Laser angioplasty of peripheral arterial occlusive disease

To evaluate the impact of laser ablation of arteriosclerotic material on the long-term results of transluminal angioplasty, 103 patients were treated by laser-assisted recanalization of peripheral arterial occlusion and followed-up for 6 and 12 months. Two pulsed laser systems (308 nm-excimer laser and 504 nm-dye laser) were tested. Laser energy was transmitted via wire-guided 4.5-, 7- and 9-French multifiber catheters. Stand-alone laser angioplasty was possible in 22% of the patients, especially in the popliteal and the lower-limb arteries. Compared to the results of balloon dilatation in the literature, the clinical success rate at 6 and 12 months after the treatment was better in occlusions with a length between 6 and 10 cm, however no improvement was seen in either shorter or longer occlusion. Due to the limited size of percutaneously applicable catheters, laser treatment and pretreatment seemed to be of most benefit in distal femoropopliteal arteries and in lower-limb arteries. Clinical improvement after revascularization depends on a sufficient run-off in branching vessels distal to the recanalized artery segment.