Holmium: YAG Coronary Laser Angioplasty (HOLCA). The American Experience
The development of a clinically effective laser angioplasty system for the percutaneous recanalization of occlusive coronary artery atherosclerosis is a complex task involving the selection of an optimal laser wavelength and coupling this energy source to a delivery catheter which can safely and effectively recanalize lesions in the coronary arteries. The potential advantages of using laser energy for percutaneous revascularization of coronary artery disease include; 1) reducing the restenosis rate that occurs following balloon angioplasty in approximately one-third of patients [5, 8]; 2) reducing the frequency of abrupt artery occlusion and emergency coronary bypass grafting associated with balloon angioplasty ; and 3) extending the indications for percutaneous recanalization to patients currently considered to be poor candidates for balloon angioplasty, such as those with unfavorable lesions or diffuse disease [12, 15].
KeywordsExcimer Laser Balloon Angioplasty Tissue Ablation Laser Angioplasty Diameter Catheter
Unable to display preview. Download preview PDF.
- 2.Deckelbaum LI, Donaldson RF, Isner JM, Bernstein JS, Clark RH (1985) Elimination of pathologic injury associated with laser induced tissue ablation using pulsed energy delivery at low repetition rates (abstract). J Am Coll Cardiol 5: 408AGoogle Scholar
- 3.Esterowitz L, Hoffman C, Storm M (1986) A comparison of the erbium mid-IR laser and the short wavelength UV excimer lasers for medical applications. Proc International Conference on Lasers: 536–539Google Scholar
- 4.Forrester JS, Litvack F, Grundfest W, Mohr FW, Papaioannou T, Goldenberg T, Laundenslager J (1988) The excimer laser: Current knowledge and future prospects. J Interven Cardiol 1: 75–80Google Scholar
- 5.Holmes DR, Vlietstra RE, Smith HC, Vetrovec GW, Kent KM, Cowley JM, Faxon DP, Gruentzig AR, Kelsey SF, Detre KM, Van Raden MJ, Mock MB (1984) Restenosis after percutaneous transluminal coronary angioplasty (PTCA): A report from the PTCA registry of the National Heart, Lung, and Blood Institute. Am J Cardiol 53: 77c - 81cPubMedCrossRefGoogle Scholar
- 7.Kopchok GE, White RA, Tabbara M, Saadatmanesh V, Peng S (1990) Holmium: YAG laser ablation of vascular tissue. Lasers Surg Med 10: 405–413Google Scholar
- 10.Macruz R, Ribeiro MP, BrumJMG, Pasqualucci A, Mnitentag J, Bozinis DG, Marques E, Jatene AD, Decourt LV, Armelin E (1985) Laser surgery in enclosed spaces: A review. Lasers Surg Med 5: 199–218Google Scholar
- 11.Parrish JA, Anderson RR, Harriet T, Paul B, Murphy GF (1983) Selective thermal effects with pulsed irradiation from lasers: From organ to organelle. Dermatology 80: 75s - 80sGoogle Scholar
- 15.Spies JB, Bakal CW, Burke DR, Bonnier JJ (1990) Guidlines for percutaneous transluminal angioplasty. Radiology 177: 619–626Google Scholar
- 19.White CJ, Ramee SR, Mesa JE, Collins TJ, Murgo JP, Godfrey M (1990) Recanalization of totally occluded arteries using a holmium: YAG laser and lensed optical fiber (abstract). Circulation 82 (suppl III): III - 677Google Scholar