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. 1989;16(3):171–176.

Complications of Laser-Assisted Angioplasty

Definition and Classification of Perforations

Edward B Diethrich 1, Ela Timbadia 1, Ilhan Bahadir 1
PMCID: PMC324877  PMID: 15227202

Abstract

Although laser-assisted angioplasty is becoming increasingly common, there has been no definitive report, drawing its data from a significant patient population, regarding the complications of this technique. To define and enumerate such adverse results, we collected data on 664 peripheral laser procedures performed in 349 patients over a 15-month period (February 1987 through April 1988). The complications proved similar to those of standard angioplasty: hematoma formation, 100 cases (15.0%); perforation/dissection, 38 cases (5.7%); acute thrombosis, 23 cases (3.5%); false aneurysm formation at the puncture site, 7 cases (1.1%); vascular spasm, 5 cases (0.8%); and embolism, 1 case (0.2%).

Because perforation was the most significant complication during angioplasty, we devised a system for uniform documentation and reporting of perforations, based on both the arterial condition responsible for the laser probe's deviation and the clinical consequences of the aberration. According to this system, Class-I perforations are dissections that do not penetrate the adventitia; Class-II perforations are adventitial wall ruptures (true perforations) that do not require treatment; and Class-III perforations are adventitial wall ruptures with hemorrhage. In our series, we had no Class-III perforation, but had 21 Class-I (3.1%) and 17 Class-II (2.6%) perforations.

Because prudent treatment of an evolving complication often can salvage the procedure, we discuss appropriate therapies, as well as preventive measures. (Texas Heart Institute Journal 1989;16:171-6)

Keywords: Angioplasty, laser-assisted

Keywords: arterial occlusive diseases

Keywords: dissection

Keywords: nomenclature, medical

Keywords: perforation

Keywords: peripheral vascular disease

Keywords: rupture, adventitial

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abela G. S. Laser arterial recanalization: a current perspective. J Am Coll Cardiol. 1988 Jul;12(1):103–105. doi: 10.1016/0735-1097(88)90362-2. [DOI] [PubMed] [Google Scholar]
  2. Abela G. S., Normann S. J., Cohen D. M., Franzini D., Feldman R. L., Crea F., Fenech A., Pepine C. J., Conti C. R. Laser recanalization of occluded atherosclerotic arteries in vivo and in vitro. Circulation. 1985 Feb;71(2):403–411. doi: 10.1161/01.cir.71.2.403. [DOI] [PubMed] [Google Scholar]
  3. Abela G. S., Seeger J. M., Barbieri E., Franzini D., Fenech A., Pepine C. J., Conti C. R. Laser angioplasty with angioscopic guidance in humans. J Am Coll Cardiol. 1986 Jul;8(1):184–192. doi: 10.1016/s0735-1097(86)80111-5. [DOI] [PubMed] [Google Scholar]
  4. Choy D. S., Stertzer S. H., Myler R. K., Marco J., Fournial G. Human coronary laser recanalization. Clin Cardiol. 1984 Jul;7(7):377–381. doi: 10.1002/clc.4960070701. [DOI] [PubMed] [Google Scholar]
  5. Choy D. S., Stertzer S., Loubeau J. M., Kesseler H., Quilici P., Rotterdam H., Meltzer L. Embolization and vessel wall perforation in argon laser recanalization. Lasers Surg Med. 1985;5(3):297–308. doi: 10.1002/lsm.1900050312. [DOI] [PubMed] [Google Scholar]
  6. Cumberland D. C., Sanborn T. A., Tayler D. I., Moore D. J., Welsh C. L., Greenfield A. J., Guben J. K., Ryan T. J. Percutaneous laser thermal angioplasty: initial clinical results with a laser probe in total peripheral artery occlusions. Lancet. 1986 Jun 28;1(8496):1457–1459. doi: 10.1016/s0140-6736(86)91498-4. [DOI] [PubMed] [Google Scholar]
  7. Cumberland D. C., Tayler D. I., Procter A. E. Laser-assisted percutaneous angioplasty: initial clinical experience in peripheral arteries. Clin Radiol. 1986 Sep;37(5):423–428. doi: 10.1016/s0009-9260(86)80048-4. [DOI] [PubMed] [Google Scholar]
  8. Cumberland D. C., Tayler D. I., Procter A. E. Percutaneous laser angioplasty. Initial clinical experience. Ann Radiol (Paris) 1986;29(2):215–218. [PubMed] [Google Scholar]
  9. Ginsburg R., Wexler L., Mitchell R. S., Profitt D. Percutaneous transluminal laser angioplasty for treatment of peripheral vascular disease. Clinical experience with 16 patients. Radiology. 1985 Sep;156(3):619–624. doi: 10.1148/radiology.156.3.3161118. [DOI] [PubMed] [Google Scholar]
  10. Labs J. D., Merillat J. C., Williams G. M. Analysis of solid phase debris from laser angioplasty: potential risks of atheroembolism. J Vasc Surg. 1988 Feb;7(2):326–335. [PubMed] [Google Scholar]
  11. Sanborn T. A., Faxon D. P., Haudenschild C. C., Ryan T. J. Experimental angioplasty: circumferential distribution of laser thermal energy with a laser probe. J Am Coll Cardiol. 1985 Apr;5(4):934–938. doi: 10.1016/s0735-1097(85)80436-8. [DOI] [PubMed] [Google Scholar]
  12. Sanborn T. A., Faxon D. P., Kellett M. A., Ryan T. J. Percutaneous coronary laser thermal angioplasty. J Am Coll Cardiol. 1986 Dec;8(6):1437–1440. doi: 10.1016/s0735-1097(86)80320-5. [DOI] [PubMed] [Google Scholar]
  13. Sanborn T. A., Greenfield A. J., Guben J. K., Menzoian J. O., LoGerfo F. W. Human percutaneous and intraoperative laser thermal angioplasty: initial clinical results as an adjunct to balloon angioplasty. J Vasc Surg. 1987 Jan;5(1):83–90. [PubMed] [Google Scholar]
  14. Sanborn T. A., Haudenschild C. C., Garber G. R., Ryan T. J., Faxon D. P. Angiographic and histologic consequences of laser thermal angioplasty: comparison with balloon angioplasty. Circulation. 1987 Jun;75(6):1281–1286. doi: 10.1161/01.cir.75.6.1281. [DOI] [PubMed] [Google Scholar]

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