抄録
Percutaneous transluminal laser angioplasty (PTLA) has been carried out on 90 lesions of peripheral arterial occlusive disease in 61 patients.
The number of lesions and degree of stenosis are as follows: 5 lesions (equal to or less than 50%), 3 lesions(over 50% and equal to or less than 80%), 54 lesions (over 80%, including complete occlusion).
There are 52 lesions that are equal to or less than 2cm in length, 24 lesions that are more than 2cm and equal to or less than 10cm, 14 lesions that are over 10cm.
A 1.06μm continuous wave Nd: YAG laser was used for the ablation and vaporization of atheromatous plaque and thrombus. The laser was irradiated by increments of 1 to 2 seconds at 80W using the noncontact method, at 10-25W using the contact method with a ceramic tip and at 10-15W with a bare laser fiber. Balloon dilatation was added.
The initial success rate was 90%. The 6-year cumulative patency rate after PTLA is 89.7% in the total lesions, 91.4% in the iliac lesions, 85.8% in the femoropopliteal lesions and 100% in the tibial or peroneal lesions.
PTLA seems to have improved the cumulative patency rate when compared with that of conventional PTA. PTLA enable to recanalized occluded arteries, even if the conventional PTA failed.
Distal embolization occured in 5 cases, but it could be avoided after we started to utilize aspiration of sludge materials with a 7 to 8F catheter.
No perforation of the artery by laser was encountered.
