[Percutaneous transluminal laser angioplasty].

Percutaneous transluminal laser angioplasty (PTLA) has been carried out on 63 peripheral arterial occlusive lesions in 43 patients. Most patients complained of intermittent claudication. The sites of lesions are the iliac artery (28 lesions or 44.4%), the femoropopliteal artery (30 lesions or 47.6%), and the below knee artery (5 lesions or 8.0%). There are 54 lesions (85.7%) that showed over 70% stenosis, with 19 of them complete occlusions (30.2%). Out of 63 lesions, 16 lesions or 25.4% had occlusions of over 10 cm. A Nd:YAG laser (1.06 microns, continuous wave) was used for the vaporization of atheromatous plaque and old thrombus. The laser was irradiated by increments of 1 to 2 seconds at 80W using the non-contact method, at 10-25W using the contact method with a ceramic tip and at 10-15W with a bare laser fiber. Balloon dilatation was then utilized. The initial success rate was 85.7%. The 5 year cumulative patency rate after PTLA is 88.4% in total cases, 88.7% in the iliac artery, 86.1% in the femoropopliteal artery, and 100% in the below knee artery. The 5 year cumulative patency rate for stenosis of the iliac artery is 91.0%, and it is 92% for stenosis of the femoropopliteal artery, and 81% for occlusion of the femoropopliteal artery. PTLA seems to have improved the cumulative patency rate when compared with that of conventional PTA.