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  • Title: Expanded indications for laser-assisted balloon angioplasty in peripheral arterial disease.
    Author: Harrington ME, Schwartz ME, Sanborn TA, Mitty HA, Miller CA, McGinnis K, Harrington EB.
    Journal: J Vasc Surg; 1990 Jan; 11(1):146-54; discussion 154-5. PubMed ID: 2136922.
    Abstract:
    Successful recanalization of isolated femoropopliteal occlusions by laser-assisted balloon angioplasty has been widely reported. However, the utility of this approach in other sites remains undetermined. The potential of laser-assisted balloon angioplasty in the treatment of a broad spectrum of lower extremity atherosclerosis was explored. Seventy-seven limbs in 69 patients were treated with laser-assisted balloon angioplasty by means of a percutaneous approach. Technical success was achieved in 62/77 (81%), with 52/77 (68%) open at discharge. At a mean of 8.6 months' follow-up, cumulative patency was 50% at 6 months and 42% at 9 months. In 10 cases initial guide wire placement was not possible; primary laser probe passage was technically successful in six, with two open at latest follow-up. Eleven patients underwent laser therapy without balloon angioplasty of distal sites with technical success in eight; at most recent follow-up five were open at the site of sole laser therapy. Complications were frequent. Bleeding requiring transfusion occurred in six, with three patients requiring emergency surgery; worsened ischemia necessitating urgent arterial bypass grafting developed in five patients. In this series laser angioplasty carried significant complications and a high failure rate. Widespread application of this procedure should await further clinical investigation.
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