Percutaneous excimer laser coronary angioplasty: Results in the first consecutive 3,000 patients

Abstract

Excimer laser angioplasty can be safely and effectively applied, even in a variety of complex lesions not well suited for percutaneous transluminal coronary angioplasty. These types may include aorto-ostial, long lesions, total occlusions crossable with a wire, diffuse disease and vein grafts. Most recent data show a trend for the selection of predominantly complex lesions and a reduction in the incidence of perforation. This procedure may broaden the therapeutic window for the interventional treatment of selected complex coronary artery disease.

Single-laser approach for fluorescence guidance of excimer laser angioplasty at 308 nm: Evaluation in vitro and during coronary angioplasty

“…The overall rate of additional PTCA after laser angioplasty was reported to be 71 to 79% [1,2]. However, in the largest excimer laser coronary angioplasty registry to date comprised of 3,000 patients, the rate of additional PTCA increased from 71% in the first 2,000 to 95% in the last 1,000 patients [2].…”

“…Recent multicenter trials demonstrated that excimer laser coronary angioplasty can be a useful adjunct to balloon angioplasty [1,2] especially in AHA/ACC type B2 and C lesions [3,4]. However, further technological improvements have to be made to optimize luminal gain and minimize the rate of dissections (13.0 to 14.7%) and coronary perforations (1.0 to 1.9%) [1,2].…”

“…However, further technological improvements have to be made to optimize luminal gain and minimize the rate of dissections (13.0 to 14.7%) and coronary perforations (1.0 to 1.9%) [1,2]. A major step in this direction will be the development of a guiding system for laser angioplasty.…”

Comparative study of Nd:YAG laser angioplasty at 1.06 μm, 1.32 μm, and 1.44 μm wavelengths: Decreased vascular spasm and early mortality with 1.44 μm laser ablation

“…Laser ablation was performed with the laser catheter in contact with the intimal surface, roughly perpendicular to the intimal surface. Each rooster had [8][9][10][11][12] sites of laser ablation in the thoracic and abdominal aorta while under general anesthetic.…”

Catheter-Based Treatment of Coronary Artery Disease

“…These included transluminal extraction catheters, directional coronary atherectomy, 22,23 rotational atherectomy, 24 and excimer laser. 25,26 For each of these technologies, the initial goal was to make the percutaneous procedure safer by removing tissue, either plaque or calcium, on the premise that "bigger is better"---ie, the larger the lumen of the treated segment, the less likely the patient would experience restenosis. Reporting a series of 524 treated lesions, Kuntz et al 27 found that apparent differences in subsequent restenosis with different devices were attributable solely to the postprocedural lumen diameter rather than the specific device used ( Figure 3).…”