Proceedings PaperLesion-specific laser catheters for angioplasty
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Since no one laser catheter can treat all types of disease, a new family of 'lesion-specific' devices was evaluated with a holmium laser source. Fifty patients (avg. 69 yrs) with lifestyle-limiting peripheral vascular disease and 29 patients (avg. 58 yrs) with symptomatic coronary disease were studied. Average lesion length was 5.3 cm in legs and 1.5 cm in hearts. A 1.5, 2.0, or 2.8 mm, tapered-tip or non-tapered, multifiber catheter (Eclipse, Palo Alto, CA) was advanced over the wire while emitting 300-1200 mj/pulse at 5 Hz. Mean percent stenosis decreased from 89% to 45% after lasing with a mean of 411 pulses in legs and from 86% to 46% with a mean of 158 pulses in hearts. Complications were infrequent. Laser technical success was 80% and overall procedural success was 97%. Conclusion: 1) Specialized laser catheters delivering holmium laser energy are capable of reducing the severity of peripheral and coronary stenoses including balloon angioplasty failures and bypass graft failures; 2) Follow-up studies are in progress to assess long term efficacy.