment, which uses as a factor the difference in energy absorption between the thrombus and the arterial wall, has shown promise as a new method of treatment, as it can act selectively, in this case only on the respective thrombus. However, it has not been applied clinically and one of the main reasons for this is that its underlying mechanism has not yet been elucidated. We have developed and analyzed a pulsed laser thrombolysis system for treating cerebral blood vessels, which consists of a diode-pumped solid-state neodymium-yttrium aluminum garnet laser, which has excellent stability and maintainability and is suitable for clinical applications coupled to a small diameter optical fiber for increased maneuverability. Moreover, we analyzed the mechanisms that occur during pulsed laser irradiation of transparent glass tubes and gelatin phantoms in various pathological cases simulated in vitro. We found that bubbles form as a thermal effect in addition to pulsed laser irradiation ablation. Additionally, we did not detect shock waves or water jets associated with generated bubbles. We carefully analyzed the dynamics and growth rate of bubbles and their effect on a rabbit blood clot phantom within them. We concluded that the bubbles generated by the laser irradiation physically cut the thrombus and therefore had a thrombectomy effect. We believe that this study will clarify the mechanism of laser thrombolysis therapy and greatly contribute to its clinical application in tomorrow's mechatronic systems.

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