Laser catheter thermal angioplasty: technique and early results in 34 patients

The laser catheter is a nylon vascular catheter with a metal tip that has an end hole as well as side holes. The metal tip is heated by laser energy delivered through an optical fiber embedded in the catheter wall. The catheter may be advanced over a guidewire for use as an adjunct to balloon angioplasty or for use in smaller vessels as the exclusive method of recanalization. We used the catheter to treat 34 patients with 54 discrete vascular lesions in 35 extremities. Twenty patients were treated for clinically significant claudication and 14 for ischemic changes. Laser catheter-assisted balloon angioplasty was used to treat six iliac artery occlusions, two iliac artery stenoses, 10 superficial femoral artery occlusions, 12 superficial femoral stenoses, four popliteal artery occlusions, and three popliteal stenoses. Initial technical and clinical success in these patients, with follow-up periods of 3-6 months, was equivalent to the results of previous reports of laser probe-assisted balloon angioplasty. In 11 patients, 15 of 17 popliteal or tibial-peroneal lesions were treated with the laser catheter without subsequent balloon angioplasty. The treatment was successful in eight of these patients, with follow-ups for up to 6 months. Our results suggest that the laser catheter is a useful device for the treatment of vascular stenosis or occlusion when used either as an adjunct to balloon angioplasty or in smaller vessels as the exclusive method for angioplasty.