Percutaneous excimer laser angioplasty of aortocoronary saphenous vein grafts
F Litvack,
WS Grundfest,
T Goldenberg,
J Laudenslager,
and
JS Forrester
Department of Medicine (Cardiology), Cedars-Sinai Medical Center, Los Angeles, California 90048.
Percutaneous coronary excimer laser angioplasty was successfully performed in two patients. An 85 year old woman with a 99% stenosis in a vein graft to a posterior descending artery had the stenosis reduced to 30% with laser angioplasty. Subsequent balloon angioplasty reduced the stenosis further to 20%. A second patient, a man aged 50 years, had multiple previous balloon angioplasties and stent implantation with two subsequent percutaneous atherectomies. Laser angioplasty of the vein graft to the obtuse marginal branch reduced the first of three sequential lesions from 60% to 40%, the second lesion from 90% to none and the third from 60% to 20% without the need for balloon angioplasty. Both procedures were well tolerated without chest pain, burning, vascular perforation or thrombus formation. These cases demonstrate the feasibility of safely performing percutaneous coronary excimer laser angioplasty. Additional studies are indicated to determine the clinical role and potential benefits of this procedure in relation to established procedures and other experimental devices.
