Department of Cardiology, Charles University, 3rd School of Medicine, Prague, Czech Republic.
Diagn Interv Radiol. 2019 Sep;25(5):392-397. doi: 10.5152/dir.2019.18515.
Percutaneous transluminal angioplasty (PTA) is a routine procedure for the treatment of peripheral arterial disease. However, its main limitation is late restenosis occurring at a 1-year rate of 6%-60%. Restenosis arises from injury to the arterial wall including overstretching, compression and rupture of the atherosclerotic plaque during balloon inflation. It is hypothesized that better long-term angioplasty results are observed if atherosclerotic plaques are removed rather than compressed and fractured. Laser angioplasty is one method to remove atherosclerotic plaques. We discuss the principles of lasers, physical properties of laser light, history of laser angioplasty and effects of laser radiation on tissues. Large clinical studies using laser angioplasty are critically assessed. In comparison to conventional PTA, there are some advantages of laser angioplasty: easier passage through chronic and calcified occlusions and according to some studies, better short- and medium-term results regarding limb salvage and management of in-stent restenoses.
经皮腔内血管成形术（PTA）是治疗外周动脉疾病的常规方法。然而，其主要局限性是在 1 年内出现的晚期再狭窄率为 6%-60%。再狭窄是由动脉壁损伤引起的，包括球囊扩张过程中动脉粥样硬化斑块的过度拉伸、压缩和破裂。人们假设，如果去除而不是压缩和断裂动脉粥样硬化斑块，将获得更好的长期血管成形术结果。激光血管成形术是一种去除动脉粥样硬化斑块的方法。我们讨论了激光的原理、激光光的物理特性、激光血管成形术的历史以及激光辐射对组织的影响。对使用激光血管成形术的大型临床研究进行了批判性评估。与传统的 PTA 相比，激光血管成形术有一些优点：更容易通过慢性和钙化闭塞，并且根据一些研究，在肢体挽救和支架内再狭窄的管理方面具有更好的短期和中期结果。
