Percutaneous excimer laser coronary angioplasty

Percutaneous excimer laser coronary angioplasty

To determine the efficacy of percutaneous excimer laser coronary angioplasty as an adjunct or alternative to conventional balloon angioplasty, 55 patients were studied in a multicenter trial. These patients underwent the procedure using a modification of conventional balloon angioplasty technique. A...

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Bibliographic Details
Published in:The American journal of cardiology Vol. 66; no. 15; pp. 1027 - 1032
Main Authors: Litvack, Frank, Eigler, Neal L., Margolis, James R., Grundfest, Warren S., Rothbaum, Donald, Linnemeier, Thomas, Hestrin, Lisa B., Tsoi, Daniel, Cook, Stephen L., Krauthamer, Daniel, Goldenberg, Tsvi, Laudenslager, James R., Segalowitz, Jacob, Forrester, James S.
Format: Journal Article
Language:English
Published: New York, NY Elsevier Inc 01-11-1990
Elsevier
Subjects:
Angioplasty, Laser - adverse effects
Biological and medical sciences
Coronary Angiography
Coronary Disease - diagnostic imaging
Coronary Disease - surgery
Coronary Vessels - surgery
Diseases of the cardiovascular system
Humans
Medical sciences
Prospective Studies
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Human
Excimer
Coronary artery
Laser
Cuffed tube
Instrumentation therapy
Cardiovascular disease
Instrumental dilatation
Coronary heart disease
Comparative study
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Summary:To determine the efficacy of percutaneous excimer laser coronary angioplasty as an adjunct or alternative to conventional balloon angioplasty, 55 patients were studied in a multicenter trial. These patients underwent the procedure using a modification of conventional balloon angioplasty technique. A first-generation, 1.6-mm diameter catheter constructed of 12 individual silica fibers concentrically arranged around a guidewire lumen was used. Catheter tip energy density varied from 35 to 50 mJ/mm 2. The mean number of pulses delivered at 20 Hz was 1,272 ± 1,345. Acute success was defined as a ≥20% increase in stenotic diameter and a lumen of ≥ 1 mm in diameter after laser treatment. Acute success was achieved in 46 of 55 (84%) patients. Adjunctive balloon angioplasty was performed on 41 patients (75%). The percent diameter stenosis as determined by quantitative angiography decreased from a baseline of 83 ± 14 to 49 ± 11% after laser treatment and to 38 ± 12% in patients undergoing adjunctive balloon angioplasty. The mean minimal stenotic diameter increased from a baseline of 0.5 ± 0.4 to 1.6 ± 0.5 mm after laser treatment and to 2.1 ± 0.5 mm after balloon angioplasty. There were no deaths and no vascular perforations. One patient (1.8%) required emergency coronary bypass surgery. These data suggest that excimer laser energy delivered percutaneously by specially constructed catheters can safely ablate atheroma and reduce coronary stenoses.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ISSN:0002-9149
1879-1913
DOI:10.1016/0002-9149(90)90499-Q