Clinical results with excimer laser coronary angioplasty.

This comprehensive review of randomized trials and registry reports makes several assertions about the clinical usefulness of excimer laser angioplasty. First, refinements in patient selection and excimer laser technique have resulted in improved procedural outcome. Second, the overall rates of clinical success for excimer laser angioplasty are approximately 90%, major and minor complications 6%, and vessel perforation 1%. Third, superior success rates are achieved for saphenous vein graft lesions, ostial stenoses and total occlusions, but decreased success rates are obtained for bifurcation, calcified and thrombus-containing lesions. The routine use of saline infusion during excimer laser angioplasty and careful evaluation of this therapy for new indications such as in-stent restenosis will increase the usefulness of excimer laser angioplasty in interventional cardiovascular medicine.