ISSN:
1432-1084
Keywords:
Arteries, extremities
;
Arteries, laser angioplasty
;
Arteries, transluminal angioplasty
;
Lasers
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract We investigated a pulsed 504 nm dye laser at a pulse duration of 1.44 μ and a pulse rate of 10 Hz for its angioplasty capabilities. Laser energy was delivered via 9 F multi-fiber ring catheters. Our experimental data showed effective ablation of atheroma and disruption of calcified plaques at an energy fluence of 9.5 J/cm2 under saline and blood. Histologically, there was only minimal thermal injury to adjacent tissues. Irregular tissue borders after radiant energy exposure of 12.7 J/cm2, under blood, provide strong evidence for ablation by a shock-or pressure-wave mechanism. Percutaneous peripheral laser-assisted angioplasty was performed in 25 patients with arterial occlusive disease of the iliac and femoro-poplteal arteries (mean occlusion length 7.2 cm). All lesions were initially traversed by a guide-wire. Technical success was achieved in 24 out of 25 patients (96%). Laser angioplasty decreased the mean stenosis rate from 100% to 51± 12% (P 〈 0.01). The ankle-brachial index (ABI) rose from 0.48±0.16 before to 0.88±0.10 after intervention (P 〈 0.01) with a value of 0.82±0.15 at 6 months follow-up. The overall success rate, judged clinically and by ABI determinations in all patients, was 84% at a mean follow-up period of 7.9 months. The number of stand-alone laser procedure was 21%. Clinical application of the delivery devices proved to be safe due to the “over-the-wire” approach. Our prelimanary clinical data encourage further refinement of pulsed dye laser angioplasty for more efficacious debulking of atheroma.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00173516
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