Percutaneous coronary laser balloon angioplasty: Initial results of a multicenter experience

• Published in: Journal of the American College of Cardiology 1990-08, Vol.16 (2), p.293-303
• Main Authors: Spears, James Richard, Reyes, Vincent P., Wynne, Joshua, Fromm, Barbara S., Sinofsky, Edward L., Andrus, Scott, Sinclair, Lan Nigel, Hopkins, Barry E., Schwartz, Leonard, Aldridge, Harold E., Plokker, H.W.Thijs, Mast, E.G., Rickards, Anthony, Knudtson, Merril L., Sigwart, Ulrich, Dear, Wayne E., Ferguson, James J., Angelini, Paolo, Leatherman, Louis L., Safian, Robert D., Jenkins, Ronald D., Douglas, John S., king, Spencer B.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - methods; Biological and medical sciences; Cardiology. Vascular system; Cineangiography; Coronary Disease - diagnostic imaging; Coronary Disease - surgery; Coronary Disease - therapy; Coronary heart disease; Female; Heart; Humans; Laser Therapy - adverse effects; Laser Therapy - methods; Male; Medical sciences; Middle Aged; Multicenter Studies as Topic; Pilot Projects; Recurrence
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/0735-1097(90)90576-B

A multicenter clinical trial was initiated to test the potential safety and short-term efficacy of a percutaneous coronary application of laser balloon angioplasty, which has been shown experimentally to alleviate the common causes (dissection, recoil, thrombus) of suboptimal luminal results of conventional balloon angioplasty. Fifty-five patients, the majority (62%) of whom had relatively high risk lesions, were treated in 10 centers with a laser balloon that was identical in size (3 × 20 mm) to a balloon used for conventional balloon angioplasty performed on the same lesion immediately before laser balloon angioplasty. One or more neodymium: yttrium aluminum garnet (Nd: YAG) (1,060 nm) laser doses of 250 to 450 J were each delivered over a 20 s duration per exposure. Immediately and 1 day after laser balloon angioplasty no significant adverse effects on the arterial lumen were noted in any patient. By computerized image analysis of cineangiograms initial conventional balloon angioplasty failed to achieve a minimal luminal diameter > 1.5 mm in 14 patients (25%), including 3 patients with acute closure. However, after subsequent laser balloon angioplasty, minimal luminal diameter exceeded this value in all patients including this subgroup. Overall, minimal luminal diameter increased from 1.74 ± 0.46 mm after conventional balloon angioplasty to 2.32 ± 0.31 mm after laser balloon angioplasty (p < 0.001) with no change found on 1 day and 1 month follow-up angiograms. Thus, laser balloon angioplaty is a safe, effective procedure for improving huminal dimensions after conventional balloon angioplasty.