The thrombogenic potential of argon ion laser endarterectomy

The surface thrombogenicity of atheromas, conventional endarterectomy (CE), laser endarterectomy (LE), and laser angioplasty (LA) were compared in the rabbit arteriosclerosis model. Normal (N = 6) and arteriosclerotic (N = 15) rabbits underwent thoracoabdominal exploration. Multiple CEs and LEs were performed in 12 arteriosclerotic rabbits leaving a segment of intact atheroma between each endarterectomy. Multiple LAs were performed in three arteriosclerotic rabbits. Argon ion laser radiation was used for all laser procedures. Blood (0.05 ml) from normal rabbits was placed on the CE surface, LE surface, LA surface, atheroma, and normal intima and clotting times were determined. Surface thrombogenicity was calculated as the ratio of the clotting time of the CE, LE, LA, or atheroma to normal intima. Surface thrombogenicity was 1.0 +/- 0.03 for normal intima (control), 0.58 +/- 0.06 for atheromas (P less than 0.001), 0.46 +/- 0.08 for CE (P less than 0.001 from atheromas), 0.46 +/- 0.08 for LE (P = NS from CE), and 0.27 +/- 0.09 for LA (P less than 0.001 from CE and LE). The thrombogenicity of LE is the same as the thrombogenicity of CE. Both forms of endarterectomy are less thrombogenic than LA in the rabbit model.