Coaxial laser energy delivery using a steerable catheter in canine coronary arteries.

Intracoronary delivery of argon laser energy was studied in eight anesthetized mongrel dogs. A No. 4.5 French single lumen catheter, with steerable guidewire and an optical fiber, was introduced through a Judkins-type femoral-coronary guiding catheter into three left anterior descending and eight left circumflex coronary arteries. A total of 65 laser energy exposures were made coaxially at 24 sites in the 11 arteries. At five sites, angiographically evident arterial perforation occurred with the first laser exposure, while at seven sites multiple laser exposures were made without angiographically evident perforation. All eight dogs remained hemodynamically stable, and were electively killed 5 +/- 1 hours following the procedure. Sections of myocardium from territories supplied by treated arteries demonstrated minimal or no pathology in 10 cases, while one territory had a small zone of early myocardial necrosis. This study suggests that standard coronary artery catheterization techniques can be used to introduce and position a steerable guidewire and an optical fiber in canine coronary arteries. Laser energy can repeatedly be delivered coaxially. Short-term deleterious effects may be reduced or eliminated, and exposure of blood elements to argon laser energy does not appear to create debris.