Laser angioplasty of the iliac arteries.
Laser-assisted balloon angioplasty has the potential to reduce mortality and morbidity by replacing aorto-femoral bypass operations in patients with occlusion of the iliac arteries. We present our early experience with 16 patients undergoing this procedure, using a Cardiolase neodymium:yttrium aluminum garnet (Nd:YAG) laser in the operating room. Initial recanalization was achieved in 14 of the 16 patients. Early re-occlusion occurred in 4 patients, one of whom had a successful repeat laser angioplasty. This patient, together with the remaining 10 patients with successful initial recanalization remain patent at a mean follow-up period of 10 months. There were no deaths or chest complications. Angiographically demonstrated arterial perforation occurred in 2 patients, neither of whom required operation on the perforated segment. We conclude that recanalization of the iliac arteries is possible and safe. The procedure is unlikely to replace aorto-femoral bypass until the proportion of early failures is reduced. This may require larger probes or the immediate placement of intra-arterial stents following laser angioplasty.
May
J
J
Department of Surgery, University of Sydney, Camperdown, New South Wales, Australia.
White
G H
GH
Waugh
R C
RC
Walker
P J
PJ
Harris
J P
JP
D000368:Aged; D016342:Angioplasty, Laser / Q000009:adverse effects / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011859:Radiography; D012008:Recurrence; D012086:Reoperation