Laser-assisted balloon angioplasty in complete femoropopliteal occlusions: preliminary results.
Laser-assisted balloon angioplasty (LA) using a Nd-YAG laser with a sapphire tip probe was performed in 40 selected patients with complete chronic femoropopliteal occlusions (SFA n = 30, PA n = 10), in whom the lesion was resistant to conventional guidewire/catheter traversal. Overall technical success rate was 77.5% (31/40). Technical failure occurred in nine cases due to calcifications (n = 2), imminent perforation (n = 5), or complete perforation (n = 4). In 1 case a Simpson atherectomy was done following LA. In addition, 3 cases of peripheral embolizations were managed successfully by selective fibrinolysis and thrombus aspiration. Follow-up studies up to 14 months demonstrated a clinical improvement in 87% (27/31). Early reocclusion rate was 4/31; after 2-14 months, reocclusion rate was 7/31. Our results demonstrate that LA may be recommended for chronic occlusions resistant to conventional guidewire or catheter traversal in spite of a relatively high rate of technical failure and complications, and recurrence.
Arlart
I P
IP
Radiologisches Institut, Katharinenhospital Stuttgart, FRG.
Gerlach
A
A
Grass
H G
HG
D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects; D016342:Angioplasty, Laser / Q000009:adverse effects; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D002908:Chronic Disease; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery; D012008:Recurrence