[Clinical experience of laser angioplasty for the peripheral and coronary arterial diseases].

In recent years, laser angioplasty has been widely performed in the world. Since the 1980's we have investigated anigoplasy using Argon laser for patients with peripheral and coronary arterial diseases. This technique aims to open the obstructive arterial lumen. Based on the excellent results of experimental studies, this technique has been clinically applied. Laser angioplasty was carried out in 98 patients with stenotic or occlusive lesions of the peripheral arteries and 10 patients with anginal attack. Argon laser and an optical fiber delivery system with metal tip probe with thermal feedback control system were used for laser angioplasty. This procedure was performed under angioscopic and intravascular ultrasound imaging. Primary clinical success was achieved in 97 (82%) of all 119 lesions, that is, 53 (91%) of 58 in the stenotic lesions and 44 (72%) of 61 in the occlusive lesions. There were no complications required emergency operation. At 95 months of follow-up, the cumulative patency rate was 80% in 83 limbs with primary success. In the 43 stenoses and 40 occlusions, the cumulative patency rare were 87% and 71%, respectively. On the other hand, laser was simultaneously applied at the time of operation for 10 patients with anginal attack in addition to coronary artery bypass grafting. Thus, laser angioplasty was safe and effective to increase the initial success rate for the lesions that were difficult to treat by balloon anigoplasty. Angioscopy and intravascular ultrasound imaging were useful for the observation of the newly recanalized channel by lasing and selection of the recanalization technique, such as laser angioplasty, atherectomy and stent, according to the characterization of the lesions. These results suggested that laser angioplasty might be a useful treatment for patients with chronic peripheral arterial occlusion and improve the long-term patency rate by eliminating restenosis more than conventional balloon angioplasty.