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Lasers in Cardiology and Cardiothoracic Surgery

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Lasers in Dermatology and Medicine

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Abstract

History and rationale for laser in the treatment of cardiovascular diseases.

Early applications, growing expectations and the development of realistic perspectives.

Current indications and applications: coronary, peripheral, TMR, EP.

Technique of lasing and catheter technology.

Adverse outcomes.

Future potential.

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References

  1. Choy DSJ. History and state-of-the-art of lasers in cardiovascular disease. Laser Med Surg News Adv. June 1988:34–8.

    Google Scholar 

  2. Cook SI, Eigler NL, Shefer A, et al. Percutaneous excimer laser coronary angioplasty of lesions not ideal for balloon angioplasty. Circulation. 1991;84:632–43.

    Article  CAS  PubMed  Google Scholar 

  3. Koster R, Kahler J, Brockhoff C, Munzel T, Meinhurtz T. Laser coronary angioplasty: history, present and future. Am J Cardiovasc Drugs. 2002;2(3):197–207.

    Article  PubMed  Google Scholar 

  4. Grundfest WS, Litvack F, Goldenberg T, et al. Pulsed ultraviolet lasers and the potential for safe laser angioplasty. Am J Surg. 1985;150:220–6.

    Article  CAS  PubMed  Google Scholar 

  5. Abela GS, Normann SJ, Cohen DM, et al. Laser recanalization of occluded atherosclerotic arteries: an in vivo and in vitro study. Circulation. 1985;71:403–11.

    Article  CAS  PubMed  Google Scholar 

  6. Forrester JS, Litvack F, Grundfest WS. Laser angioplasty and cardiovascular disease. Am J Cardiol. 1986;57:990–2.

    Article  CAS  PubMed  Google Scholar 

  7. Bittl JA, Sanborn TA, Tcheng JE. Clinical success, complications and restenosis rates with excimer laser coronary angioplasty. Am J Cardiol. 1992;70:1553–9.

    Article  Google Scholar 

  8. Geschwind HJ, Dubois-Rande JL, Zelinsky R, et al. Percutaneous coronary mid-infrared laser angioplasty. Am Heart J. 1991;122:552–8.

    Article  CAS  PubMed  Google Scholar 

  9. Bittl JA, Ryan TJ, Keaney JF. Coronary artery perforation during excimer laser coronary angioplasty. J Am Coll Cardiol. 1993;21:1158–65.

    Article  CAS  PubMed  Google Scholar 

  10. Topaz O. Whose fault is it? Notes on “true” versus “pseudo” laser failure. Cathet Cardiovasc Diagn. 1995;36:1–4.

    Article  CAS  PubMed  Google Scholar 

  11. Taylor K, Reiser C. Large eccentric laser angioplasty catheter. In proceedings of lasers in surgery: advanced characterization, therapeutics and systems. SPIE. 1997;2970:34–41.

    Google Scholar 

  12. Tcheng JE. Saline infusion in excimer laser coronary angioplasty. Semin Interv Cardiol. 1996;1:135–41.

    PubMed  CAS  Google Scholar 

  13. Topaz O. A new safer lasing technique for laser facilitated coronary angioplasty. J Interv Cardiol. 1993;6:297–306.

    Article  CAS  PubMed  Google Scholar 

  14. Topaz O. Coronary laser angioplasty. In: Topol EJ, editor. Textbook of interventional cardiology. 2nd ed. Philadelphia: WB Saunders Company; 1995. p. 235–55.

    Google Scholar 

  15. Topaz O, Safian RD. Excimer laser coronary angioplasty. In: Safian RD, Freed MS, editors. Manual of interventional cardiology. 3rd ed. Royal Oaks, MI: Physicians Press; 2001. p. 681–91.

    Google Scholar 

  16. Rawlins J, Shah N, O'Kane P. Ajuvent interventional techniques for the treatment of intra-coronary thrombus. Heart. 2013;99(3):216.

    Article  PubMed  Google Scholar 

  17. Topaz O, Rozenberg EA, Luxenberg MG, Schumacher A. Laser assisted coronary angioplasty in patients with severely depressed left ventricular function: quantitative coronary angiography and clinical results. J Interv Cardiol. 2005;8:661–9.

    Article  Google Scholar 

  18. Topaz O, Minisi AJ, Bernardo NL, Alimar R, Ereso A, Shah R. Comparison of effectiveness of excimer laser angioplasty in patients with acute coronary syndromes in those with and without normal left ventricular function. Am J Cardiol. 2003;91:797–802.

