Plaque removal from arteries
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Minimally Invasive Techniques for Arterial Plaque Removal
Ultrasound-Assisted Laser and Focused Ultrasound Methods
Recent research has explored combining ultrasound with laser energy to remove atherosclerotic plaques more safely and efficiently. By synchronizing pulsed laser and ultrasound, the required laser power for plaque removal can be reduced, potentially lowering the risk of complications and improving treatment outcomes. Experiments on human plaque samples have shown that this method can effectively remove lipid deposits, with ultrasound enhancing the mechanical disruption of plaque through cavitation effects. Laser-only or ultrasound-only treatments at similar energy levels were not effective, highlighting the benefit of the combined approach 19.
Another promising approach uses catheter-assisted pulsed focused ultrasound (FUS). By applying FUS energy to a metal catheter wire inside the artery, inertial cavitation is induced, which mechanically depletes plaque. This method has demonstrated significant removal of lipid tissue from both animal and human plaque samples, with the catheter-assisted FUS group showing much greater efficacy than FUS alone .
Ultrasonic Angioplasty and Ablation
Ultrasonic energy has also been used directly for plaque ablation. Intra-arterial ultrasonic angioplasty involves inserting a wire or transducer into the artery to deliver intense ultrasonic waves, ablating plaque at the tip. This method can remove both fibrous and calcified plaques quickly, with minimal damage to healthy vessel walls when pulsed energy and proper technique are used. Early studies have shown successful recanalization of occluded arteries and suggest that ultrasonic energy is a promising tool for plaque ablation 38.
Specialized ultrasonic probes have been developed for minimally invasive plaque removal, including designs with aspiration channels to remove debris during the procedure. These devices aim to reduce post-operative complications and limit damage to surrounding tissues .
Mechanical and Robotic Plaque Removal
Mechanical atherectomy systems, such as novel coring devices, physically cut and remove calcified plaque from arteries. These systems are designed to capture most of the plaque fragments within the catheter, reducing the risk of debris entering the bloodstream. Some systems can even remove soft plaque using suction alone, without mechanical cutting .
Magnetic-controlled spiral microrobots represent a new frontier in plaque removal. These tiny robots can be guided through blood vessels using external magnetic fields, grinding away plaque with high precision. In laboratory tests, these microrobots have demonstrated efficient and controlled removal of simulated arterial plaque, suggesting potential for future in vivo applications .
Pharmacological Approaches to Plaque Reduction
Pharmacological agents are also being investigated for their ability to reduce or remove arterial plaques. 2-hydroxypropyl-β-cyclodextrin (HPβCD) has shown promise in a clinical case, where intravenous infusion led to significant reduction of coronary artery plaques, lower cholesterol and triglyceride levels, and improved kidney function, without major side effects .
Some lipolytic drugs, such as bile acid factors and phosphatidylcholine, have demonstrated the ability to reduce the size and soften the consistency of plaques, making them easier to detach from the artery wall. However, these agents did not completely dissolve or destroy plaques in short-term studies .
Conclusion
A variety of innovative techniques are being developed to remove arterial plaque, including ultrasound-assisted laser ablation, focused ultrasound with catheters, ultrasonic angioplasty, mechanical atherectomy, microrobotic systems, and pharmacological agents. Each method offers unique advantages in terms of safety, efficacy, and precision, with ongoing research aimed at improving outcomes and minimizing risks for patients with atherosclerotic disease 12345678+2 MORE.
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