Effect of CO2 and blood media on laser probe temperature

Blood may limit laser ablation of arterial plaque by decreasing thermal energy transfer from metal‐capped probes to arterial occlusions. Since a gas is a good insulator of heat, CO2 may be a better medium for laser recanalization. To study this possibility, a metal‐capped fiber was positioned in a segment of blood‐filled polyethylene tubing and activated with an argon laser. Probe temperatures were measured in blood and as the blood was displaced by flowing CO2 gas. Probe temperatures were higher at all powers studied in CO2 gas than in blood. Maximum probe temperatures averaged 518 ± 24°C after CO2 infusion versus 320 ± 7°C in blood, (P < 0.0001). Blood aggregate formation was noted on the probe surface in blood but not in CO2 medium. Thus CO2 gas may be a preferable medium for laser recanalization, since higher probe temperatures are achieved, and the probe surface remains free of insulating blood coagulate.