CORONARY LASER ANGIOPLASTY - CURRENT CLIN ICAL STATUS AND EXPERIMENTAL PERSPECTIVES

From 1988 to 1995, approximately 10 000 patients with coronary artery disease have been treated using excimer laser angioplasty. All data un derline the feasibility and saftey of this technique. However, coronar y excimer laser angioplasty has been performed as a stand-alone proced ure in a minority of patients, only, either due to an insufficient ang iographic result, or due to complications such as abrupt vessel closur e, severe dissection or perforation. Clinical and angiographic follow- up studies have also documented that excimer laser angioplasty does no t reduce the incidence of restenosis following the coronary interventi on. Experimental results underline the importance of pressure waves an d bubble formations, which can cause additional vessel wall trauma des pite thermal injury. Promising new laser devices should offer high abl ation rates with only minimal thermal and acoustic tissue injury. It i s expected that such laser devices will emit in the mid-infrared spect rum of light.