Clinical experience of endovascular laser intervention in cardiovascular disease.

Abstract

The authors studies laser angioplasty for patients with obstructive arterial diseases since the 1980s. Usefulness of laser angioplasty for endovascular surgery was recognized especially for patients having short segments of severe atherosclerotic changes in vessels. The authors retrospectively reviewed clinical experience of angioplasty by argon laser for 113 patients (103 peripheral, 10 coronary artery). Using an argon laser optimal conditions were (a) 6W in output and 3 sec in irradiation time or (b) metal tip temperature of 200 degrees C and 5 sec of ablation time for the peripheral artery. On the other hand, 4-5 W in output and 2 sec in irradiation time were optimal conditions for the same procedure on the coronary artery. The initial success rate of laser angioplasty for the peripheral artery was 92% in the stenotic lesions and 73% in the occlusive lesions. However, cumulative patency rate was 85% in the stenotic lesions and 74% in the occlusive lesions in the long-term follow-up study of 106 months among the patients with clinical success. On the basis of the excellent results in the peripheral arterial diseases, coronary laser angioplasty and coronary artery bypass grafting was intraoperatively performed in 10 patients with anginal attack. Patency rate was 90% in this series. Laser angioplasty for endovascular surgery was a useful procedure for patients with stenotic and occlusive changes of the peripheral and coronary arteries. Consequently, this method should be recommended especially for high-risk patients with atherosclerosis.