Laser recanalization, laser assisted balloon angioplasty and laser angioplasty

The efficacy of laser recanalization (LR), laser assisted balloon angioplasty (LABA) and laser angioplasty (LA) was evaluated. These procedures were performed a total of 55 times upon 49 patients who had occlusive arterial disease of a lower extremity with a history of incapacitating, intermittent claudication, rest pain or loss of tissue, or all three. Patients with lesions through which a guide wire could be passed were eliminated from this study. Two lesions in the common iliac artery, 44 in the superficial femoral artery, seven in the popliteal artery and two in the infrapopliteal artery were studied. Thirty-nine of 55 lesions (71 per cent), including 12 of 12 stenoses and 27 of 43 occlusions (63 per cent), were successfully recanalized. None of the seven total length occlusions were successfully recanalized (p less than 0.001); perforation occurred in four. Bypass procedures were required in six of 13 and two of 25 lesions treated by LR and LABA, respectively (p less than 0.05). All patients with lesions successfully recanalized using LR, LABA and LA were observed for a period of 15 days to six months, with an 82 per cent patency rate (32 of 39). Total length occlusions are not a good indication for treatment with currently available laser techniques. The addition of balloon dilation in LR decreased the requirement for bypass procedures in a significant number of patients.