Seeger J, Abela G S
Surg Annu. 1990;22:299-315.
Laser energy transmitted through fiberoptic systems can recanalize totally occluded peripheral arteries and improve extremity perfusion in selected patients with peripheral vascular disease. Such a technique is obviously appealing in that it (1) reduces the morbidity currently associated with the surgical treatment of symptomatic peripheral atherosclerosis, and (2) allows treatment of patients currently excluded from therapy by the presence of other severe medical problems or relatively mild symptoms. Unfortunately, current delivery systems allow recanalization of only a small channel by laser energy alone, and channel enlargement using balloon dilation is usually required. Clinical trials of laser angioplasty (laser-assisted balloon angioplasty) have shown acceptable results in the treatment of stenosis or short occlusions in the iliac and superficial femoral arteries, but results in patients with long occlusions or disease below the knee remain well below the results achieved by standard surgical therapy. Thus the impact of laser angioplasty on the treatment of peripheral vascular disease is limited at present and much work remains to be done to further develop this exciting new therapy for the treatment of peripheral vascular disease.
通过光纤系统传输的激光能量能够使完全闭塞的外周动脉再通，并改善部分患有外周血管疾病患者的肢体灌注。这种技术显然具有吸引力，因为它（1）降低了目前与有症状的外周动脉粥样硬化手术治疗相关的发病率，并且（2）能够治疗那些因存在其他严重内科问题或相对较轻症状而目前被排除在治疗之外的患者。不幸的是，目前的输送系统仅靠激光能量只能使一小通道再通，通常还需要使用球囊扩张来扩大通道。激光血管成形术（激光辅助球囊血管成形术）的临床试验表明，在治疗髂动脉和股浅动脉狭窄或短段闭塞方面取得了可接受的结果，但在治疗长段闭塞或膝以下疾病的患者中，其结果仍远低于标准手术治疗所取得的结果。因此，目前激光血管成形术对外周血管疾病治疗的影响有限，为进一步开发这种用于治疗外周血管疾病的令人兴奋的新疗法，仍有许多工作要做。
