Despite four years of intensive clinical investigation, excimer laser coronary angioplasty has not been accepted by the interventional cardiology community as the intervention of choice for any lesion type. Although the preliminary analysis presented here shows that the new technology shows promise for the treatment of saphenous vein graft lesions, aorto-ostial lesions and other lesions, these lesion types account for only about 5 - 10% of cases currently targeted for angioplasty and can frequently be treated with other interventional methods. Broader use of excimer laser angioplasty requires convincing proof that the new technology has clear superiority over other interventional techniques for a wider range of lesion types. Furthermore, the mechanisms of vessel dissection, perforation and abrupt closure need further clarification. Thus, the major challenges for excimer laser angioplasty include: (1) randomized trials to document the superiority of excimer laser over balloon angioplasty; (2) improved catheter designs, including devices for eccentric lesions and total occlusions; and (3) a better understanding of laser-tissue interactions to reduce the unpredictability of unfavorable angiographic outcome.

Date Published: 23 June 1993
PDF: 7 pages
Proc. SPIE 1878, Diagnostic and Therapeutic Cardiovascular Interventions III, (23 June 1993); doi: 10.1117/12.146575

Published in SPIE Proceedings Vol. 1878:
Diagnostic and Therapeutic Cardiovascular Interventions III
George S. Abela M.D., Editor(s)