Abstract
Percutaneous laser angioplasty is an established modality for the treatment of severe peripheral vascular disease and is generally used as an adjunct to balloon angioplasty. In the coronary circulation laser angioplasty is feasible, although its efficacy and safety remain to be defined. This article addresses the rationale for laser angioplasty, examines the influences of the various components of the laser system, and considers future direction given the accomplishments to date and the limitations of current instrumentation.
Similar content being viewed by others
References
McGuff, Bushnell, Soroff, Detterling.Studies of the surgical applications of laser (light amplification by stimulated emission of radiation). Surgical Forum 1963;14: 143–5.
Macruz R, Martins JRM, Tupinamba A, et al.Therapeutic possibilities of laser beams in atheromas. Arq Bras Cardiol 1980;34: 9.
Choy DSJ.Flexible hollow catheter for tunneting through vessel obstructions Beijing-Shangai Proceedings of an International Conference on Lasers. John Wiley and Sons, Inc. 1980: 685.
Abels GS, Normann SJ, Cohen DM, et al.Laser recanalization of occluded atherosclerotic arteries in vivo and in vitro. Circulation 1985;71: 403–8.
Ginsburg R, Wexler L, Mitchell RS andProfitt D.Percutaneous transluminal laser angioplasty for treatment of peripheral vascular disease: clinicalexperience with sixteen patients. Radiology 1985;156: 619–24.
Geshwind H, Houssignac G, Teisseire B, Benheim N, Bitton R, Laurent D.Conditions for effective Nd: YAG laser angioplasty. Br Heart J 1984;52: 484–9.
Case RB, Choy DSJ, Dwyer D, Silvernail P.Absence of distal emboli during in vivo laser recanalization. Lasers Surg Med 1985;5: 281–9.
Abela GS, Crea F, Smith W, Pepine C, Conti CR.In vitro effects of argon laser radiation on blood: quantitative and morphologic analysis. J Am Coll Cardiol 1985;5: 231–6.
Ginsburg R, Kim D, Githamer D, Toth J, Mitchell R.Salvage of an ischaemic limb by laser angioplasty: description of a new technique. Clin Cardiol 1984;7: 56–8.
Lee G, Seckinger D, Chan MC, et al.Potential complications of coronary laser angioplasty. Am Heart J 1984;106: 1577–9.
Crea F, Fenech A, Smith W, Conti CR, Abela GS.Laser recanalization of acutely thrombosed coronary arteries in live dogs: early results. J Am Coll Cardiol 1985;6: 1052–6.
Crea F, Abela GS, French A, Smith W, Pepine CJ, Conti CR.Transluminal laser irradiation of coronary arteries in live dogs: an angiographic and morphologic study of acute effects. Am J Cardiol 1985;57: 171–6.
Isner JM, Donaldson RF, Funai JT, et al.Factors contributing to perforations resulting from laser coronary angioplasty: observations in an intact human postmortem preparation of intraoperative laser angioplasty. Circulation 1985;72 (suppl II): 191–9.
Choy DSJ, Stertzer SH, Myler RK, Marco J, Fourniai G.Human coronary laser recanalization. Clin Cardiol 1984;7: 377.
Isner JM, Clarke RH, Donaldson RF, Aharon A.Identification of photoproducts liberated by in vitro argon laser irradiation of atherosclerotic plaque, calcified cardiac valves and myocardium. Am J Cardiol 1985;55: 1192–6.
Shelton ME, Hoxworth B, Shelton JA, Virmani GC, Friesinger GC.A new model to study quantitative effects of laser angioplasty on human atherosclerotic plaque. J Am Coll Cardiol 1986;7: 909–15.
Prevosti LG, Lawrence JF, Leon MB, et al.Reduced surface thrombogenicity after thermal ablation of plaque. Circulation 1987; 76 (Suppl IV): 1625.
Grudfest WS, Litvack F, Forrester, JS.Laser ablation of human atherosclerotic plaque without adjacent tissue injury. J Am Coll Cardiol 1985;5: 929–33.
Isner JM, Donaldson RF, Decklbaum LI, et al.The excimer laser: gross, light microscopic and ultrastructural analysis of potential advantges for use in laser therapy of cardiovascular disease. J Am Coll Cardiol 1985;6: 1102–9.
Shehab SA, Schnee MJ, Frazier OH, et al.Excimer laser operating parameters for safe and effective coronary angioplasty and endartectomy. Presented to an International Congress on Laser Applications in Vascular Surgery, Phoenix, 1988.