    Article  PubMed  Google Scholar 

  19. Topaz O, Ebersole D, Das T, Alderman EL, Madyoon H, Vora K, Baker JD, Hilton D, Dahm JB. Excimer laser angioplasty in acute myocardial infarction [the CARMEL multicenter study]. Am J Cardiol. 2004;93:694–701.

    Article  PubMed  Google Scholar 

  20. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012;33:2569–619.

    Article  CAS  Google Scholar 

  21. American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction. J Am Coll Cardiol. 2013;61:e78–140.

    Google Scholar 

  22. Dahm JB, Topaz O, Woenckhaus C, et al. Laser facilitated thrombectomy: a new therapeutic option for treatment of thrombus-laden coronary lesions. Catheter Cardiovasc Interv. 2002;56:365–72.

    Article  PubMed  Google Scholar 

  23. Topaz O, Minisi AJ, Morris C, Mohanty PK, Carr ME Jr. Photoacoustic fibrinolysis: pulsed-wave, mid infrared laser-clot interaction. J Thrombo Thrombolysis. 1996;3:209–14.

    CAS  Google Scholar 

  24. Topaz O, Minisi AJ, Bernardo NL, McPherson RA, Martin E, Carr SL, Carr ME Jr. Alterations of platelet aggregation kinetics with ultraviolet laser emission: the stunned platelet “phenomenon”. Thromb Haemost. 2001;86:1087–93.

    Article  CAS  PubMed  Google Scholar 

  25. Topaz O, Bernardo NL, Shah R, et al. Effectiveness of excimer laser coronary angioplasty in acute myocardial infarction or in unstable angina pectoris. Am J Cardiol. 2001;87:849–55.

    Article  CAS  PubMed  Google Scholar 

  26. Topaz O, Ebersole D, Dahm JB, Alderman EL, Madyoon H, Vora K, Baker JD, Hilton D, Das T. Excimer laser in myocardial infarction: a comparison between STEMI patients with established Q-Wave versus patients with non-STEMI. Lasers Med Sci. 2008;23:1–10.

    Article  PubMed  Google Scholar 

  27. Topaz O, Shah R, Mohanty PK, McQueen RA, Janin Y, Bernardo NL. Application of excimer laser angioplasty in acute myocardial infarction. Lasers Surg Med. 2001;29:185–92.

    Article  CAS  PubMed  Google Scholar 

  28. Dorr M, Vogelgesang D, Hummel A, et al. Excimer laser thrombus elimination for prevention of distal embolisation and no-reflow in patients with acute ST elevation myocardial infarction: results from the randomised LaserAMI study. Int J Cardiol. 2007;116:20–6.

    Article  PubMed  Google Scholar 

  29. Niccoli G, Belloni F, Cosentino N, Fracassi F, Falcioni E, Roberto M, Panico RA, Mongiardo R, Porto I, Leone AM, Burzotta F, Trani C, Crea F. Case-control registry of excimer laser coronary angioplasty versus distal protection devices in patients with acute coronary syndromes due to saphenous vein graft disease. Am J Cardiol. 2013;112(10):1586–91.

    Article  PubMed  Google Scholar 

  30. Shishikura D, Otsuji S, Takiuchi S, Fukumoto A, Asano K, Ikushima M, Yasuda T, Hasegawa K, Kashiyama T, Yabuki M, Hanafusa T, Higashino Y. Vaporizing thrombus with excimer laser before coronary stenting improves myocardial reperfusion in acute coronary syndrome. Circ J. 2013;77(6):1445–52.

    Article  PubMed  Google Scholar 

  31. Bittl JA. Clinical results with excimer laser coronary angioplasty. Semin Interv Cardiol. 1996;1:129–34.

    PubMed  CAS  Google Scholar 

  32. Bilodeau L, Fretz EB, Taeymans Y, Koolen J, Taylor K, Hilton DJ. Novel use of a high energy excimer laser catheter for calcified and complex coronary artery lesions. Cath Cardiovasc Interv. 2004;62:155–61.

    Article  Google Scholar 

  33. McKenzie DB, Talwar S, Jokhi PP, O’Kane PD, Osherov A, Strauss B, Dahm J. How should I treat severe coronary artery calcification when it is not possible to inflate a balloon or deliver a RotaWire? EuroIntervention. 2011;6(6):779–83.

