Percutaneous transluminal laser angioplasty with contact probes.

Percutaneous transluminal laser angioplasty (PTLA) with a metal contact probe and a sapphire contact probe was performed under experimental conditions and in 88 patients with femoropopliteal artery occlusions. The experiment revealed that more ablation was caused by the sapphire probe than by the metal probe. Because of heat accumulation in subsurface tissue layers the metal probe caused a three to four times larger zone of thermal necrosis surrounding the tissue defect. Clinically both contact probes revealed similar results. The initial rate of recanalization of femoropopliteal artery occlusions with a mean length of 8 cm was 78% (metal probe) to 82% (sapphire probe), and the perforation rate was 14% (metal probe) to 8% (sapphire probe). Doppler ultrasound examinations after 6 months revealed a patency rate of 84%. PTLA has proved to be a successful and safe procedure for recanalization of arterial obstructions that are not appropriate for fibrinolysis.