title: Early outcome of high energy Laser (Excimer) facilitated coronary angioplasty ON hARD and complex calcified and balloOn-resistant coronary lesions: LEONARDO Study.
abstract: OBJECTIVE
  An innovative xenon-chlorine (excimer) pulsed laser catheter (ELCA X80) has been recently used for the treatment of complex coronary lesions, as calcified stenosis, chronic total occlusions and non-compliant plaques. Such complex lesions are difficult to adequately treat with balloon angioplasty and/or intracoronary stenting. The aim of this study was to examine the acute outcome of this approach on a cohort of patients with coronary lesions.
  
  
  RESULTS
  Eighty patients with 100 lesions were enrolled through four centers, and excimer laser coronary angioplasty was performed on 96 lesions (96%). Safety and effectiveness data were compared between patients treated with standard laser therapy and those treated with increased laser therapy. Laser success was obtained in 90 lesions (93.7%), procedural success was reached in 88 lesions (91.7%), and clinical success in was obtained in 87 lesions (90.6%). There was no perforation, major side branch occlusion, spasm, no-reflow phenomenon, dissection nor acute vessel closure. Increased laser parameters were used successfully for 49 resistant lesions without complications.
  
  
  CONCLUSIONS
  This study suggests that laser-facilitated coronary angioplasty is a simple, safe and effective device for the management of complex coronary lesions. Furthermore, higher laser energy levels delivered by this catheter improved the device performance without increasing complications.
authors.affiliation: Montevergine Clinic, Mercogliano, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Ambrosini
authors.affiliation: Montevergine Clinic, Mercogliano, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sorropago
authors.affiliation: Montevergine Clinic, Mercogliano, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Laurenzano
authors.affiliation: Montevergine Clinic, Mercogliano, Italy; Moriggia-Pelascini Hospital, Gravedona, Como, Italy. Electronic address: lucagolino.jazz@alice.it.
authors.forename: Luca
authors.initials: L
authors.lastname: Golino
authors.affiliation: Montevergine Clinic, Mercogliano, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Casafina
authors.affiliation: Montevergine Clinic, Mercogliano, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Schiano
authors.affiliation: University Hospital Ospedali Riuniti, Ancona, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Gabrielli
authors.affiliation: Spedali Civili University Hospital, Brescia, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Ettori
authors.affiliation: Spedali Civili University Hospital, Brescia, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Chizzola
authors.affiliation: University Hospital S. Maria Misericordia, Udine, Italy.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Bernardi
authors.affiliation: University Hospital S. Maria Misericordia, Udine, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Spedicato
authors.affiliation: Istituto Italiano Ricerche Mediche, Verona, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Armigliato
authors.affiliation: Telethon Institute of Genetics and Medicine (TIGEM), Naples, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Spampanato
authors.affiliation: Istituto Italiano Ricerche Mediche, Verona, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Furegato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D017222:Angioplasty, Balloon, Laser-Assisted / Q000379:methods; D017225:Atherectomy, Coronary / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
keywords: Complex coronary lesions; Coronary angioplasty; Hard calcified stenosis; Xenon–Chlorine laser