Femoropopliteal artery recanalization: factors affecting clinical outcome of conventional and laser-assisted balloon angioplasty.
OBJECTIVE
The clinical efficacy of 44 successful conventional and laser-assisted recanalizations of the femoropopliteal artery was assessed in a noncomparative study by the life-table method.


METHODS
Laser-assisted angioplasty using continuous laser and a sapphire probe was performed to achieve primary recanalization in femoral artery occlusions when conventional guidewire recanalization had already failed. Nineteen of the patients underwent a conventional recanalization (PTA; mean length of occlusion 4.4 +/- 4.1 cm), and 25 underwent percutaneous laser-assisted angioplasty (PLA; mean length of occlusion 10.1 +/- 6.7 cm).


RESULTS
There was no statistical relation between the preprocedure Fontaine classification and the success rate in the PTA cases (p = 0.25), whereas there was a statistical relation in the PLA cases: The success rate in patients preprocedurally classified as Fontaine II was better than in those classified as Fontaine III/IV (p = 0.05). After a 3-year follow-up the patency rate in the patients with the PTA recanalizations was 37% and that in those with the PLA procedure was 53%. This difference was not statistically significant (p = 0.47).


CONCLUSIONS
It is concluded that the laser should remain an investigational device.
Odink
H F
HF
Department of Radiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
de Valois
H C
HC
Eikelboom
B C
BC
D000800:Angioplasty, Balloon; D017222:Angioplasty, Balloon, Laser-Assisted / Q000009:adverse effects; D001157:Arterial Occlusive Diseases / Q000601:surgery / Q000628:therapy; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D015993:Life Tables; D011150:Popliteal Artery; D011446:Prospective Studies; D012008:Recurrence; D014654:Vascular Patency