RECANALIZATION OF CHRONIC CORONARY OCCLUSIONS USING A LASER WIRE

Between August, 1993-December, 1994, recanalization of a chronically o ccluded coronary artery was attempted in 412 patients, with an overall success rate of 77%. The main reason for failure was subintimal track ing of the guide wire. However, in 13 patients, advancing the guide wi re was not possible either subintimally or in the former true lumen. I n 8 of these 13 patients with failed conventional recanalization, a se cond attempt was made using a 0.018'' laser wire. The suspected occlus ion duration was 6 wk-6 yr, and the occlusion length 6-21 mm. Successf ul crossing of the occlusion was achieved in 7 of 8 patients. One pati ent experienced pericardial hematoma without severe clinical consequen ces. Adjunctive conventional laser angioplasty and/or balloon dilatati on led to a residual stenosis of <50% in 7 patients. The laser wire te chnique may become an important new method for recanalizing chronic to tal coronary occlusions in selected patients. (C) 1996 Wiley-Liss, Inc .