Abstract
Excimer laser coronary angioplasty (ELCA) is a unique revascularization modality that can vaporize plaque and thrombus. Compared to thrombus aspiration therapy, ELCA is reported to provide better microcirculation and reduced peripheral embolism in treatment for acute coronary syndrome. Excimer laser catheters come in various sizes, and we sought to compare the 0.9- and 1.4-mm-diameter catheters. We retrospectively enrolled 90 acute myocardial infarction (AMI) patients who underwent primary percutaneous coronary intervention with excimer laser from August 2013 to March 2017 in our hospital. Patients were grouped by diameter of catheter that had been used, the 0.9 mm group (n = 51) and 1.4 mm group (n = 39). We evaluated myocardial perfusion, procedural success rate, short-term outcome, lesion crossability, and complications between the two groups. The percentage of patients whose final thrombolysis in myocardial infarction (TIMI) grade was 3 (0.9 mm 86.3% vs 1.4 mm 89.7% p = 0.75) and final myocardial blush grade (MBG) was 3 (0.9 mm 72.5% vs 1.4 mm 69.2% p = 0.82) was similarly high for both groups. Procedural success rate, in-hospital major adverse cardiac events (MACE), lesion crossability, and complications were also similar. This study showed that efficacy of 0.9 and 1.4 mm excimer laser catheter was equivalent in ELCA for AMI patients. If one takes into account lesion crossability, debulking effects, and the stunned platelets phenomenon, the 0.9 mm excimer laser catheter is sufficient for ELCA in AMI patients.
Highlights
thrombolysis in myocardial infarction (TIMI) grade . 0.9 mm . 1.4 mm Excimer laser coronary angioplasty (ELCA) is a unique revascularization modality that recently became available in Japan
The indication for ELCA was decided by the operator based on imaging studies, namely, angiography and intravascular ultrasound (IVUS) or optical coherence tomography (OCT) results
We evaluated myocardial reperfusion according to thrombolysis in myocardial infarction (TIMI) grade and myocardial blush grade (MBG) [14, 15]
Summary
Excimer laser coronary angioplasty (ELCA) is a unique revascularization modality that recently became available in Japan. Sometimes referred to as photoablation, ELCA uses ultraviolet light to vaporize or debulk atherosclerotic plaque and thrombus [1, 2]. ELCA has been shown to be Despite many advances in reperfusion therapy for coronary artery disease, problems remain. The no reflow phenomenon is one of them that occur in a notable proportion of patients with AMI. No reflow is associated with reduced left ventricular ejection fraction, left ventricular remodeling, and poor clinical outcomes, indicating that merely re-establishing patency in a blocked artery is not good enough [7, 8]. The CARMEL multicenter trial found that ELCA was an effective and safe revascularization modality for treatment of AMI [9]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
