Clinical coronary laser balloon angioplasty: effect on ergonovine responsiveness

Abstract

Laser balloon angioplasty involves delivery of continuous wave Nd-YAG laser energy radially from the surface of a specially designed a.ngioplast.y balloon directly to the luniirial surface of an arterial segment immediately after it.s succeasfu] dilatation by conventional balloon angioplasty, the purpose being to fuse loose flaps and disrupted atheroinatous plaque thermally hack against the arterial wall and to reduce elastic recoil and smooth muscle proliferation, in an attempt to prevent re stenosis . Ergonovirie stimulates arterial wall smooth muscle, normally causes arteries to constrict and is used in the diagnosis of coronary artery spasm. Three patients were treated with laser balloon angioplasty, each receiving 380 3 over 20 seconds (30 W for 5 a, 18 W for 5 s & 14 W for 10 5) . The minimum lumirial diameter of the treated arterial segment was measured angiographically before and after conventional balloon angioplasty, immediately after laser balloon angioplasty and again 1 month later both before and after ergonovine was given. The measurements were (respectively, in mm): 1.03, 1.71, 1.85, 2.37 and 2.37 in patient 1; 0.30, 1.54, 1.85, 2.07 and 2.11 in patient 2; and 0.98, 1.76, 2.27, 2.40 and 2.40 in patient 3. The before and after ergonovire measurements were almost identical, suggesting that laser balloon angioplasty abolishes ergonovine responsiveness for at least up to one month following the procedure, and thus might be of use in treating coronary artery spasm which is resistant to medical therapy.