Author + information
- Received October 22, 1990
- Accepted December 5, 1990
- Published online May 1, 1991.
- Timothy A. Sanborn, MDa,∗,1,
- John A. Bittl, MD, FACCa,∗,
- Ronnie A. Hershman, MDa,† and
- Robert M. Siegel, MDa,‡
- ↵∗Address for reprints: Timothy A. Sanborn, MD, Division of Cardiology, Box 1030, Mount Sinai Medical Center, One Gustave L, Levy Place, New York, New York 10029.
Initial multicenter clinical experience with percutaneous coronary excimer laser-assisted angioplasty is described for 158 lesions in 141 patients. Using a xenon chloride (308 nm) excimer laser generator and 1.5 to 1.75 mm catheters, excimer laser angioplasty was attempted at 135 ns pulse width, 25 to 40 Hz repetition rate, 2 to 5 s laser delivery time and 30 to 60 mJ/mm2+energy fluence. Laser success (> 20% improvement in luminal diameter) was achieved in 138 (87%) of 158 lesions, with a reduction to < 50% stenosis noted in 77 lesions (49%). Overall, laser-assisted balloon angioplasty success (< 50% residual stenosis without major complication) was observed in 129 (91%) of 141 patients. Procedural complications (abrupt closure 1.3%, side branch occlusion 1.9%, intimal dissection 6.3%, embolizalion 1.3%, filling defect 1.3%, perforation 1.9% and spasm 1.3% and major complications (non-Q wave myocardial infarction 4.8%, emergency coronary bypass surgery 3.5% and death 0%) were infrequent and predominantly related to subsequent balloon angioplasty. In the early follow-up period (range 1 to 10 months, mean 7), 111 (79%) of the 141 patients remain asymptomatic, whereas symptoms have recurred in 27 (19%) and 3 patients (2.1%) have died. Thus, percutaneous coronary excimer laser angioplasty appears to be a feasible and safe procedure. Assessment of the impact of this technology on the acute complications of and restenosis rates after angioplasty awaits further follow-up analysis.
↵1 Dr. Sanborn is the Arthur Ross Scholar in Cardiovascular Medicine.
☆ This study was presented in part at the 39th Annual Meeting of Ihe American College of Cardiology, New Orleans, Louisiana, March 1990. It was supported in part by The Spectranetics Corp., Colorado Springs, Colorado.
- Received October 22, 1990.
- Accepted December 5, 1990.