7 research outputs found
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Direct holmium laser-assisted balloon angioplasty in acute myocardial infarction
The holmium laser (Thulium-Holmium-Chromium: yttrium-aluminum garnet [YAG]laser) system was recently introduced for the treatment of atherosclerotic peripheral arterial and coronary artery lesions.
1–6 This pulsed mid-infrared laser (2.1 μm) ablates atherosclerotic tissue without significant thermal damage to adjacent tissue.
2,3,6,7 This study was designed to test the hypothesis that delivery characteristics of and tissue sensitivities to holmium laser energy make it a feasible treatment option in patients with acute myocardial infarction, with thrombosis and atherosclerotic plaque. In this report, we provide data on the first 3 cases of direct laserassisted balloon angioplasty during an acute myocardial infarction
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Effectiveness of Holmium laser-assisted coronary angioplasty
The efficacy of Holmium laser-assisted angioplasty was studied in 365 narrowings in 331 consecutive patients with coronary artery disease. Clinical indications for study were unstable angina pectoris in 140 patients (42%), stable angina in 136 patients (41%), postmyocardial infarction angina in 35 patients (10.5%), silent myocardial ischemia in 11 patients (3%), acute myocardial infarction in 1 patient (0.3%) and undefined in 8 patients (2%). Coronary morphology characteristics by Multivessel Angioplasty Prognosis Study group criteria were type A in 12.6%, type B1 in 34.2%, type B2 in 27.4% and type C in 25.4%. The laser successfully crossed the total length of the narrowing in 85.2%. Procedural success was 94.2%. Laser alone reduced mean percent luminal narrowing from 88 ± 11% to 57 ± 22%. Subsequent balloon angioplasty further reduced the mean luminal narrowing to 23 ± 18%. Major complication rate was 2.7% (death 0.3%, Q-wave myocardial infarction 0.5%, and emergent bypass surgery 2.7%). Six-month angiographic restenosis (>50% stenosis) rate was 44%