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Journal of Biomedical Optics

Thulium fiber laser recanalization of occluded ventricular catheters in an ex vivo tissue model
Author(s): Thomas C. Hutchens; David A. Gonzalez; Luke A. Hardy; C. Scott McLanahan; Nathaniel M. Fried
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Paper Abstract

Hydrocephalus is a chronic medical condition that occurs in individuals who are unable to reabsorb cerebrospinal fluid (CSF) created within the ventricles of the brain. Treatment requires excess CSF to be diverted from the ventricles to another part of the body, where it can be returned to the vascular system via a shunt system beginning with a catheter within the ventricle. Catheter failures due to occlusion by brain tissues commonly occur and require surgical replacement of the catheter. In this preliminary study, minimally invasive clearance of occlusions is explored using an experimental thulium fiber laser (TFL), with comparison to a conventional holmium: yttrium aluminium garnet (YAG) laser. The TFL utilizes smaller optical fibers ( < 200 - μ m OD) compared with holmium laser ( > 450 - μ m OD), providing critical extra cross-sectional space within the 1.2-mm-inner-diameter ventricular catheter for simultaneous application of an endoscope for image guidance and a saline irrigation tube for visibility and safety. TFL ablation rates using 100 - μ m core fiber, 33-mJ pulse energy, 500 - μ s pulse duration, and 20- to 200-Hz pulse rates were compared to holmium laser using a 270 - μ m core fiber, 325-mJ, 300 - μ s , and 10 Hz. A tissue occluded catheter model was prepared using coagulated egg white within clear silicone tubing. An optimal TFL pulse rate of 50 Hz was determined, with an ablation rate of 150    μ m / s and temperature rise outside the catheter of 10 ° C . High-speed camera images were used to explore the

Paper Details

Date Published: 21 April 2017
PDF: 8 pages
J. Biomed. Opt. 22(4) 048001 doi: 10.1117/1.JBO.22.4.048001
Published in: Journal of Biomedical Optics Volume 22, Issue 4
Show Author Affiliations
Thomas C. Hutchens, The Univ. of North Carolina at Charlotte (United States)
David A. Gonzalez, The Univ. of North Carolina at Charlotte (United States)
Luke A. Hardy, The Univ. of North Carolina at Charlotte (United States)
C. Scott McLanahan, Carolinas Medical Ctr. (United States)
Nathaniel M. Fried, The Univ. of North Carolina at Charlotte (United States)

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