Limb Salvage following Laser-Assisted Angioplasty for Critical Limb Ischemia: Results of the LACI Multicenter Trial

• Published in: Journal of endovascular therapy 2006-02, Vol.13 (1), p.1-11
• Main Authors: Laird, John R., Zeller, Thomas, Gray, Bruce H., Scheinert, Dierk, Vranic, Mitar, Reiser, Cristopher, Biamino, Giancarlo
• Format: Article
• Language: English
• Subjects: Aged; Amputation; Angioplasty, Balloon, Laser-Assisted - adverse effects; Arterial Occlusive Diseases - complications; Arterial Occlusive Diseases - surgery; Critical Illness; Female; Femoral Artery - diagnostic imaging; Follow-Up Studies; Foot Ulcer - complications; Foot Ulcer - pathology; Foot Ulcer - surgery; Humans; Ischemia - etiology; Ischemia - mortality; Ischemia - surgery; Leg - blood supply; Leg - diagnostic imaging; Limb Salvage; Male; Patient Selection; Popliteal Artery - diagnostic imaging; Radiography; Stents; Survival Rate; Tibial Arteries - diagnostic imaging
• ISSN: 1526-6028; 1545-1550
• DOI: 10.1583/05-1674.1

Purpose: To evaluate the effectiveness of laser-assisted angioplasty for patients with critical limb ischemia (CLI) who were poor candidates for surgical revascularization. Methods: A prospective registry at 14 sites in the US and Germany enrolled 145 patients with 155 critically ischemic limbs; the patients were poor candidates for bypass surgery owing to inadequate target vessel or saphenous vein, prohibitive cardiac disease, or significant comorbidities (ASA class 4). Additional comorbid risk factors included diabetes in 66%, hypertension in 83%, previous stroke in 21%, and myocardial infarction in 23%. Endovascular treatment included guidewire traversal and excimer laser angioplasty followed by balloon angioplasty with optional stenting. Results: Occlusions were present in 92% of limbs. A mean of 2.7±1.4 lesions were treated per limb; the total median treatment length was 11 cm (mean 16.2, range 0.2–123). Stents were implanted in 45% of limbs. Procedural success, defined as