| Laser coronary angioplasty: history, present and future. | |
| | |
MedLine Citation:
|
PMID: 14727981 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The efficacy of percutaneous transluminal coronary angioplasty (PTCA) is limited by remaining plaque tissue and the development of restenosis. It has been demonstrated that the restenosis rate is low if a large lumen diameter is achieved after coronary intervention. Debulking of coronary stenoses is a concept to increase the luminal diameter after intervention. Laser angioplasty debulks coronary stenoses by ablation of atherosclerotic plaque. Since the first intravascular laser intervention, the technique has been significantly improved by the use of optimized wavelength, the development of flexible optimally spaced multifiber catheters and an additional saline flush technique. These technical advancements allowed a reduction in the incidence of adverse events, such as the number of dissections and perforations, associated with the use of the laser technique. Coronary laser angioplasty is commonly combined with adjunctive balloon angioplasty to optimize the outcome. Laser coronary angioplasty was not followed by a lower restenosis rate compared with plain balloon angioplasty in lesions without stents, however, a randomized comparison of the techniques including the use of the saline flush technique is not available yet. The value of excimer (acronym for excited dimer) laser coronary angioplasty for treatment of in-stent restenosis is still under investigation. So far, nonrandomized single center studies have not suggested a relevant benefit for this technique used for in-stent restenosis. In nonstented lesions there remain niche indications for laser angioplasty such as the treatment of ostial lesions, diffuse lesions or lesions traversable with a guidewire but not with an angioplasty balloon. Laser coronary angioplasty may also be useful after a failed balloon angioplasty and in patients with chronic total occlusions. The potential advantages of combining laser coronary angioplasty with vaporization of thrombus in patients with acute coronary syndromes are currently under evaluation. |
| | |
Authors:
|
Ralf Köster; Jan Kähler; Carsten Brockhoff; Thomas Münzel; Thomas Meinertz |
Publication Detail:
|
Type: Historical Article; Journal Article; Review |
Journal Detail:
|
Title: American journal of cardiovascular drugs : drugs, devices, and other interventions Volume: 2 ISSN: 1175-3277 ISO Abbreviation: Am J Cardiovasc Drugs Publication Date: 2002 |
Date Detail:
|
Created Date: 2004-01-19 Completed Date: 2004-04-14 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 100967755 Medline TA: Am J Cardiovasc Drugs Country: New Zealand |
Other Details:
|
Languages: eng Pagination: 197-207 Citation Subset: IM |
Affiliation:
|
Department of Cardiology, University Hospital Eppendorf, Medical Clinic, Hamburg, Germany. rkoester@uni-hamburg.de |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Angioplasty, Laser*
/
history,
methods,
trends Coronary Disease / surgery* History, 20th Century History, 21st Century Humans Randomized Controlled Trials as Topic |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Naturoceutical agents in the management of cardiovascular disease.
Next Document: Clinical potential of nonhemoglobin oxygen therapeutics in cardiac and general surgery.