Overview of medical applications and cardiovascular intervention

Summary form only given. Lasers play an increasing role in a broad range of medical therapies. Our group has investigated multiple laser wavelengths for a variety of applications in cardiovascular disease, ophthalmology, soft tissue surgery, stone disease and photodynamic therapy. Choosing the optimal combination of laser generator, wavelength, delivery system and desired outcomes requires a thorough understanding of the interaction between the laser energy and the tissue of interest. Determination of the optimal laser wavelength requires knowledge of the tissue absorption and scattering characteristics, the depth of penetration within the target tissue and in surrounding tissues, and the ablation threshold. Careful in vitro studies can serve as the basis for system design and choice of laser; however, testing in animal models and careful clinical trials are often required to achieve optimal results. The energy parameters for laser welding of tissue are significantly different than the energy needed for tissue ablation within blood vessels. In tissue welding, uniform energy deposition through the thickness of tissue to be welded is critical. During intra-arterial tissue ablation, precise deposition leading to small volumes of ablation are preferred in order to achieve precise control. Variability of tissue characteristics and thicknesses must be considered in both cases.