Femoropopliteal artery recanalization: factors affecting clinical outcome of conventional and laser-assisted balloon angioplasty.

PURPOSE

The clinical efficacy of 44 successful conventional and laser-assisted recanalizations of the femoropopliteal artery was assessed in a noncomparative study by the life-table method.

METHODS

Laser-assisted angioplasty using continuous laser and a sapphire probe was performed to achieve primary recanalization in femoral artery occlusions when conventional guidewire recanalization had already failed. Nineteen of the patients underwent a conventional recanalization (PTA; mean length of occlusion 4.4 +/- 4.1 cm), and 25 underwent percutaneous laser-assisted angioplasty (PLA; mean length of occlusion 10.1 +/- 6.7 cm).

RESULTS

There was no statistical relation between the preprocedure Fontaine classification and the success rate in the PTA cases (p = 0.25), whereas there was a statistical relation in the PLA cases: The success rate in patients preprocedurally classified as Fontaine II was better than in those classified as Fontaine III/IV (p = 0.05). After a 3-year follow-up the patency rate in the patients with the PTA recanalizations was 37% and that in those with the PLA procedure was 53%. This difference was not statistically significant (p = 0.47).

CONCLUSION

It is concluded that the laser should remain an investigational device.