EFFECT OF MIDINFRARED HOLMIUM-YAG LASER ANGIOPLASTY WITH AND WITHOUT BALLOON ANGIOPLASTY ON ACUTE OUTCOME AND RESTENOSIS IN ATHEROSCLEROTICFEMORAL ARTERIES IN RABBITS
M. Ragosta et al., EFFECT OF MIDINFRARED HOLMIUM-YAG LASER ANGIOPLASTY WITH AND WITHOUT BALLOON ANGIOPLASTY ON ACUTE OUTCOME AND RESTENOSIS IN ATHEROSCLEROTICFEMORAL ARTERIES IN RABBITS, Lasers in surgery and medicine, 16(3), 1995, pp. 235-245
Background and Objective: Pulsed laser may lessen vascular damage and
reduce restenosis. This study examined the acute and chronic effects o
f midinfrared laser angioplasty with and without balloon angioplasty i
n atherosclerotic femoral arteries in rabbits. Study Design/Materials
and Methods: Atherosclerosis was induced in arteries by air desiccatio
n and cholesterol feeding. Arteries were assigned to one of four group
s: (1) laser angioplasty with a Thullium/Holmium/Chromium:YAG infrared
laser (Eclipse), (2) balloon angioplasty, (3) laser followed by ballo
on angioplasty, and (4) no intervention. Arteries were examined angiog
raphically and histologically at 2 hours and 28 days. Results: Interve
ntion groups had significant initial gain, but this gain was less with
laser alone than after balloon or after laser plus balloon. At 2 hour
s, laser alone caused greater arterial damage and thrombosis compared
to controls. At 28 days, arteries treated with laser plus balloon had
greater narrowing compared with arteries treated with balloon angiopla
sty. By multivariate regression analysis, the severity of the pre-inte
rvention stenosis (P = 0.001) and intervention with laser plus balloon
(P = 0.01) correlated independently with the severity of luminal narr
owing at 28 days. Conclusion: Midinfrared Ho:YAG laser angioplasty res
ulted in substantial acute damage with increased frequency of thrombus
formation in this rabbit model. Arteries treated with laser alone had
suboptimal initial gain and more obstruction by plaque at 28 days com
pared to nonintervened arteries. The adjunctive use of balloon angiopl
asty improved initial gain, but correlated with smaller luminal diamet
ers and more severe narrowing by plaque at 28 days. (C) 1995 Wiley-Lis
s, Inc.