Laser Atherectomy in Peripheral Arterial Interventions

Chapter

Abstract

Xenon Chloride Excimer Laser via using fiberoptic catheters delivers pulsatile energy that breaks the carbon bonds in atherosclerotic plaque and thrombi and ablates tissue (photoablation) that is in contact with the catheter. These features make laser atherectomy an efficient tool in the treatment of peripheral arteries with higher atherosclerotic burden and thrombus, as well as in the treatment of diffuse intimal hyperplasia that is seen with in-stent restenosis of previously stented peripheral arteries.

Keywords

Xenon Chloride Excimer Laser Laser atherectomy Peripheral arterial disease Atherectomy Photoablation 

References

  1. 1.
    Akkus NI, Abdulbaki A, Jimenez E, Tandon N. Atherectomy devices: technology update. Med Devices (Auckl). 2014;8:1–10.Google Scholar
  2. 2.
    Casserly IP, Sachar R, Yadav JS. In: Casserly I, editor. Practical peripheral vascular intervention. 2nd ed. Wolters Kluwer: Lippincott William and Wilkins; 2011.Google Scholar
  3. 3.
    Lawrence JB, Prevosti LG, Kramer WS, Smith PD, Bonner RF, Lu DY, Leon MB. Pulsed laser and thermal ablation of atherosclerotic plaque: morphometrically defined surface thrombogenicity in studies using an annular perfusion chamber. J Am Coll Cardiol. 1992;19:1091–100.CrossRefGoogle Scholar
  4. 4.
    Rogers JH, Laird JR. Overview of new technologies for lower extremity revascularization. Circulation. 2007;116(18):2072–85.CrossRefGoogle Scholar
  5. 5.
    Taylor K, Reiser C. Next generation catheters for excimer laser coronary angioplasty. Lasers Med Sci. 2001;16:133–40.CrossRefGoogle Scholar
  6. 6.
    Laird JR, Zeller T, Gray BH, et al. Limb salvage following laser-assisted angioplasty for critical limb ischemia: results of the LACI multicenter trial. J Endovasc Ther. 2006;13(1):1–11.CrossRefGoogle Scholar
  7. 7.
    Dippel EJ, Makam P, Kovach R, George JC, et al. Randomized controlled study of excimer laser atherectomy for treatment of femoropopliteal in-stent restenosis: initial results from the EXCITE ISR trial (EXCImer laser randomized controlled study for treatment of FemoropopliTEal in-stent restenosis). JACC Cardiovasc Interv. 2015;8(1 Pt A):92–101.CrossRefGoogle Scholar
  8. 8.
    Walker C; EXCITE ISR Investigators. Presented in 2015 New Cardiovascular Horizons meeting, New Orleans; 2015.Google Scholar
  9. 9.
    Schmidt A, Zeller T, Sievert H, et al. Photoablation using the turbo-booster and excimer laser for in-stent restenosis treatment: twelve-month results from the PATENT study. J Endovasc Ther. 2014;21:52–60.CrossRefGoogle Scholar
  10. 10.
    Dave RM, Patlola R, Kollmeyer K, et al. Excimer laser recanalization of femoropopliteal lesions and 1-year patency: results of the CELLO registry. J Endovasc Ther. 2009;16:665–75.CrossRefGoogle Scholar
  11. 11.
    On Topaz. Lasers in cardiovascular interventions. In: Robert A, editor. Gallalino laser for treatment of complex superficial femoral artery disease. London: Springer-Verlag; 2015. p. p167–9.Google Scholar
  12. 12.
    van Leeuwen TG, Meertens JH, Velema E, Post MJ, Borst C. Intraluminal vapor bubble induced by excimer laser pulse causes microsecond arterial dilation and invagination leading to extensive wall damage in the rabbit. Circulation. 1993;87(4):1258–63.CrossRefGoogle Scholar
  13. 13.
    Mauro MA, Murphy KPJ, Thomson KR. Image guided interventions; expert radiology series. In: Balzer JO, Kahn V, editors. Endovascular laser Threapy. Philadelphia: Sounders; 2014. p. E111–7.Google Scholar
  14. 14.
    Isner JM, Pickering JG, Mosseri M. Laser-induced dissections: pathogenesis and implications for therapy. J Am Coll Cardiol. 1992;19:1619–21.CrossRefGoogle Scholar
  15. 15.
    Grundfest WS, Litvack F, Forrester JS, et al. Laser ablation of human atherosclerotic plaque without adjacent tissue injury. J Am Coll Cardiol. 1985;5:929–33.CrossRefGoogle Scholar
  16. 16.
    Tcheng JE. Saline infusion in excimer laser coronary angioplasty. Semin Interv Cardiol. 1996;1:135–41.PubMedGoogle Scholar
  17. 17.
    Scheinert and Biamino. Femeropopliteal occlusions: experience with peripheral Excimer laser angioplasty. Curr Intervl Cardiol Rep. 2001;3:130–8.CrossRefGoogle Scholar
  18. 18.
    Biamino and Scheinert. Excimer laser treatment of SFA occlusions. Endovascular Today. 2003;37:1–4.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Baptist Health CardiologyLittle RockUSA
  2. 2.Louisiana State University – Shreveport, Department of Medicine- Section of CardiologyShreveportUSA

Personalised recommendations