Lasers And Angioplasty

Abstract

Percutanous transluminal coronary angioplasty (PTCA) has revolutionized the treatment of coronary disease. However, a high restenosis rate is still a major complication of PTCA. In theory, the incidence of restenosis might be lower with laser techniques because atheromatous mass within the artery can be removed rather than pressed against the vessel wall. Further, the treated surface may be less ragged and less prone to inducing smooth muscle proliferation. The basic laser angioplasty systern comprises the laser, fiberoptic laser delivery catheter, and a means to guide the catheter to its target site. A variety of lasers are used with the excimer laser receiving the most current interest. Laser systems are effective as a means of opening small channels in obstructed peripheral or coronary arteries. The lasers can be used alone or as a supplement to balloon angioplasty. Despite favorable initial results, late restenosis continues to be a nagging problem with lasers. However, with certain types of lesions lasers appear to have a lower restenosis rate than conventional balloon angioplasty.