Margolis J R, Mehta S
Cardiovascular Laboratories, South Miami Hospital, Florida.
Am J Cardiol. 1992 May 7;69(15):3F-11F. doi: 10.1016/0002-9149(92)91176-5.
Recent experience with excimer laser coronary angioplasty (ELCA) has shown the safety and efficacy of the technique in the treatment of coronary stenosis, with results similar to percutaneous transluminal coronary angioplasty (PTCA). Several advantages of the excimer laser for intravascular use have been identified by the ELCA Registry, a group of 15 institutions nationally that have pooled data on their cooperative experience with ELCA. Advantages include the ability of the laser to ablate atheroma with microscopic precision without thermal injury and the ability of vessel surfaces to heal without scarring. The initial results of the multicenter investigation of ELCA in 958 patients indicate that ELCA may be indicated particularly for long, diffuse lesions. With the advent of larger diameter catheters, ELCA is a viable alternative to PTCA. Restenosis was seen as a significant problem, and it remained problematic at 6-month follow-up. In comparison with conventional balloon angioplasty, ELCA may eliminate that component of restenosis due to inadequate dilation or elastic recoil, but it does not appear to affect restenosis caused by smooth muscle proliferation. Catheter design and energy delivery continue to evolve and may affect future results of laser coronary angioplasty.
近期准分子激光冠状动脉成形术（ELCA）的经验表明，该技术在治疗冠状动脉狭窄方面具有安全性和有效性，其结果与经皮腔内冠状动脉成形术（PTCA）相似。准分子激光血管内应用的几个优点已被ELCA注册研究确认，该研究由全国15家机构组成，汇总了它们在ELCA合作经验方面的数据。优点包括激光能够以微观精度消融动脉粥样硬化斑块而无热损伤，以及血管表面能够无瘢痕愈合。ELCA对958例患者进行的多中心研究的初步结果表明，ELCA可能特别适用于长段弥漫性病变。随着更大直径导管的出现，ELCA成为PTCA的一种可行替代方法。再狭窄被视为一个重大问题，在6个月的随访中仍然存在。与传统球囊血管成形术相比，ELCA可能消除因扩张不足或弹性回缩导致的再狭窄部分，但似乎不影响由平滑肌增殖引起的再狭窄。导管设计和能量传输持续发展，可能会影响激光冠状动脉成形术未来的结果。
