The state of the excimer laser for coronary intervention in the drug-eluting stent era

Cardiovasc Revasc Med. Mar-Apr 2013;14(2):93-8. doi: 10.1016/j.carrev.2012.12.008. Epub 2013 Jan 16.

Abstract

Objectives: This study aims to determine how excimer laser coronary atherectomy (ELCA) performs in the drug-eluting stent (DES) era.

Background: For more than 20 years, ELCA has been used for coronary intervention. With developments in the coronary intervention field, the role of ELCA is in question.

Methods: The study includes 119 patients with 124 lesions who underwent percutaneous coronary intervention (PCI) with ELCA in our institution from January 2004 to May 2011.

Results: The main indications for ELCA use were saphenous vein graft (SVG) (45 lesions), acute myocardial infarction (AMI) (7 lesions), chronic total occlusion (CTO) (32 lesions), in-stent restenosis (ISR) (15 lesions), and calcified de-novo lesions (25 lesions). High success rates were recorded for the SVG, AMI, CTO, ISR, and calcified lesion indications (91.1%, 85.7%, 93.8%, 86.7%, and 80%; respectively). ELCA related complications were reported in 10 patients (8%); four dissections, three no-reflow phenomena, two perforations, and one thrombus formation.

Conclusion: ELCA is an alternative solution with acceptable performance in the treatment of complex coronary lesions not ideally suitable for balloon angioplasty.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary / adverse effects
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Atherectomy, Coronary / adverse effects
  • Atherectomy, Coronary / instrumentation*
  • Chi-Square Distribution
  • Coronary Disease / diagnosis
  • Coronary Disease / therapy*
  • Coronary Occlusion / therapy
  • Coronary Restenosis / therapy
  • Drug-Eluting Stents*
  • Equipment Design
  • Female
  • Graft Occlusion, Vascular / therapy
  • Humans
  • Lasers, Excimer / therapeutic use*
  • Male
  • Middle Aged
  • Myocardial Infarction / therapy
  • Patient Selection
  • Prosthesis Design
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Vascular Calcification / therapy