Atherosclerotic vascular disease is the leading cause of death in this country. Current therapeutic modalities, however, are not ideal and are associated with significant morbidity, mortality, and expense.
The aim of this project is to develop and apply the techniques of angioscopy, hematoporphyrin-laser induced photoatherolysis and laser angioplasty for the treatment of atherosclerotic disease. Specific goals are (A) To develop a fiberoptic waveguide that permits transmission of ultraviolet light and simultaneous visualization and lasing. (B) To evaluate the efficacy of perfulorocarbon solutions and coronary sinus retroprofusion for myocardial oxygenation during temporary obstruction of blood flow. (C) To demonstrate selective hematoporphyrin concentration in atheroma and investigate the possibility of laser activated, hematoporphyrin induced photoatherolysis. (D) To define the dose-response of a variety of lasers on vascular tissue. (E) To examine the physical and chemical changes that occur when vascular tissue is irradiated by laser energy. (F) To determine if photochemical rather than photothermal ablation can be accomplished in vascular tissue. (G) To determine the informational valve of direct intravascular visualization of atherosclerotic disease. (H) To gain initial experience with angioscopy and laser angioplasty in man and to determine the efficacy and safety of these procedures.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08HL001522-03
Application #
3081893
Study Section
(SRC)
Project Start
1985-07-01
Project End
1990-06-30
Budget Start
1987-07-01
Budget End
1988-06-30
Support Year
3
Fiscal Year
1987
Total Cost
Indirect Cost
Name
Cedars-Sinai Medical Center
Department
Type
DUNS #
075307785
City
Los Angeles
State
CA
Country
United States
Zip Code
90048
Segalowitz, J; Grundfest, W S; Treiman, R L et al. (1990) Angioscopy for intraoperative management of thromboembolectomy. Arch Surg 125:1357-61;discussion 1362
Litvack, F; Grundfest, W S; Segalowitz, J et al. (1990) Interventional cardiovascular therapy by laser and thermal angioplasty. Circulation 81:IV109-16
Litvack, F; Grundfest, W S; Goldenberg, T et al. (1989) Percutaneous excimer laser angioplasty of aortocoronary saphenous vein grafts. J Am Coll Cardiol 14:803-8
Litvack, F; Grundfest, W S; Adler, L et al. (1989) Percutaneous excimer-laser and excimer-laser-assisted angioplasty of the lower extremities: results of initial clinical trial. Radiology 172:331-5
Grundfest, W S; Litvack, F; Glick, D et al. (1988) Intraoperative decisions based on angioscopy in peripheral vascular surgery. Circulation 78:I13-7
Litvack, F; Grundfest, W S; Goldenberg, T et al. (1988) Pulsed laser angioplasty: wavelength power and energy dependencies relevant to clinical application. Lasers Surg Med 8:60-5
Forrester, J S; Litvack, F; Grundfest, W et al. (1987) A perspective of coronary disease seen through the arteries of living man. Circulation 75:505-13
Grundfest, W S; Litvack, F; Hickey, A et al. (1987) The current status of angioscopy and laser angioplasty. J Vasc Surg 5:667-73
Sherman, C T; Litvack, F; Grundfest, W et al. (1986) Coronary angioscopy in patients with unstable angina pectoris. N Engl J Med 315:913-9
Litvack, F; Grundfest, W S; Forrester, J S et al. (1985) Effects of hematoporphyrin derivative and photodynamic therapy on atherosclerotic rabbits. Am J Cardiol 56:667-71

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