Leon MB, Smith PD, Lu DU, et al.In vivo excumer laser angioplasty: design criteria ad preliminary animal results. Circulation 1986;74: (Suppl II): 8.
Anderson HV, Zaatari GS, Roubin GS, Leimgruber PP, Gruntzig AR.Steerable fibreoptic catheter delivery of laser energy in atherosclerotic rabbits. Am Heart J 1986;111: 1065–72.
Nordstrom LA, Castaneda-Zuniga WR, Grese GD, Schoster JV.Laser-enhanced transluminal angioplasty: the role of coaxial fibre placement. Seminars Interv Radiol3: 47~52.
Abela GS, Seegar JM, Barbeiri E, et al.Laser angioplasty with angioscopic guidance in humans. J Am Coll Cardiol 1986;8: 184–92.
Keogh BE, Crea F, Davies GD, et al.Angioscopy and intraoperative coronary angioplasty. Lancet 1987; ii: 969.
Chaux A, Lee ME, Blanche C, et al.Intraoperative coronary angioscopy. Technique and results in the first 58 patients. J Thorac Cardiovasc Surg 1986;92: 972–6.
Anonymous.Looking inside arteries (Editorial). Lancet 1987;1: 374~5.
Deckelbaum LI, Stetcz ML, Lam JK, et al.Fiberoptic laser-induced fluorescence detection of atherosclerosis and plaque ablation: potential for laser angioplasty guidance. Circulation 1986;74 (suppl II); 7.
Leon MB, Prevosti LG, Smith JA, et al.In vivo laser-induced fluorescence plaque detection: preliminary results in patients. Circulation 1987;76 (suppl IV): 1623.
Sartori M, Welibaecher D, Henry P, Kubodera S, Tittel F, Sauerbrey R.Autofluorescence maps of human arteries. Circulation 1987;76 (suppl IV): 1624.
Spears JR.Percutaneous laser treatment of atherosclerosis: an overview of emerging techniques. Cardiovasc Intervent Radiol 1986;9: 303–12.
Kaminow IP, Wiesenfeld JM, Choy DSJ.Argon laser disintegration of thrombus and atherosclerotic plaque. Appl Optics 1984;23: 1302.
Prince MR, Deutsch TF, Shapiro AH et al.Preferential light absorption in atheromas in vitro. Implications for laser angioplasty. J Clin Invest 1986;78: 295–302.
Prince MR, Deutsch TF, Shapiro AH et al.Selective ablation of atheromas using a flashlamp excited dye laser at 465 nm. Proc Natl Acad Sci USA 1986;83: 7064–8.
Murphy-Chutorian D, Kosok J, Mok W et al.Selective absorption of ultraviolet laser energy by human atherosclerotic plaque treated with tetracycline. Am J Cardiol 1985;55: 1293–7.
Spears JR, Serur J, Shropshire D, Paulin S.Fluorescence of experimental atheromatous plaques with haematoporphyrin derivative. J Clin Invest 1983;71: 395–9.
Cumberland DC, Tayler DI andProcter AE.Laser assisted percutaneous angioplasty: initial clinical experience in peripheral arteries. Clinical Radiol 1986;37: 423–8.
Ben-Sachar G, Spector ML, Morse DE, Adams ME, Sivakoff MC, Riemenschneider TH.Hazardous byproduct of laser irradiation. A qualitative and quantitative study. J Am Coll Cardiol 1986;7 (2): 46A.
Keogh BE, Pashazadeh M, Crea F, Taylor KM.Laser endarterectomy and angioplasty: a cautionary note. J Thorac Cardiovasc Surg 1987;95: 351–2.
Hussein H.A novel fiberoptic laser probe for treatment of occlusive vessel disease. In Optical and Laser Technology in Medicine SPIE. 1986;605: 59~66.
Sanborn TA, Faxon DP, Haudenschild CC, Ryan TJ.Experimental angioplasty: circumferential distribution of laser energy with a laser probe. J Am Coll Cardiol 1985;5: 934–8.
Litvack F, Grundfest W, Mohr F, Struhl B, Forrester JS.“Hot Tip” angioplasty by a novel radiofrequency catheter. Circulation 1987;76 (suppl IV): 185.
