Late Presenting ST Elevation Myocardial Infarction Managed with Adjunctive Laser Therapy

Abstract

Here we present a case using Excimer Laser coronary angioplasty (ELCA) prior to ballooning and stent implantation. Laser therapy has been designed to have both a lytic effect on thrombus and a debulking effect on plaque with the idea of reducing distal embolization, microvascular dysfunction and facilitating stent deployment. The technology has been around for over two decades and its use has been explored in acute coronary syndromes, in-stent restenosis, chronic total occlusions and calcified lesions, but its uptake is poor and evidence base mainly limited to registry data. Further, prospective randomized trials are needed in order to better define its role, especially in the Primary PCI setting.