Femoropopliteal arterial occlusions: laser-assisted versus conventional percutaneous transluminal angioplasty

Recanalization of 75 femoropopliteal arterial occlusions was attempted with either conventional percutaneous transluminal angioplasty (n = 28; mean occlusion length, 5.5 cm) or percutaneous laser-assisted angioplasty (PLA) (n = 47; mean occlusion length, 11.6 cm). Conventional recanalization was technically successful in 21 patients (mean occlusion length, 4.4 cm +/- 3.9) and was a technical failure in seven (mean occlusion length, 8.7 cm +/- 6.2). The technical outcome was a function of the length of the occlusion (P = .04). The PLA procedure, performed with a laser with a sapphire probe, was a technical success in 32 patients (mean length, 10.7 cm +/- 6.5) and a technical failure in 15 (mean length, 13.6 cm +/- 8.2). With PLA, the length of the occlusion did not determine the technical (P = .20) or clinical (P = .12) outcome. In patients with gangrene, PLA of occlusions longer than 5 cm failed clinically (P = .02). This PLA method appeared to be safe and allowed passage through occlusions longer than 10 cm.