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Increasing arterial compliance by laser modification of fibro-calcific plaques

Rajebahadur S, Velluva Rayaroth N, King JB, Alexandrovskaya YM, Guagliumi G, Glatz A, Johnson JE, Miranda Romero F et al.

Frontiers in cardiovascular medicine, 2025

Abstract

Background: Calcium is a constituent of numerous types of atherosclerotic plaques. While various vessel modification devices have been introduced, plaque heterogeneity presents a challenge to direct therapy to specific components within the arterial wall.

Aims: We introduce a novel approach for non-destructive modification of arterial fibrocalcific plaques with controlled spatial-temporal diode-laser irradiation. The laser thermomechanical approach enables the controlled formation of microstructural defects, stress relaxation, microcracking, and plaque molding. Primary objectives of this exploratory study include: (1) Determine an optimal laser dosimetry in fibro-calcific plaques in ex vivo human arteries that mitigates against non-specific thermal injury of the vessel wall; (2) Identify arterial structural modifications; and (3) Characterize changes in lumen, vessel diameter and compliance in response to laser irradiation.

Methods: Diode laser radiation with a wavelength of 1,470 nm is delivered to ex-vivo human femoral artery specimens through an optical fiber inside a semi-compliant balloon containing heavy water. Laser dosimetry at the intimal surface is specified using a numerical model informed by vessel lumen diameter and beam profile measurements. Radiometric temperature increases at the outer surface of the vessel in response to laser irradiation is measured with an infrared camera. Micro-CT and IV-OCT images, recorded before and after laser irradiation, are aligned…

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