Groundbreaking treatment for heart disease uses lasers to vaporize blockages

[Mar. 3, 2023: Larry Frum, American Institute of Physics]

Researchers have developed a method that combines a low-power laser with ultrasound to safely remove arterial plaque. (CREDIT: iStockPhotos)

Atherosclerosis, a buildup of plaque, can lead to heart disease, arterial disease, and chronic kidney disease and is traditionally treated by inserting and inflating a balloon to dilate the artery. Other laser-based treatments can remove blockages rather than simply compress them but are little used because they present a high risk of complication and low effectiveness.

Rohit Singh of the University of Kansas and other researchers have developed a method that combines low-power laser with ultrasound to safely and effectively remove arterial plaque.

High-powered laser treatments direct thermal energy to vaporize water in the artery and create a vapor bubble, which expands and collapses to break up plaque. Similarly, the technology, developed by Xinmai Yang, the team’s doctoral advisor, uses a low-power nanosecond pulsed laser to produce microbubbles. The addition of ultrasonic irradiation causes the microbubbles to expand, collapse and rupture the plate.

“In conventional laser angioplasty, high laser power is required for the entire cavitation process, whereas in our technology, lower laser power is only required to initiate the cavitation process,” Singh said. “Overall, the combination of ultrasound and laser reduces the need for laser power and improves the efficiency of atherosclerotic plaque removal.”

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Because it destroys rather than compresses plaque, the combined technique will have a lower rate of restenosis, or re-narrowing of the artery, compared to balloon angioplasty or stenting. The control provided by the ultrasound and the low power laser will reduce the risk of dissection and perforation of the arteries.

Atherosclerosis, a buildup of plaque, can lead to heart disease, arterial disease, and chronic kidney disease and is traditionally treated by inserting and inflating a balloon to dilate the artery. (CREDIT: Rohit Singh, University of Kansas)

The team performed ex vivo experiments on carotid artery plaque samples and pork belly samples, and are currently planning to perform in vivo experiments. Laser and ultrasound techniques are commonly used by clinicians and should be easy to teach and implement after in vivo studies.

The combination of low power lasers and ultrasound techniques is not limited to atherosclerosis treatments. Singh and his collaborators also use the methodology for photo-mediated ultrasound therapy and ultrasound-assisted endovascular laser thrombolysis. The former can be used to remove abnormal microvessels in the eye to prevent blindness, while the latter can dissolve blood clots in the veins.

Heart disease symptoms

Symptoms of heart disease depend on the type of heart disease.

Coronary artery disease is a common heart condition that affects the major blood vessels that supply the heart muscle. Cholesterol deposits (plaques) in the heart arteries are usually the cause of coronary heart disease. The buildup of these plaques is called atherosclerosis (ath-ur-o-skluh-ROE-sis). Atherosclerosis reduces blood flow to the heart and other parts of the body. This can lead to heart attack, chest pain (angina) or stroke.

Symptoms of coronary heart disease can be different for men and women. For example, men are more likely to have chest pain. Women are more likely to have other symptoms besides chest discomfort, such as shortness of breath, nausea, and extreme fatigue.

Symptoms of coronary artery disease can include:

  • Chest pain, chest tightness, chest pressure and chest discomfort (angina pectoris)

  • Shortness of breath

  • Pain in the neck, jaw, throat, upper stomach, or back

  • Pain, numbness, weakness, or feeling cold in the legs or arms if the blood vessels in those parts of the body are narrowed

Symptoms of heart disease caused by irregular heartbeats (heart arrhythmias)

The heart may beat too fast, too slow, or irregularly. Symptoms of cardiac arrhythmia can include:

  • Chest pain or discomfort

  • Dizziness

  • Fainting (syncope) or near fainting

  • Floating in the chest

  • Stun

  • Running heart rate (tachycardia)

  • Shortness of breath

  • Slow heartbeat (bradycardia)

Heart disease symptoms caused by congenital heart defects

Serious congenital heart defects are usually noticed soon after birth. Symptoms of congenital heart defect in children can include:

  • Pale gray or blue skin or lips (cyanosis)

  • Swelling of the legs, stomach area, or areas around the eyes

  • In an infant, shortness of breath during feedings, leading to poor weight gain

Less serious congenital heart defects are often not diagnosed until later in childhood or adulthood. Symptoms of congenital heart defects that are usually not immediately life-threatening include:

  • Being easily short of breath during exercise or activity

  • Tiring easily during exercise or activity

  • Swelling of the hands, ankles or feet

Symptoms of heart disease caused by diseased heart muscle (cardiomyopathy)

The early stages of cardiomyopathy may not cause noticeable symptoms. As the condition worsens, symptoms may include:

  • Dizziness, lightheadedness and fainting

  • Fatigue

  • Feeling short of breath during activity or at rest

  • Feeling short of breath at night when trying to sleep or waking up breathless

  • Irregular heartbeats that seem fast, pounding, or fluttering

  • Swollen legs, ankles or feet

Symptoms of heart disease caused by problems with the heart valves (valvular heart disease)

The heart has four valves – the aortic, mitral, pulmonary and tricuspid valves. They open and close to circulate blood through the heart. Many things can damage heart valves. A heart valve can narrow (stenosis), leak (regurgitation or insufficiency) or close incorrectly (prolapse).

Valvular heart disease is also called heart valve disease. Depending on which valve is not working properly, symptoms of heart valve disease typically include:

  • Chest pain

  • Fainting (syncope)

  • Fatigue

  • Irregular heartbeat

  • Shortness of breath

  • Swollen feet or ankles

Endocarditis is an infection that affects the heart valves and the inner lining of the heart chambers and heart valves (endocardium). Symptoms of endocarditis can include:

You may not be diagnosed with coronary heart disease until you have a heart attack, angina, stroke, or heart failure. It is important to monitor heart symptoms and discuss your concerns with your health care provider. Heart (cardiovascular) disease can sometimes be caught early with regular checkups.

For more science and technology articles, see our New Innovations section on The bright side of the news.

Note: The documents provided above by American Institute of Physics. Content may be edited for style and length.

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