Sanborn TA, Haudenschild CC, Garber GR, Ryan TJ, Faxon DP.Angiographic and histologic consequences of laser thermal angioplasty; comparison with balloon angioplasty. Circulation 1986;75: 1281–6.
Cumberland DC, Sanborn TA, Tayler DI, et al.Percutaneous laser thermal angioplasty; initial clinical results with a laser probe in total peripheral artery occlusions. Lancet 1986;1: 1457–9.
Zeitler E, Richter EI, Seyferth W, Femoro-popliteal Arteries.In:Dotter CT, Gruntzig A, Schoop W, Zeitler E, eds.Percutaneous transluminal angioplasty. Technique, early and late results. Berlin: Springer-Verlag 1983: 105–14.
Martin EC, Frankuchen EI, Karlson KB.Angioplasty for femoral artery occlusion: comparison with surgery. Am J Radiol 1981;137: 915–9.
Myler RK, Cumberland DA, Stertzer SH, Tatpati DA, Sen Sarma PK.High and low power laser thermal angioplasty of total occlusions and restenosis in man. Circulation 1987;76 (suppl IV): 916.
Sanborn TA, Cumberland DC, Welsh CL, Greenfield AJ, Guben JA.Laser thermal angioplasty as an adjunct to peripheral balloon angioplasty: one year follow-up results. Circulation 1987;76 (suppl IV): 916.
Crea F, Davies GJ, McKenna WJ, et al.Transluminal laser treatment with metal-capped optical fibres of normal coronary arteries in live dogs: an angiographic and histological study of the acute effects. Lasers Med Sci 1987;2: 159–63.
Crea F, Davies G, McKenna W, et al.Laser recanalization of coronary arteries by metal-capped optical fibres: early clinical experience in patients with stable angina pectoris. Br Heart J 1988;2: 214.
Cumberland DC, Starkey IR, Oakley GDG, et al.Percutaneous laser-assisted coronary angioplasty. Lancet 1986;2: 214.
Keogh BE, Crea F, Pashazadeh M, Blackie RAS, Taylor KM.Metal-capped optical fibres: Is blood embolization a problem? Advances in Angioplasty. First German Symposim on Laser Angioplasty. Freie Universtat, Berlin, 1987.
Keogh BE, Crea F, Bull T, Blackie RAS, Taylor K.An in vitro study to assess the risk of embolism following lasing of human coronary atherosclerotic plaque with metal capped optical fibres. Eur Heart J 1988;9 (suppl 1): 1393.
Keogh BE, Crea F, Bull T, Blackie RAS, Taylor KM.The effect of lasing with metal-capped optical fibres on atherosclerotic coronary arteries and adjacent coronary side branch origins. Presented at International Congress on Laser Applications in Vascular surgery, Phoenix, 1988.
Geschwind HJ, Blair JD, Mongkolsmai D, et al.Development and experimental application of contact probe catheter for laser angioplasty. J Am Coll Cardiol 1987;9: 101–7.
Verdaasdonk RM, Cross FW, Borst C.Physical properties of sapphire fibretips for laser angioplasty. Lasers Med Sci 1987;2: 183–8.
Bowker TJ, Cross FW, Bown SG, Rickards AF.Reduction of vessel wall perforation by the use of sapphire tipped optical fibres in laser angioplasty. Br Heart J 1987;57: 88.
Fourrier JL, Brunetaud JM, Prat A, et al.Percutaneous laser angioplasty with sapphire tip. Lancet 1987; i: 105.
Cross FW andBowker TJ.Percutaneous laser angioplasty with sapphire tips. Lancet 1987; i: 330.
Lammer J, Pilger E, Ascher WP.Clinical results on Nd: YAG-laser recanalization. Presented at The First German Symposium on Laser Angioplasty. Berlin; November, 1987.
Hiehle JK, Bourgelais DBC, Shaplay S, Schoen FJ, Kim D, Spears R.Nd: YAG laser fusion of human atheromatous plaque arterial wall separations in vitro. Am J Cardiol 1985;56: 953–7.
Sinclair IN, Anand R, Spears R.Laser Balloon angioplasty: thermal profile for in vitro welding of neointimal arterial separations. J Am Coll Cardiol 1987;9: 105A.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Keogh, B.E., Smith, P.L. Laser coronary angioplasty: An evolving technique. Indian J Thorac Cardiovasc Surg 5, 35–46 (1987). https://doi.org/10.1007/BF02664054
Issue Date:
DOI: https://doi.org/10.1007/BF02664054