Author + information
- Received May 2, 1990
- Revision received September 24, 1990
- Accepted October 5, 1990
- Published online March 15, 1991.
- Karl R. Karsch, MD∗,
- Karl K. Haase, MD,
- Manfred Wehrmann, MD,
- Stefan Hassenstein, MD and
- Hartmut Hanke, MD
- ↵∗Address for reprints: Karl R. Karsch, MD, Division of Cardiology, Department of Internal Medicine, University of Tuebingen, Olfried-Mueller-Str, 10, 7400 Tuebingen, Federal Republic of Germany.
It has been shown that coronary excimer laser angioplasty can remove atherosclerotic intracoronary tissue. Stand alone coronary excimer laser angioplasty was successfully performed in a 53 year old white man with 90% stenosis of the left anterior descending coronary artery and exertional angina (Canadian Cardiovascular Society class III). The lesion was reduced to a 30% residual stenosis with use of a 1.2 mm and subsequently a 1.8 mm diameter laser catheter. Early follow-up angiography 24 h later revealed persistent patency and unchanged lesion diameter of the target vessel. The patient was free of symptoms during the 2 month follow-up period, but died suddenly while playing in a tennis tournament 63 days alter the procedure.
Postmortem histologic examination revealed 80% restenosis at the lesion site without plaque disruption or thrombosis. Specific staining of the histologic specimen for smooth muscle cells using alpha-actin revealed significant smooth muscle cell proliferation at the site of coronary excimer laser angioplasty. However, most of the vessel narrowing appeared to be due to underlying fibrotic plaque as a result of insufficient tissue ablation. This was probably related to the size of the currently available catheters, which are too small to create a large channel.
- Received May 2, 1990.
- Revision received September 24, 1990.
- Accepted October 5, 1990.