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Proceedings Paper

Early results of pulsed dye laser angioplasty with integral ball-tips in long femoral occlusions
Author(s): Alan Murray; David C. Mitchell; Richard F. M. Wood M.D.
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Paper Abstract

A Pulsed Dye laser together with specifically designed integral ball-tipped optical fibres have been used for the primary recanalisation of femoropopliteal vascular disease in 25 limbs of 23 patients. All patients had complete occlusions of the vessels ranging from 8-49cms in length (mean 22cms), having presented with critical ischaemia (18) or severe claudication warranting operative intervention (5). Pedal ulceration was present in 8 limbs and digital gangrene in 4. The laser produced visible light at 480nm in lOOmJ/lus pulses, at a frequency of 10-20Hz. The energy delivery device comprised a smooth atraumatic ball-tip constructed from the glass of the optical fibre, which was loaded retrogradely into a standard balloon angioplasty catheter. The device was introduced through a common femoral artery cutdown. Angiographic recanalisation was achieved in 22 of the 25 limbs with a mean energy of 280J(range 68-727J) and in each case the channel created by the laser fibre was augmented by balloon angioplasty. Technical failure occurred in three cases, caused by a wall dissection, persistent side-branch entry and incomplete lesion penetration respectively. Eighteen of procedures (72%) were clinically successful with marked symptomatic improvement. Of the four angiographic successful but clinical failures, acute occlusion within 48 hours occurred in 2 diabetic patients with very poor run-off and distal gangrene. The third case failed acutely due to a technically inadequate balloon dilatation and the fourth patient failed to improve symptomatically due to widespread with segmental tibial vessel disease below a successful recanalisation. Over a mean follow-up period of 7 months, three patients died of myocardial infarction. Twelve of the 23 patients (52%) remain well with patent vessels. These early results demonstrate the efficacy of pulsed dye laser angioplasty using ball-tipped optical fibres.

Paper Details

Date Published: 1 July 1990
PDF: 9 pages
Proc. SPIE 1201, Optical Fibers in Medicine V, (1 July 1990); doi: 10.1117/12.17533
Show Author Affiliations
Alan Murray, St. Bartholomew's Hospital (United Kingdom)
David C. Mitchell, St. Bartholomew's Hospital (United Kingdom)
Richard F. M. Wood M.D., St. Bartholomew's Hospital (United Kingdom)

Published in SPIE Proceedings Vol. 1201:
Optical Fibers in Medicine V
Abraham Katzir, Editor(s)

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