    Article  PubMed  Google Scholar 

  34. Fernandez JP, Hobson AR, McKenzie D, Shah N, Sinha MK, Wells TA, Levy TM, Swallow RA, Talwar S, O'Kane PD. Beyond the balloon: excimer coronary laser atherectomy used alone or in combination with rotational atherectomy in the treatment of chronic total occlusions, non-crossable and non-expansible coronary lesions. EuroIntervention. 2013;9(2):243–50.

    Article  PubMed  Google Scholar 

  35. Werner GS, Schofer J, Sievert H, Kugler C, Reifart NJ. Multicentre experience with the BridgePoint devices to facilitate recanalisation of chronic total coronary occlusions through controlled subintimal re-entry. EuroIntervention. 2011;7:192–200.

    Article  PubMed  Google Scholar 

  36. Joyal D, Thompson CA, Grantham JA, Buller CE, Rinfret S. The retrograde technique for recanalization of chronic total occlusions: a step-by-step approach. JACC Cardiovasc Interv. 2012;5:1–11.

    Article  PubMed  Google Scholar 

  37. Topaz O. Laser for chronic total occlusions recanalization. In: Waksman R, Saito S, editors. Chronic total occlusions—a guide to recanalization. 2nd ed. Oxford: Wiley–Blackwell; 2013. p. 251–6.

    Chapter  Google Scholar 

  38. Holmes DR Jr, Forrester JS, Litvack F, et al. Chronic total obstructions and short term outcome: the excimer laser angioplasty registry experience. Mayo Clin Proc. 1993;68:5–10.

    Article  PubMed  Google Scholar 

  39. Sunew J, Chandwaney RH, Stein DW, et al. Excimer laser facilitated percutaneous coronary intervention of a nondilatable coronary stent. Catheter Cardiovasc Interv. 2001;53:513–7.

    Article  CAS  PubMed  Google Scholar 

  40. Latib A, Takagi K, Chizzola G, Tobis J, Ambrosini V, Niccoli G, Sardella G, DiSalvo ME, Armigliato P, Valgimigli M, Tarsia G, Gabrielli G, Lazar L, Maffeo D, Colombo A. Excimer Laser LEsion modification to expand non-dilatable stents: the ELLEMENT registry. Cardiovasc Revasc Med. 2014;15(1):8–12.

    Article  PubMed  Google Scholar 

  41. Egred M. A novel approach for under-expanded stent: excimer laser in contrast medium. J Invasive Cardiol. 2012;24(8):E161–3.

    PubMed  Google Scholar 

  42. Fernadez J, Hobson AR, Mckenzie DB, Talwar S, O’Kane P. How should I treat severe calcific coronary artery disease? EuroIntervention. 2011;3:400–7.

    Article  Google Scholar 

  43. Dahm JB. Excimer laser coronary angioplasty for diffuse in stent restenosis: beneficial long-term results after sufficient debulking with a lesion-specific approach using various laser catheters. Lasers Med Sci. 2001;16:84–9.

    Article  CAS  PubMed  Google Scholar 

  44. Mehran R, Mintz GS, Satler LF, et al. Treatment of in-stent restenosis with excimer laser coronary angioplasty: mechanisms and results compared to PTCA alone. Circulation. 1997;96:2183–9.

    Article  CAS  PubMed  Google Scholar 

  45. Dahm JB, Kuon E. High-energy eccentric excimer laser angioplasty for debulking diffuse in-stent re-stenosis leads to better accurate and 6-month follow-up results. J Invasive Cardiol. 2000;12(7):335–42.

    PubMed  CAS  Google Scholar 

  46. Bittl JA, Sanborn TA, Yardley DE, et al. Predictors of outcome of percutaneous excimer laser coronary angioplasty of saphenous vein bypass lesions. Am J Cardiol. 1994;74:144–8.

    Article  CAS  PubMed  Google Scholar 

  47. Topaz O. Holmium laser angioplasty. Semin Intervent Cardiol. 1996;1:149–61.

    CAS  Google Scholar 

  48. Ebersole DG. Excimer laser for revascularization of saphenous vein grafts. Lasers Med Sci. 2001;16:78–83.

    Article  CAS  PubMed  Google Scholar 

  49. Rawlins J, Green M, Talwar S, O’Kane P. Optical coherance tomography tomography following percutaneous coronary intervention with Excimer laser atherectomy. Cardiovasc Revasc Med. 2014;15(1):29–34.

    Article  PubMed  Google Scholar 

  50. Topaz O, Polkampally PR, Mohanty PK, Rizk M, Bangs J, Bernardo NL. Excimer laser debulking for percutaneous coronary intervention in left main coronary artery disease. Lasers Med Sci. 2009;24(6):955–60.

