Initial results and subsequent outcome of laser thermal-assisted balloon angioplasty of 56 consecutive femoropopliteal lesions.
Laser thermal-assisted balloon angioplasty (LABA) was prospectively applied in the treatment of 56 atherosclerotic femoropopliteal occlusive lesions in 51 consecutive patients. All procedures were performed in the operating room using a neodynium:yttrium-aluminum-garnet (Nd:YAG) laser source, and patients were evaluated for immediate and long-term hemodynamic and clinical improvement. Technically successful recanalization was achieved in 82% of cases, with 57% of all patients (32 of 56) obtaining early hemodynamic and clinical improvement. Long-term clinical success (by life-table analysis) was obtained by only 22.5% at 6 months, and only 13.5% at 12 months. Patients presenting with intermittent claudication did significantly better than those presenting for limb salvage (p = 0.01), and trends toward improved outcome were noted for short versus long lesions as well as for patients with "good" versus "poor" distal runoff (NS). Procedure-related morbidity occurred in 14%, and there was one peri-procedural mortality (1.8%). We conclude that the use of LABA is associated with long-term clinical success in only a small proportion of patients, and that widespread clinical application of this technique is not indicated at the present time.
Feinberg
R L
RL
Division of Vascular Surgery, Eastern Virginia Graduate School of Medicine, Norfolk 23510.
Wheeler
J R
JR
Gregory
R T
RT
Snyder
S O
SO
Gayle
R G
RG
Parent
F N
FN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D011446:Prospective Studies