Intra-arterial ultrasonic imaging for recanalization by spark erosion

Presently many recanalization methods are being developed to reopen obstructed arteries during catherization. Spark erosion is such a new obstruction removal technology. As reported by Slager et al (1), spark erosion can be used to evaporate atherosclerotic plaque and other arterial obstructions. The technique was studied in specimen of human aorta obtained at autopsy. It works well on fatty and fibrous tissue. The method is less suited for removal of purely calcified areas. The removal of obstructing tissue and the healing response are important parameters, but so is the steerability of the ablation process. one of the main problems is arterial curvature and the asymmetry of the obstruction in relation to the arterial wall. In many of the newly proposed recanalization methods, this asymmetry introduces the risk of arterial wall perforation. For optimal use knowledge of the localization and geometry of arterial obstruction is necessary. Catheter tip ultrasonic guidance seemed a good choice. In principle it can be combined with spark erosion, which in turn can be made steerable by the use of multiple electrodes.