Early and Late Quantitative Angiographic Results of Vein Graft Lesions Treated by Excimer Laser With Adjunctive Balloon Angioplasty

Abstract

Excimer laser angioplasty with adjunctive balloon angioplasty can be safely and successfully performed in diseased, old saphenous vein bypass graft lesions considered at high risk for reintervention. The extent of laser ablation remains limited by the diameter and effectiveness of the catheters. Late restenosis and, in particular, total occlusion mitigate the early benefits of the procedure. Other approaches such as the routine use of additional anticoagulation (eg, warfarin) should be considered to reduce the risk of late occlusions and restenosis after laser angioplasty of bypass grafts.

Use of Proxis for percutaneous coronary intervention in patients with totally occluded saphenous vein grafts: an alternative approach

“…For all these reasons multiple device development strategies have been developed for the management of diseased SVGs in recent decades: much progress has been made, especially in materials, drugs, methodology and protocols for intervention, leading to an increased outcome of PCI for SVG treatment [9,10]. In recent years different treatments for SVGs have been suggested, such as directional coronary atherectomy [11], excimer laser angioplasty [12] and thrombectomy devices [13], yielding limited successes. The use of stents improved the poor (short-term and long-term) outcomes of balloon angioplasty alone [14].…”

Large laser sheaths for pacing and defibrillator lead removal

“…3) shows features similar to excimer laser coronary angioplasty (ELCA) [5][6][7]. The plots depict a threshold fluence, below which advancement will not occur.…”

ACC/AHA/SCAI Practice Guidelines, February 21, 2006

“…The immediate results of PCI in midshaft ostial or distal anastomotic vein graft stenoses may be enhanced by coronary stent deployment (537,538). Ablative technologies such as directional atherectomy or excimer laser coronary angioplasty may facilitate angioplasty and stent deployment in patients with aorto-ostial vein graft stenoses (539,540).…”