Expanded indications for laser-assisted balloon angioplasty in peripheral arterial disease.
Successful recanalization of isolated femoropopliteal occlusions by laser-assisted balloon angioplasty has been widely reported. However, the utility of this approach in other sites remains undetermined. The potential of laser-assisted balloon angioplasty in the treatment of a broad spectrum of lower extremity atherosclerosis was explored. Seventy-seven limbs in 69 patients were treated with laser-assisted balloon angioplasty by means of a percutaneous approach. Technical success was achieved in 62/77 (81%), with 52/77 (68%) open at discharge. At a mean of 8.6 months' follow-up, cumulative patency was 50% at 6 months and 42% at 9 months. In 10 cases initial guide wire placement was not possible; primary laser probe passage was technically successful in six, with two open at latest follow-up. Eleven patients underwent laser therapy without balloon angioplasty of distal sites with technical success in eight; at most recent follow-up five were open at the site of sole laser therapy. Complications were frequent. Bleeding requiring transfusion occurred in six, with three patients requiring emergency surgery; worsened ischemia necessitating urgent arterial bypass grafting developed in five patients. In this series laser angioplasty carried significant complications and a high failure rate. Widespread application of this procedure should await further clinical investigation.
Harrington
M E
ME
Department of Surgery, Mount Sinai School of Medicine, New York, NY 10029.
Schwartz
M E
ME
Sanborn
T A
TA
Mitty
H A
HA
Miller
C A
CA
McGinnis
K
K
Harrington
E B
EB
D000368:Aged; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000401:mortality / Q000628:therapy; D005260:Female; D005263:Femoral Artery; D006801:Humans; D007083:Iliac Artery; D007511:Ischemia / Q000401:mortality / Q000628:therapy*; D053685:Laser Therapy; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery