Laser angioplasty: a review

Laser angioplasty enables the removal of atheromatous material from arterial plaques, and may reduce the rate of restenosis, which is the main problem with balloon angioplasty. Extensive experimental work seems to indicate that pulse-mode lasers (such as excimer) are more suitable than continuous-mode lasers, while the wavelength may be of less importance for plaque removal. However, optical fibers capable of transmitting the laser radiation are available for only certain laser wavelengths, and their absence may presently limit the use of some potentially effective lasers (such as CO2 and excimer). Catheter systems are crucial for clinical application; they provide efficient laser-fiber coupling, protect the distal tip and improve the efficiency and accuracy of laser emission. The coupling of balloon and laser angioplasty, and the "hot tip" thermal laser angioplasty have extended the potential use of laser angioplasty. Clinical application in the peripheral arteries, and experimental coronary human laser angioplasty studies, are described.