Effectiveness of holmium laser-assisted coronary angioplasty. The Holmium Laser Coronary Registry.
The efficacy of holmium laser-assisted angioplasty was studied in 365 narrowings in 331 consecutive patients with coronary artery disease. Clinical indications for study were unstable angina pectoris in 140 patients (42%), stable angina in 136 patients (41%), postmyocardial infarction angina in 35 patients (10.5%), silent myocardial ischemia in 11 patients (3%), acute myocardial infarction in 1 patient (0.3%) and undefined in 8 patients (2%). Coronary morphology characteristics by Multivessel Angioplasty Prognosis Study group criteria were type A in 12.6%, type B1 in 34.2%, type B2 in 27.4% and type C in 25.4%. The laser successfully crossed the total length of the narrowing in 85.2%. Procedural success was 94.2%. Laser alone reduced mean percent luminal narrowing from 88 +/- 11% to 57 +/- 22%. Subsequent balloon angioplasty further reduced the mean luminal narrowing to 23 +/- 18%. Major complication rate was 2.7% (death 0.3%, Q-wave myocardial infarction 0.5%, and emergent bypass surgery 2.7%). Six-month angiographic restenosis (> 50% stenosis) rate was 44%.
de Marchena
E J
EJ
Department of Medicine, University of Miami/Jackson Memorial Medical Center, Florida.
Mallon
S M
SM
Knopf
W D
WD
Parr
K
K
Moses
J W
JW
Murphy-Chutorian
D
D
Myerburg
R J
RJ
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D017222:Angioplasty, Balloon, Laser-Assisted / Q000009:adverse effects; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D005260:Female; D006695:Holmium; D006801:Humans; D008297:Male; D011859:Radiography; D012008:Recurrence; D012042:Registries; D016896:Treatment Outcome
D006695:Holmium