Percutaneous excimer laser coronary angioplasty

• 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
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(90)90499-Q

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.