Early experiences with laser-assisted thermal angioplasty for peripheral vascular disease

Laser-assisted angioplasty has been used on 47 occasions in 45 patients for the management of atherosclerosis of the superficial femoral and proximal popliteal arteries. Twenty-four procedures were performed to treat disabling intermittent claudication and 23 procedures were performed for a "threatened limb" (rest pain, ischaemic ulceration or digital gangrene). Technical success was achieved in 40 (85%) cases; the mean length of occluded segment was 7.7 cm. The presence of heavily calcified occlusions contributed significantly (P less than 0.001) to technical failure. In 28 (70%) of the successfully treated cases, the recanalized arteries were patent at one month and in 21 (53%) cases they have remained patent during the follow-up period. In five of nine cases with a nine-month follow-up, the arteries still were patent. The mean length of the occluded segments that were treated initially was 7.1 cm in those that remained patent compared with 8.2 cm in those that reoccluded. Thirty-six (77%) patients were discharged from hospital on the day after the procedure. Laser-assisted angioplasty is a promising new technique that is applied best to short-segment, non-calcified occlusions and should reduce the requirement for femoropopliteal arterial bypass surgery.