The effects of laser energy on the arterial wall

Laser energy has been proposed as a method of resecting atherosclerotic plaque since the mid 1960s. However, only over the past several years have we come to understand some of the unique interactions of the laser with cardiovascular tissue. In laser angioplasty a major challenge has been choosing the optimal laser and duration of laser exposure to achieve adequate resection of plaque, while minimizing such complications as thrombosis, perforation, embolization, aneurysm formation, and accelerated atherosclerosis. Ultimately we must develop a more selective laser that resects plaque while leaving adjacent arterial wall uninjured. This review describes the physics of laser energy, the different lasers available for use in the cardiovascular system, laser-arterial wall interactions, and some of the limitations of laser angioplasty.