Laser Uses in Noncoronary Arterial Disease

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Therapy

Background:

• Excimer laser angioplasty (ELA) has gained prominence for treating peripheral artery disease (PAD).
• Laser technology is increasingly used for off-label applications, including in situ fenestration of aortic endografts.
• This review synthesizes the therapeutic applications of lasers in arterial disease management.

Purpose of the Study:

• To review the diverse therapeutic applications of lasers in treating arterial diseases.
• To evaluate the efficacy of excimer laser angioplasty in peripheral artery disease.
• To explore novel, off-label uses of laser technology in endovascular interventions.

Main Methods:

• Systematic literature review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
• Inclusion of 106 relevant English-language papers, with exclusion of unrelated articles, letters, commentaries, and reviews.
• Analysis of 26 selected articles forming the basis of this comprehensive review.

Main Results:

• For PAD atherosclerotic plaques, ELA showed a mean primary patency of 65% ± 20% with a 5% distal embolism rate.
• In-stent restenosis treatment via ELA achieved 98% technical success and 68% ± 18% primary patency with a 9% distal embolism rate.
• Off-label laser uses included in situ fenestrations for complex aortic aneurysms in 5 of 8 described articles.

Conclusions:

• Laser atherectomy and laser-assisted techniques represent significant advancements in vascular surgery.
• These laser modalities are essential components of the interventionalist's toolkit.
• The review underscores the expanding role and efficacy of lasers in managing arterial diseases.