[Acute and long-term results of coronary Excimer laser angioplasty].
Laser and catheter technology have been considerably improved within the first 2 years of the clinical use of coronary excimer laser angioplasty. Furthermore, patient selection has changed due to increasing operator experience. We report on the acute- and long-term results achieved in 163 patients in three subgroups with different system parameters and catheter technology. In the initial series 1 (N:60) a prototype catheter with a diameter of 1.4 mm was used. In series 2 and 3, we employed improved transmission devices with 1.3, 1.5 or 1.8 mm. In series 3 the pulsewidth was increased from 60 ns to 115 ns. The target vessel was the LAD in 68%, the LCX in 10%, and the RCA in 21%. According to the AHA/ACC Lesion classification there were 13% type A, 26% type B1, 55% type B2, and 5% type C lesions. Stand-alone laser angioplasty was performed in 23/60 (38%), 24/40 (60%), and 34/64 (53%) in series 1, 2, and 3, respectively. Additional balloon angioplasty was necessary in 32, 11, and 21 interventions. Failure of laser angioplasty occurred in five patients of series 1 and 2, and nine patients of series 3. Frequently observed complications included coronary spasm in 18 to 32%, dissections in 16% to 33%, and vessel closure in 18 to 27%. Myocardial infarction occurred in three patients in the first and one patient of the second and third series. There was one in-hospital death in series 1 and 2.(ABSTRACT TRUNCATED AT 250 WORDS)
Baumbach
A
A
Medizinische Klinik, Abteilung III, Eberhard-Karls-Universität, Tübingen.
Wachter
C
C
Haase
K K
KK
Hanke
H
H
Voelker
W
W
Mauser
M
M
Ickrath
O
O
Karsch
K R
KR
D016342:Angioplasty, Laser / Q000295:instrumentation*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012008:Recurrence; D012086:Reoperation
Akut- und Langzeitergebnisse der koronaren Excimer-Laserangioplastie.