Percutaneous laser angioplasty with a pulsed Nd:YAG laser. Initial clinical experience and early follow-up

Percutaneous laser-assisted balloon angioplasty with a pulsed Nd:YAG laser coupled to sapphire tipped optical fibers was used for the treatment of 22 patients presenting with 30 chronic occlusions of peripheral arteries (mean length 11 cm) during 25 sessions. The procedure was completed by balloon dilatation in 67%. Successful recanalization was achieved in 92%, clinically the procedure was successful in 68% with mean ABPI increase from 0.43 +/- 0.13 to 0.79 +/- 0.21. In 8 cases complications occurred. Two reocclusions were treated by streptokinase infusion, and 2 procedures were repeated 2 months later, one patient was referred to elective bypass surgery, and 3 patients were treated conservatively. Six patients were followed-up for more than 6 months. In 1 patient claudication of 400 m reappeared. These results are encouraging and it is likely that this method could become an important adjunct to balloon angioplasty.