The use of the holmium:YAG laser in coronary disease: the utility of a unique lensed fiber catheter.
Alternatives to balloon angioplasty, which has a restenosis rate of 25%-68%, are being sought for patients at high risk for restenosis.  The mid-infrared holmium laser may have properties more advantageous for coronary angioplasty than the ultraviolet excimer laser.  The Coronary HaloCath (Trimedyne, Inc.) has a diverging lens that allows the beam diameter to approximate the catheter tip diameter, increasing the size of the channel that can be created by laser ablation.  This unique ability may make it more efficacious in treating arteriosclerotic disease.  This device was used to treat: 1) a chronic total occlusion, creating a recanalized diameter larger than the catheter diameter; and 2) an ostial right coronary stenosis, which opened more readily than would have been expected with balloon angioplasty.  The Coronary HaloCath may prove useful in difficult-to-treat coronary lesions.
Heuser
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Department of Cardiology, Arizona Heart Institute & Foundation, Phoenix.
D000368:Aged; D000535:Aluminum; D016342:Angioplasty, Laser / Q000295:instrumentation* / Q000379:methods; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D004867:Equipment Design; D005336:Fiber Optic Technology; D006695:Holmium; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012008:Recurrence; D015019:Yttrium