Disparate absorption of argon laser radiation by fibrous versus fatty plaque: Implications for laser angioplasty

The thermal response of white fibrous atheromatous plaque to argon laser irradiation was compared with the thermal response of yellow fatty plaque and normal aortic wall to the same type of radiation. Samples of normal aorta, fibrous, and fatty plaque were irradiated in air with 3.5 Watts of laser power on a 2 mm spot for 5 and 10 seconds. Heterogeneous foci, each covering normal aorta and either fibrous or fatty plaque, were additionally irradiated with 7 Watts on a 1 cm spot for 30 seconds to 2.5 minutes. Tissue surface temperature was monitored during laser irradiation via a 3‐5 μm infrared camera. For the 2 mm spot and 5 second exposure time, argon laser irradiation of normal aorta produced popping and surface tearing at a peak temperature of 145 ± 10°C. Irradiation of fatty plaque produced popping and crater formation at a peak temperature of 200 ± 10°C. However, fibrous plaque was nonablatively discolored by the same dose of laser radiation with a peak temperature of only 85 ± 10°C. Irradiation for 10 seconds caused crater formation and carbonization in the fatty plaque but failed to produce ablation in the fibrous plaque. Irradiation of the heterogeneous foci confirmed the disparity in the temperature attained by these two types of plaque and their degree of damage. Therefore, this study suggests that the ablation threshold for soft atheroma is strongly dependent on the optical properties of the particular type of tissue. Yellow fatty plaque preferentially absorbs argon laser radiation, but white fibrous plaque absorbs this radiation less readily than normal aortic wall.