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After the first intraoperative application of an Argon-laser by Choy in 1983, a special trial on laser angioplasty was started in Houston in 1985. Under the indications of tandem stenoses, diffuse atherosclerotic alteration or peripheral stenoses, laser endarterectomy was performed with a hand-held CO2-laser in addition to conventional bypass surgery. Between January 1985 and December 1986, 20 patients were treated with this combined method. Laser endarterectomy was successful in 37 out of 40 diseased vessels. After an interval of one week to 6 months after operation, 18 patients underwent a reangiography, showing a patency rate of 76% in the lased arterial segments. This result is comparable to conventional endarterectomy or intraoperative balloon angioplasty in similar cases. Further improvements can be expected by modifications in antiplatelet drug therapy.