[Use of laser in vascular surgery]

The use of lasers in the field of vascular surgery concerns 3 completely different principles of application. The main field is the therapy of hemangiomas and congenital vascular diseases (CVD). The experience of the therapy of congenital diseases can be also used in the treatment of varicosis, especially in the treatment of the perforating veins. In contrast to the angioplasty, where the therapeutic aim is recanalisation of an arterial vessel, in the venous system it is the occlusion of a vessel. The thermal procedures using argon- or Nd:YAG lasers with hot tips, saphire tips or with the bare fiber are no longer relevant. Only photoablation using pulsed lasers is able to remove calcified material. The excimer laser is currently the best known system for angioplasty. New developments, for example solid state lasers like the holmium laser, have as yet to show their advantages. A main emphasis of research should be the improvement of catheter systems since present applications are limited by those currently available catheter systems. Tissue fusion is still an experimental procedure. There is a lot of basic research to be done to establish this procedure in the clinical routine.