title: The state of the excimer laser for coronary intervention in the drug-eluting stent era.
abstract: OBJECTIVE
  This study aims to determine how excimer laser coronary atherectomy (ELCA) performs in the drug-eluting stent (DES) era.
  
  
  BACKGROUND
  For more than 20 years, ELCA has been used for coronary intervention. With developments in the coronary intervention field, the role of ELCA is in question.
  
  
  METHODS
  The study includes 119 patients with 124 lesions who underwent percutaneous coronary intervention (PCI) with ELCA in our institution from January 2004 to May 2011.
  
  
  RESULTS
  The main indications for ELCA use were saphenous vein graft (SVG) (45 lesions), acute myocardial infarction (AMI) (7 lesions), chronic total occlusion (CTO) (32 lesions), in-stent restenosis (ISR) (15 lesions), and calcified de-novo lesions (25 lesions). High success rates were recorded for the SVG, AMI, CTO, ISR, and calcified lesion indications (91.1%, 85.7%, 93.8%, 86.7%, and 80%; respectively). ELCA related complications were reported in 10 patients (8%); four dissections, three no-reflow phenomena, two perforations, and one thrombus formation.
  
  
  CONCLUSIONS
  ELCA is an alternative solution with acceptable performance in the treatment of complex coronary lesions not ideally suitable for balloon angioplasty.
authors: Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC 20010, USA.
authors: Salem
authors: S
authors: Badr
authors: Itsik
authors: I
authors: Ben-Dor
authors: Danny
authors: D
authors: Dvir
authors: Israel M
authors: IM
authors: Barbash
authors: Hironori
authors: H
authors: Kitabata
authors: Sa'ar
authors: S
authors: Minha
authors: Lakshmana K
authors: LK
authors: Pendyala
authors: Joshua P
authors: JP
authors: Loh
authors: Rebecca
authors: R
authors: Torguson
authors: Augusto D
authors: AD
authors: Pichard
authors: Ron
authors: R
authors: Waksman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D017225:Atherectomy, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy*; D054059:Coronary Occlusion / Q000628:therapy; D023903:Coronary Restenosis / Q000628:therapy; D054855:Drug-Eluting Stents; D004867:Equipment Design; D005260:Female; D006083:Graft Occlusion, Vascular / Q000628:therapy; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D018579:Patient Selection; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000628:therapy