    Article  PubMed  Google Scholar 

  51. Tcheng JE, Bittl JA, Sanborn TA, et al. Treatment of aorto-ostial disease with percutaneous excimer laser coronary angioplasty. Circulation. 1992;86(Suppl I):1–512A.

    Google Scholar 

  52. Eigler NL, Weinstock B, Douglas JS, et al. Excimer laser coronary angioplasty of aorto-ostial stenosis: results of the excimer laser coronary angioplasty [ELCA] registry in the first 200 patients. Circulation. 1993;88:2049–57.

    Article  CAS  PubMed  Google Scholar 

  53. Topaz O. Myocardial revascularization: the role of the Vineberg operation and related procedures. In: Abela GS, editor. Myocardial revascularization-novel percutaneous approaches. New York: Wiley-Liss; 2002. p. 3–12.

    Google Scholar 

  54. Spanier T, Smith CR, Burkhoff D. Angiogenesis: a possible mechanism underlying the clinical benefits of transmyocardial laser revascularization. J Clin Med Surg. 1997;15:269–73.

    Article  CAS  Google Scholar 

  55. Li W, Chiba Y, Kimura T, et al. Transmyocardial laser revascularization induced angiogenesis correlated with the expression of matrix metalloproteinases and platelet-derived endothelial cell growth factor. Eur J Cardiothorac Surg. 2001;19:156–63.

    Article  CAS  PubMed  Google Scholar 

  56. Canestri F. Thermal lesions produced by CO2 laser beams: new findings to improve the quality of minimally invasive and transmyocardial laser revascularization protocols. Clin Laser Med Surg. 2000;18:49–55.

    Article  CAS  Google Scholar 

  57. Horvath KA, Cohn LH, Cooley DA, et al. Transmyocardial laser revascularization: results of a multicenter trial with transmyocardial laser revascularization used as sole therapy for end–stage coronary artery disease. J Thorac Cardiovasc Surg. 1997;113:645–53.

    Article  CAS  PubMed  Google Scholar 

  58. Allen KB, Dowling RD, Fudge TL, et al. Comparison of transmyocardial revascularization with medical therapy in patients with refractory angina. N Engl J Med. 1999;341:1029–36.

    Article  CAS  PubMed  Google Scholar 

  59. Aaberge L, Nordstrand K, Dragsund M, et al. Transmyocardial revascularization with CO2 laser in patients with refractory angina pectoris. J Am Coll Cardiol. 2000;35:1170–7.

    Article  CAS  PubMed  Google Scholar 

  60. Van Der Sloot JAP, Huikeshhoven M, Tukkie R, et al. Transmyocardial revascularization using an XeCL excimer laser: results of a randomized trial. Ann Thorac Surg. 2004;78:875–81.

    Article  PubMed  Google Scholar 

  61. Godwak LH, Schettert IT, Rochitte CE. Transmyocardial laser revascularization plus cell therapy for refractory angina. Int J Cardiol. 2008;127:295–7.

    Article  Google Scholar 

  62. Hayat N, Shafie M, Gumaa MK, Khan N. Transmyocardial revascularization: is the enthusiasm justified? Clin Cardiol. 2001;24:321–4.

    Article  CAS  PubMed  Google Scholar 

  63. Minisi AJ, Topaz O, Quinn SM, Mohanty LB. Cardiac nociceptive reflexes after transmyocardial laser revascularization: implications for the neural hypothesis of angina relief. J Thorac Cardiovasc Surg. 2001;122:712–9.

    Article  CAS  PubMed  Google Scholar 

  64. Topaz O, Cowley MJ, Mohanty PK, Vetrovec GW. Percutaneous revascularization modalities for heart transplant recipients. Catheter Cardiovasc Interv. 1999;46:227–37.

    Article  CAS  PubMed  Google Scholar 

  65. Topaz O, Bailey NT, Mohanty PK. Application of solid state pulsed wave mid infrared laser for percutaneous revascularization in heart transplant recipient. J Heart Lung Transplantation. 1998;17:505–10.

    CAS  Google Scholar 

  66. Topaz O, Janin Y, Bernardo N. Coronary revascularization in heart transplant recipients by excimer laser angioplasty. Laser Surg Med. 2000;26:425–31.

    Article  CAS  Google Scholar 

  67. Moskowitz WB, Titus JL, Topaz O. Excimer laser ablation for valvular angioplasty in pulmonary atresia and intact ventricular septum. Lasers Surg Med. 2004;35:327–35.

