Peripheral arterial occlusions: initial results from percutaneous angioplasty with a hybrid laser probe.

Percutaneous laser-assisted angioplasty performed with a laser-heated metal-capped fiber has been shown to be safe and effective. A hybrid probe was developed that allows a small percentage of laser light to emerge, converting the rest to heat. The probe was used to recanalize 37 peripheral arterial occlusions (10 in the iliac segment, 2-7 cm long, and 27 in the femoropopliteal segment, 1-35 cm long) in 37 patients. Primary success was defined as successful recanalization and continued patency during the first 24 hours, as assessed at physical examination. Primary success in the iliac segments was 70% and in the femoropopliteal segments was 85% (overall, 81%). The only complication was an arterial wall perforation, which had no sequelae. The probe is safe for use in peripheral arterial occlusions. There was no increase in the rate of perforation compared with the rate with the "hot-tip" laser probe, and the technique may have advantages over use of the original "hot-tip" laser probe.