Abstract
Since laser angioplasty of coronary atherosclerotic obstruction was initially described, 1 lasers and laser delivery catheter systems have been gradually improved to increase their effectiveness and safety in the clinical setting. Early intraoperative laser revascularization in coronary obstruction studies suggests that the procedure was feasible, with long-term patency persisting despite competitive flow from the bypass graft. 2,3 Subsequent case studies demonstrated the potential efficacy of coronary laser angioplasty via the percutaneous route in widening an existing stenotic channel. A laser delivery system with a rounded metallic tip at the end of an optical fiber was used in one of these studies, 4 whereas another featured a laser-thermal catheter coaxially guided over a steerable central guidewire. 5 We have further studied and extended the technique in selected patients with chronic total coronary occlusions. These cases are reported herein.
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