Excimer laser angioplasty in acute myocardial infarction (the CARMEL multicenter trial)

• Published in: The American journal of cardiology 2004-03, Vol.93 (6), p.694-701
• Main Authors: Topaz, On, Ebersole, Douglas, Das, Tony, Alderman, Edwin L, Madyoon, Hooman, Vora, Kishor, Baker, John D, Hilton, David, Dahm, Johannes B
• Format: Article
• Language: English
• Subjects: Angioplasty; Angioplasty, Laser - adverse effects; Biological and medical sciences; Cardiology. Vascular system; Clinical trials; Coronary Angiography; Coronary heart disease; Diseases of the cardiovascular system; Female; Heart; Heart attacks; Humans; Lasers; Male; Medical sciences; Middle Aged; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - pathology; Myocardial Infarction - surgery; Myocarditis. Cardiomyopathies; Patients; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Saphenous Vein - pathology; Severity of Illness Index; Statistical analysis; Studies; Treatment Outcome; United States; Ventricular Function, Left
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2003.11.050

Patients with acute myocardial infarction (AMI) with thrombus-laden lesions constitute a revascularization challenge. Thrombus and atherosclerotic plaque absorb laser energy; thus, we studied the safety and efficacy of excimer laser in AMI. In a multicenter trial, 151 patients with AMI underwent excimer laser angioplasty. Baseline left ventricular ejection fraction was 44 ± 13%, and 13% of patients were in cardiogenic shock. A saphenous vein graft was the target vessel in 21%. Quantitative coronary angiography and statistical analysis were performed by independent core laboratories. A 95% device success, 97% angiographic success, and 91% overall procedural success rate were recorded. Maximal laser gain was achieved in lesions with extensive thrombus burden (p