Document Detail


Recanalization of chronic total coronary arterial occlusions by percutaneous excimer-laser and laser-assisted angioplasty.
MedLine Citation:
PMID:  2251989     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A low primary success and high restenosis rate after recanalization of chronic total occlusions by conventional coronary angioplasty have encouraged the application of new interventional techniques like excimer-laser angioplasty. In 39 patients with a coronary occlusion for 1 to 12 months, recanalization was attempted by laser angioplasty through a multifiber-catheter coupled to a pulsed XeCl excimer laser. After successful passage of the occlusion by a standard guidewire in 27 patients (69%), the laser catheter was advanced over the central guidewire and crossed the occlusion in 25 patients (64%). In 2 patients with unsuccessful passage of the laser catheter, the subsequent attempt with a low profile balloon catheter also failed. In 19 of the 25 patients with successful laser recanalization, the residual stenosis exceeded 50% and was therefore followed by additional balloon angioplasty. The average residual stenosis after laser was 61 +/- 17% of the vessel diameter, and after balloon angioplasty 28 +/- 9% (n = 19), whereas after laser angioplasty alone it was 38 +/- 5% (n = 6). No complications associated with the laser application were observed. Angiographic control after 24 hours showed a reocclusion of 2 (8%) recanalized vessels. In this pilot study, laser angioplasty proved to be a safe and feasible method for the treatment of chronic total coronary occlusions. Because it was necessary to guide the catheter by a central wire, the primary success was limited by a successful passage of the wire of the occlusion. The rate of stand-alone laser angioplasty has to be increased by future improvements of the technique to enable a comparative evaluation of this method with conventional angioplasty.
Authors:
G S Werner; A Buchwald; C Unterberg; E Voth; H Kreuzer; V Wiegand
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  66     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1990 Dec 
Date Detail:
Created Date:  1991-01-11     Completed Date:  1991-01-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1445-50     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Georg-August University, Goettingen, Federal Republic of Germany.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Laser*
Arterial Occlusive Diseases / surgery*
Coronary Angiography
Coronary Disease / surgery*
Female
Humans
Male
Middle Aged
Pilot Projects
Recurrence
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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