Intraoperative angioscopically monitored laser-assisted angioplasty in treating lower-extremity atherosclerotic occlusive disease.

As part of an ongoing multi-institutional study, our surgical center offered laser-assisted angioplasty to patients with significant, documented lower-extremity atherosclerotic occlusive disease, as an alternative to standard femoral-popliteal or femoral-tibial bypass. During the 1st 12 months of the study (September 1987 through August 1988), 31 patients had laser-assisted angioplasty in 34 limbs. The procedures were performed with an argon-powered laser probe that features a heated metallic tip and a window that furnishes 20% of the laser energy as a direct argon laser beam. Angioscopic monitoring was provided in each case. The immediate recanalization rate was 82% (28 of 34 limbs). After a follow-up period of 6 to 18 months (mean, 14 months), the patients continue to show clinical improvement of pretreatment symptoms, and noninvasive studies continue to reveal improved segmental arterial pressures. On the basis of this experience, we conclude that angioscopically monitored laser-assisted angioplasty has a role in the management of lower-extremity atherosclerotic occlusive disease.