Percutaneous coronary angioplasty with midinfrared laser and a new mult i f iber ca theter (letter)
- HJ Geschwind, JL Dubois-Rand, D Murphy-Chutor ian
Thirty patients with stenosis or total occlusion of the coronary artery were treated with mid infra-red pulsed laser angioplasty. The device consisted of a holmium-YAG laser operating at 2.1μm, 500 mJ pulse−1, 3.5 Hz, 250μs pulse−1. The laser was coupled into a multifibre catheter consisting of 37 optical fibres of 150μm each concentrically arranged around a central lumen for the passage of a guidewire. This ‘over-the-wire’ system allowed for safe and effective recanalization without perforation, death, arrythmia, distal embolus. Chest sensation but not pain occurred during laser emission. There was spasm in six patients which could be relieved by nitrates. In previously failed balloon angioplasty laser angioplasty allowed for successful repeat dilatation with low inflation pressure. Technical improvement should be made in reducing the dead space left in between the fibres at the distal catheter tip, in distal tip flexibility and in increasing the channel diameter for more laser ‘stand-alone’ therapy.