Laser recanalization of peripheral arteries

Abstract

The aim of this study was to assess safety and efficacy of excimer laser (XeCl, 308 nm) recanalization of diseased peripheral arteries not amenable to conventional balloon dilatation. In 21 patients (ages 44–77) with multiple vascular lesions, laser recanalization of 43 calcified occlusions (2–5 per patient) of 0.5–17.5 cm in length; iliac (21 iliac lesions in 9 patients: group I, 31 femoropopliteal lesions in 12 patients: group II) was attempted. Laser irradiation (60–80 mJ io:/mm² and 120 ns per pulse, 20 Hz) was applied via concentric and excentric multifiber 4.5–9.0 Fr catheters. In group I, perforation of the aortic wall occurred in one, long-term patency, and normal pain-free walking distances were achieved in all nine patients. In group II, perforation/dissection occurred in four, successful recanalization resulted in peripheral embolization in three, and late reocclusion occurred in two patients. However, clinical improvement (Fontaine class 0–II) could be verified in 7 (60%) of the 12 patients in a follow-up of 9–34 months. Excimer laser recanalization is an alternative to surgical revascularization in patients with peripheral artery occlusions not amenable to conventional percutaneous angioplasty procedures.