[Value of the combined Lastac laser-angioplasty technic in symptomatic superficial femoral occlusion].
The results of peripheral transluminal angioplasty are satisfactory in stenotic arteries but those observed in the recanalisation of occluded peripheral arteries are not so good. There would therefore seem to be a good therapeutic opportunity for laser between angioplasty and surgery for patients with symptomatic arterial occlusion. The authors report their experience with the Lastac laser in 12 patients with symptomatic superficial femoral arterial occlusion. This is a no-contact laser. All patients had surgical indications in case of failure to recanalise by laser, despite collateral circulation by the profunda artery which was inadequate on effort leading to claudication and a limited walking perimeter. After 1 initial failure, 11 successful procedures were performed. There were no perforations due to the Argon laser beam but 2 were observed with the guide wire which was rapidly sealed by the balloon catheter. A surgical haematoma at the percutaneous puncture point resulted in 1 reocclusion during the patient's hospital period so that the 11 technical successes became 10 clinical successes. At medium-term follow-up, one asymptomatic occlusion had occurred and one restenosis was successfully redilated. The advantages of a continuous Argon "Lastac" laser compared with a contact laser are its capacity for auto-control, its coaxial fibre placement and the absence of direct contact with the lesion. The coaxial fibre arrangement plays an important role in preventing vascular perforation. These factors enable it to be used with more safety in patients with arterial occlusion.
Valeix
B
B
Unité cardio-vasculaire, clinique Casamance, Aubagne.
Labrunie
P
P
Nebunu
J C
JC
Boyer
C
C
Escojido
H
H
Dravet
F
F
Gautier
J P
JP
D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D012008:Recurrence
Intérêt de la technique combinée Lastac laser-angioplastie dans les occlusions fémorales superficielles symptomatiques.