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Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
Recanalization of failed autogenous conduit utilizing laser revascularization
Rajiv K Chander1, Parind Oza, Mayank Patel
1Department of Surgery, Montefiore Medical Center—North Division, 600 East 233rd Street, Bronx, NY 10466, USA. rchander08820@yahoo.com
Vascular and Endovascular Surgery
|October 11, 2011
Summary
Excimer laser atherectomy (LA) offers a new approach for treating occluded autogenous vein bypasses, particularly those resistant to traditional angioplasty. This endovascular technique successfully recanalized extensive lesions, providing symptom relief and avoiding more invasive surgical revisions.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Therapy
Background:
- Restenosis of autogenous vein bypasses often requires surgical revision, carrying significant morbidity.
- Traditional endovascular methods like angioplasty are challenging for diffuse or extensive longitudinal lesions.
Observation:
- A series of cases involving occluded autogenous saphenous vein bypasses were treated with excimer laser atherectomy (LA).
- Two cases of extensive occlusions (35 cm and 30 cm) that failed angioplasty were successfully treated with LA.
Findings:
- Excimer laser atherectomy (LA) effectively recanalized long-segment occlusions in autogenous vein bypasses.
- Patients experienced resolution of presenting symptoms following LA treatment.
- Follow-up periods of 6 months (infrainguinal) and 1 year (infragencular) demonstrated sustained success.
Implications:
- LA presents a viable endovascular alternative to surgical revision for complex vein bypass occlusions.
- This technique may improve outcomes and reduce morbidity in patients with limb-threatening ischemia due to graft failure.
- Further research into LA for extensive vascular lesions is warranted.
