Laser Angioplasty in Total Coronary Occlusions

In 41 patients (pts) with class II and III angina pectoris and total coronary artery occlusion, laser PTCA was considered at the Turkey's Advanced Specialty Hospital in Ankara. The obstructed artery was left anterior descending in 15 pts, circumflex in 11 pts and the right coronary artery in 15 pts. Conventional PTCA utilizing floopy, intermediate, standard and magnum guide-wires preceded the procedure and proved successful in 23 pts. Occlusions not opened up by the conventional method in 18 pts (44 %) were subjected to laser angioplasty by Argon laser (Lastac System II). The procedure was abandoned in 6 patients due to lack of ascertainment of the Lastac balloon fiber being centralized. Of the 12 pts in whom laser angioplasty was carried out, the occlusion was opened in 7 and failed to be opened in the remaining five pts. This raised the overall angioplasty success ratio in total occlusions to 73 %. In conclusion, careful selection and application of laser coronary angioplasty is a useful and valuable method which is particularly indicated in total occlusions of less than 6 months' duration.