    Article  PubMed  Google Scholar 

  68. Isner JM, Rosenfield K. Redefining the treatment of peripheral artery disease: role of percutaneous revascularization. Circulation. 1993;84:1534–57.

    Article  Google Scholar 

  69. Das TS. Percutaneous peripheral revascularization with excimer laser: equipment, technique and results. Lasers Med Sci. 2001;16:101–7.

    Article  CAS  PubMed  Google Scholar 

  70. Boccalandro F, Muench A, Sdringola S, et al. Wireless laser-assisted angioplasty of the superficial femoral artery in patients with critical limb ischemia who have failed conventional percutaneous revascularization. Catheter Cardiovasc Interv. 2004;63:7–12.

    Article  PubMed  Google Scholar 

  71. Editorial TO. Rescue excimer laser angioplasty for treatment of critical limb ischemia. Catheter Cardiovasc Interv. 2004;63:13–4.

    Article  Google Scholar 

  72. Biamino GC, Ragg JC, Struk B, et al. Long occlusions of the superficial femoral artery: success rate and 1 year follow-up after excimer laser assisted angioplasty. Eur Heart J. 1994;15(Suppl):147.

    Google Scholar 

  73. Gilligan DM, Dan D. Excimer laser for pacemaker and defibrillator lead extraction: techniques and clinical results. Lasers Med Sci. 2001;16:113–21.

    Article  CAS  PubMed  Google Scholar 

  74. Sohal M, Williams S, Akhtar M, Shah A, Chen Z, Wright M, O’Neill M, Patel N, Hamid S, Cooklin M, Bucknall C, Bostock J, Gill J, Rinaldi CA. Laser lead extraction to facilitate cardiac implantable electronic device upgrade and revision in the presence of central venous obstruction. Europace. 2014;16:81–7.

    Article  PubMed  Google Scholar 

  75. Worley SJ, Gohn DC, Pulliam RW. Excimer laser to open refractory subclavian occlusion in 12 consecutive patients. Heart Rhythm. 2010;7(5):634–8.

    Article  PubMed  Google Scholar 

  76. Sediva L, Petru J, Skoda J, Janotka M, Chovanec M, Reddy V, Neuzil P. Visually guided laser ablation: a single-centre long-term experience. Europace. 2014;16(12):1746–51.

    Article  PubMed  Google Scholar 

  77. Topaz O, Polkampally PR, Topaz A, Jara J, Rizk M, Polkampally CR, McDowell K, Feldman G. Utilization of excimer laser debulking for critical lesions unsuitable for standard renal angioplasty. Lasers Surg Med. 2009;41:622–7.

    Article  PubMed  Google Scholar 

  78. Topaz O. The thrombus containing lesion. In: Topol EJ, Teirstein P, editors. Textbook of interventional cardiology. 7th ed. Philadelphia: Elsevier; 2015. p. 439–63.

    Google Scholar 

  79. Topaz A, Topaz O. Laser in acute myocardial infarction. In: Topaz O, editor. Cardiovascular laser interventions. London: Springer; 2015. p. 55–88.

    Chapter  Google Scholar 

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Authors and Affiliations

  1. Dorset Heart Centre, Royal Bournemouth Hospital, Bournemouth, UK

    Andrew Whittaker M.B.C.h.B., M.D., M.R.C.P., John Rawlins B.Sc., M.B.B.S., M.D., M.R.C.P. & Peter O’Kane B.Sc., M.B.B.S., M.D., F.R.C.P.

  2. Hackensack University Medical Center, Hackensack, NJ, USA

    Allyne Topaz M.D.

  3. Asheville VA Medical Center, Asheville, NC, USA

    On Topaz M.D.

  4. Duke University Medical School, Durham, NC, USA

    On Topaz M.D.

Authors
  1. Andrew Whittaker M.B.C.h.B., M.D., M.R.C.P.
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  2. John Rawlins B.Sc., M.B.B.S., M.D., M.R.C.P.
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  3. Allyne Topaz M.D.
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  4. On Topaz M.D.
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  5. Peter O’Kane B.Sc., M.B.B.S., M.D., F.R.C.P.
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Correspondence to Andrew Whittaker M.B.C.h.B., M.D., M.R.C.P. .

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Editors and Affiliations

  1. Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA

    Keyvan Nouri

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Whittaker, A., Rawlins, J., Topaz, A., Topaz, O., O’Kane, P. (2018). Lasers in Cardiology and Cardiothoracic Surgery. In: Nouri, K. (eds) Lasers in Dermatology and Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-76220-3_9

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