[Angioplasty of coronary arteries by laser radiation in 1988].
The ability of laser radiation to destroy healthy or pathologic vascular tissue in vitro and in vivo marked the beginning of therapeutic ablation of atheromatous deposits in man. The problems encountered by application of this procedure to treatment of coronary heart disease are very complex, and experience acquired using lasers for peripheral vascular disease is of not much help in this area. It is clear that continuous emission lasers (YAG, Argon, CO2), which produce coagulation necrosis, thrombosis, and vasospasm must be ruled out in favor of impulse type lasers (CO2TEA, YAG Q-S, pumped lasers with dye and exciplex lasers) if the latter can provide a critical thermal relaxation time. Currently, exciplex lasers are a possible method whose potential efficacy and safety gave been demonstrated with certainty in coronary angioplasty. Indeed, although their mechanism of action is poorly understood, they offer the twofold advantage of being able to focus on a volumetrically defined ablation, and to leave the surrounding tissue intact. The clinical application of these tools remains to be developed. Laser angioplasty requires in situ diagnostic methods based on the optical utilization of intrinsic and extrinsic chromophores, the objective of intensive research. Its relative role in comparison to other methods of ablation, and specific indications remain to be defined.
Ollivier
J P
JP
Service de Cardiologie, Hôpital Militaire du Val-de-Grâce, Paris.
Avrillier
S
S
D003327:Coronary Disease / Q000532:radiotherapy*; D005336:Fiber Optic Technology; D006801:Humans; D053685:Laser Therapy
L'angioplastie des artères coronaires par rayonnement laser en 1988.