Nd-YAG Laser Angioplasty

  • M. P. Heintzen
  • T. Neubaur
  • M. Klepzig
  • E. I. Richter
  • E. Zeitler
  • B. E. Strauer
Conference paper

Abstract

To date clinical laser angioplasty has been performed mostly with argon and Nd-YAG laser systems, but more recently also excimer and dye lasers have been applied for clinical investigations. We performed experimental and clinical studies with a continuous-wave Nd-YAG laser with a wavelength of 1064 nm. For transmitting laser light to the obstructive tissue, silica fibers with a core diameter of 0.6 mm were used. In earlier studies it was shown that, in contrast to argon laser angioplasty, even calcified atherosclerotic plaques could be vaporized with a specially prepared melted fiber tip. However, approximately tenfold the laser energy is required to achieve the same effect compared with laser application on fibrous-fatty plaques [9]. The major problem of laser angioplasty with bare fibers, high incidence of vessel wall perforation and only inadequate lumen improvement, were solved by the development of a novel laser catheter system [9, 13]. In this paper the results of Nd-YAG laser angioplasty in the femoropopliteal region are summarized [6, 7, 10, 18]. Also early results in iliac arteries are presented.

Keywords

Catheter Argon Polyethylene Heparin Luminal 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Abela GS, Fenech A, Crea F, Conti CR (1985) “Hot-tip”: another method of laser vascular recanalization. Lasers Surg Med 5: 327–335PubMedGoogle Scholar
  2. 2.
    Cumberland DC, Sanborn TA, Tayler DI, Moore DJ, Welsh CL, Greenfield AJ, Guben JK, Ryan TJ (1986) Initial clinical results with a laser probe in total peripheral artery occlusion. Lancet: 1457–1459Google Scholar
  3. 3.
    Geschwind HJ, Teisseire B, Boussignac G, Vielledent C (1986) Transluminal laser angioplasty in man. Semin Intervent Radiol 3: 69–74CrossRefGoogle Scholar
  4. 4.
    Ginsberg R, Kim DS, Guthaner D, Toth J, Mitchel RS (1984) Salvage of an ischemic limb by laser angioplasty: description of a new technique. Clin Cardiol 7: 377–381Google Scholar
  5. 5.
    Ginsberg R, Wexler L, Mitchell RS, Profit D (1985) Percutaneous transluminal laser angio-plasty for treatment of peripheral vascular disease. Radiology 156: 619–624Google Scholar
  6. 6.
    Heintzen MP, Neubaur T, Klepzig M, Zeitler E, Strauer BE (1987) Percutaneous peripheral laser angioplasty by a novel bare fiber catheter: initial clinical results. Circulation 76 (Suppl IV): 231Google Scholar
  7. 7.
    Heintzen MP, Neubaur T, Klepzig M, Zeitler E, Richter EI, Strauer BE (1988) Clinical experiences in Nd:YAG laser angioplasty in the periphery. In: Müller GJ, Biamino G (eds) Advances in laser medicine I. First German symposium on laser angioplasty. Ecomed, Landsberg, pp. 103–113Google Scholar
  8. 8.
    Hessel S, Frank F, Ischinger T, Heintzen M (1988) Possibilities for the use of Nd: YAG laser in vascular recanalization. In: Müller GJ, Biamino G (eds) Advances in laser medicine I. First German symposium on laser angioplasty. Ecomed, Landsberg, pp. 89–95Google Scholar
  9. 9.
    Klepzig M, Neubaur T, Stellwaag M, Strauer BE (1986) Nd-YAG laser angioplasty: vascular effects, catheter development and in vivo application. Circulation 74 (Suppl II): 203Google Scholar
  10. 10.
    Klepzig M, Neubaur T, Richter EI, Zeitler E, Strauer BE (1987) Transfemorale periphere Laserangioplastie. Dtsch med Wochenschr 112: 324PubMedGoogle Scholar
  11. 11.
    Lammer J, Pilger E, Kleinert R, Ascher PW (1987) Laserangioplastie peripherer arterieller Verschlüsse. Fortschr Geb Röntgenstr Ergänzungsband 147: 119–123CrossRefGoogle Scholar
  12. 12.
    Lee G, Ikeda RM, Theis JH, Chan MC, Stobbe D, Ogata C, Kumagai A, Mason DT (1985) Limitations, risks and complications of laser recanalization: a cautious approach warranted. Am J Cardiol 56: 181–185PubMedCrossRefGoogle Scholar
  13. 13.
    Neubaur T, Klepzig M, Strauer BE (1988) Perkutane transluminale Laserangioplastie bei peripherer arterieller Verschlußkrankheit. Entwicklung eines neuen Kathetersystems. Z Kardiol 77: 245–250PubMedGoogle Scholar
  14. 14.
    Prevosti LG, Lawrence JF, Leon MB, Kramer WS, Lu DY, Smith PD, Bonner RF (1987) Reduced surface thrombogenicity after thermal ablation of plaque. Circulation 76 (Suppl IV): 408Google Scholar
  15. 15.
    Sanborn TA, Cumberland DC, Welsh CL, Greenfield AJ, Guben JK (1986) Laser ther¬mal angioplasty: reduced restenosis compared to balloon angioplasty. Circulation 74 (Suppl II): 6CrossRefGoogle Scholar
  16. 16.
    Schneider E, Grüntzig AR, Bollinger A (1983) Long-term patency rate after percutaneous transluminal angioplasty for iliac and femoropopliteal obstructions. In: Dotter CT, Grüntzig AR, Schoop W, Zeitler E (eds) Percutaneous transluminal angioplasty. Springer, Berlin Heidelberg New York, pp 175–180CrossRefGoogle Scholar
  17. 17.
    Seyfert W, Ernsting M, Grosse-Vorholt R, Zeitler E (1983) Complications during and after percutaneous transluminal angioplasty. In: Dotter CT, Grüntzig AR, Schoop W, Zeitler E (eds) Percutaneous transluminal angioplasty. Springer, Berlin Heidelberg New York, pp 161–169CrossRefGoogle Scholar
  18. 18.
    Strauer BE, Neubaur T, Klepzig M, Heintzen MP, Zeitler E, Richter EI (1988) Perkutane periphere Laserangioplastie: erste klinische Ergebnisse. Z Kardiol 77: 29–35PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • M. P. Heintzen
  • T. Neubaur
  • M. Klepzig
  • E. I. Richter
  • E. Zeitler
  • B. E. Strauer

There are no affiliations available

Personalised recommendations