Percutaneous transluminal coronary angioplasty restenosis: potential prevention with laser balloon angioplasty.

Restenosis after percutaneous transluminal coronary angioplasty may result primarily from the combination of a thrombogenic surface and local flow separation produced by disruption of the arterial wall and lumen. Elastic recoil and, perhaps, cellular proliferation further contribute to luminal compromise after percutaneous transluminal coronary angioplasty. Laser balloon angioplasty, performed during the final inflation of an otherwise conventional balloon angioplasty procedure, uses the coagulative properties of Nd:YAG laser radiation to weld together disrupted tissue elements thermally, to reduce elastic recoil and to destroy viable arterial tissue. Studies in human postmortem atheromatous arteries and in animal models in vivo indicate that laser balloon angioplasty, by creating a lumen that approximates the size and smooth cylindrical shape of the balloon, should be effective in the treatment of important causes of restenosis.