J. Honye et al., INTRAVASCULAR ULTRASOUND IMAGING AFTER EXCIMER-LASER ANGIOPLASTY, Catheterization and cardiovascular diagnosis, 32(3), 1994, pp. 213-222
To help elucidate the mechanism of excimer laser coronary angioplasty
(ELCA), intravascular ultrasound (IVUS) imaging was performed in 19 of
29 patients who were treated with ELCA. The results were compared wit
h a non-randomized control group of 18 patients who had IVUS studies b
oth before and after PTCA alone. After ELCA alone, lumen diameter (1.9
x 1.7 mm) and lumen cross-sectional area (CSA) (2.9 mm2) by IVUS were
not significantly different from baseline values in the patients befo
re PTCA alone (2.1 x 1.8 mm, 3.2 mm2). After balloon dilatation in the
laser treated group, lumen diameter (2.5 x 2.1 mm) and lumen CSA (4.9
mm2) were significantly greater than those post ELCA alone. However,
there was no difference in lumen CSA or atheroma CSA in the group trea
ted with excimer laser plus balloon dilatation vs. these measurements
in the group treated with PTCA alone. ELCA does not ablate a large amo
unt of atheroma (9% reduction) but creates a pathway to permit easier
passage of a PTCA balloon. These quantitative and morphologic results
may help explain why the restenosis rate with ELCA is similar to PTCA
alone. (C) 1994 Wiley-Liss, Inc.