REVIEW PAPER
Usage of excimer laser in coronary and peripheral artery stenosis – analysis of its safety aspect
1
Department of Epidemiology and Clinical Research Methodology, Medical University, Lublin, Poland
Corresponding author
Piotr Artur Machowiec
Department of Epidemiology and Clinical Research Methodology, Medical University, Radziwiłłowska 11, 20-080 Lublin, Poland
Department of Epidemiology and Clinical Research Methodology, Medical University, Radziwiłłowska 11, 20-080 Lublin, Poland
J Pre Clin Clin Res. 2020;14(4):145-150
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The technology of laser atherectomy has been known for about 20 years. Initial studies were not encouraging due to similar or lower efficacy compared to conventional angioplasty and greater complication rate. The introduction of new, low-profile catheters with high parameters of transmitted energy, a change in the procedure for performing angioplasty and the proper qualification of the lesions resulted in a reduction of adverse effects.
Objective:
The aim of the study was to present the current state of knowledge regarding the usage of excimer laser in coronary and peripheral arteries stenosis, its indications and contraindications as well as safety aspect. The article reviews 32 recent publications available on the PubMed and Google Scholar databases.
Abbreviated description of the state of knowledge:
The excimer laser emits ultraviolet energy and ablates the tissue in a vessel. The main indications for the use of the laser include: restenosis in the stent, ostial lesions, long, calcified lesions >20 mm and moderately and severely calcified lesions. There are isolated reports describing the use of ELCA in the treatment of acute coronary syndromes. Excimer laser also can be applied in a treatment of stenosis of peripheral arteries.
Conclusions:
Excimer laser coronary atherectomy is a safe and feasible technique for the treatment of ISR and is associated with a relatively low recurrent restenosis compared to scoring balloon dilatation alone. It is a very important and safe alternative to classic treatment methods, but further research assessing the usefulness of this procedure is required.
The technology of laser atherectomy has been known for about 20 years. Initial studies were not encouraging due to similar or lower efficacy compared to conventional angioplasty and greater complication rate. The introduction of new, low-profile catheters with high parameters of transmitted energy, a change in the procedure for performing angioplasty and the proper qualification of the lesions resulted in a reduction of adverse effects.
Objective:
The aim of the study was to present the current state of knowledge regarding the usage of excimer laser in coronary and peripheral arteries stenosis, its indications and contraindications as well as safety aspect. The article reviews 32 recent publications available on the PubMed and Google Scholar databases.
Abbreviated description of the state of knowledge:
The excimer laser emits ultraviolet energy and ablates the tissue in a vessel. The main indications for the use of the laser include: restenosis in the stent, ostial lesions, long, calcified lesions >20 mm and moderately and severely calcified lesions. There are isolated reports describing the use of ELCA in the treatment of acute coronary syndromes. Excimer laser also can be applied in a treatment of stenosis of peripheral arteries.
Conclusions:
Excimer laser coronary atherectomy is a safe and feasible technique for the treatment of ISR and is associated with a relatively low recurrent restenosis compared to scoring balloon dilatation alone. It is a very important and safe alternative to classic treatment methods, but further research assessing the usefulness of this procedure is required.
Machowiec PA, Ręka G, Piecewicz-Szczęsna H. Usage of excimer laser in coronary and peripheral arteries stenosis with analysis of its safety aspect. J Pre-Clin Clin Res. 2020; 14(4): 145–150. doi: 10.26444/jpccr/127732
REFERENCES (32)
1.
Shibui T, Tsuchiyama T, Masuda S, et al. Excimer laser coronary atherectomy prior to paclitaxel-coated balloon angioplasty for de novo coronary artery lesions. Lasers Med Sci. 2020 Apr 18. https://doi.org/10.1007/s10103....
2.
Egred M, Brilakis ES. Excimer Laser Coronary Angioplasty (ELCA): Fundamentals, Mechanism of Action, and Clinical Applications. J Invasive Cardiol. 2020 Feb; 32(2): E27-E35.
3.
Mangieri A, Jabbour RJ, Tanaka A, et al. Excimer laser facilitated coronary angioplasty of a heavy calcified lesion treated with bioresorbable scaffolds. J Cardiovasc Med (Hagerstown). 2016 Dec; 17 Suppl 2: e149-e150. https://doi.org/10.2459/JCM.00....
4.
Rawlins J, Din JN, Talwar S, et al. Coronary Intervention with the Excimer Laser: Review of the Technology and Outcome Data. Interv Cardiol. 2016 May; 11(1): 27–32. https://doi.org/10.15420/icr.2....
5.
Ambrosini V, Sorropago G, Laurenzano E, et al. Early outcome of high energy Laser (Excimer) facilitated coronary angioplasty ON hARD and complex calcified and balloOn-resistant coronary lesions: LEONARDO Study. Cardiovasc Revasc Med. 2015 Apr-May; 16(3): 141–6. https://doi.org/10.1016/j.carr....
6.
Hirose S, Ashikaga T, Hatano Y, et al. Treatment of in-stent restenosis with excimer laser coronary angioplasty: benefits over scoring balloon angioplasty alone. Lasers Med Sci. 2016 Nov; 31(8): 1691–1696. https://doi.org/10.1007/s10103....
7.
Ichimoto E, Kadohira T, Nakayama T, et al. Long-Term Clinical Outcomes after Treatment with Excimer Laser Coronary Atherectomy for In-Stent Restenosis of Drug-Eluting Stent. Int Heart J. 2018 Jan 27; 59(1): 14–20. https://doi.org/10.1536/ihj.16....
8.
Nakabayashi K, Sunaga D, Kaneko N, et al. Simple percutaneous coronary interventions using the modification of complex coronary lesion with excimer laser. Cardiovasc Revasc Med. 2019 Apr; 20(4): 293–302. https://doi.org/10.1016/j.carr....
9.
Miyazaki T, Ashikaga T, Fukushima T, et al. Treatment of In-Stent Restenosis by Excimer Laser Coronary Atherectomy and Drug-Coated Balloon: Serial Assessment with Optical Coherence Tomography. J Interv Cardiol. 2019 Apr 18; 2019: 6515129. https://doi.org/10.1155/2019/6....
10.
Yoshida R, Takagi K, Morishima I, et al. The mechanism and prognosis of vessel perforation following excimer laser coronary angioplasty in the new generation laser catheter era. Postepy Kardiol Interwencyjnej. 2019; 15(3): 364–367. https://doi.org/ 10.5114/aic.2019.87894.
11.
Almasoud A, Walters D, Mahmud E. Robotically performed excimer laser coronary atherectomy: Proof of feasibility. Catheter Cardiovasc Interv. 2018 Oct 1; 92(4): 713–716. https://doi.org/10.1002/ccd.27....
12.
Ocaranza-Sánchez R, Abellás-Sequeiros RA, Galvão-Braga C, et al. Excimer Laser Coronary Atherectomy During Percutaneous Coronary Intervention. Rev Esp Cardiol (Engl Ed). 2016 Sep; 69(9): 867–8. https://doi.org/10.1016/j.rec.....
13.
McKenzie D, Talwar S, Jokhi P, et al. How should I treat severe coronary artery calcification when it is not possible to dilate a balloon or deliver a RotaWire™? EuroIntervention. 2011; 6(6): 779–783. https://doi.org/10.4244/eijv6i....
14.
Rawlins J, Talwar S, Green M, et al. Optical coherence tomography following percutaneous coronary intervention with excimer laser coronary atherectomy. Cardiovasc Revasc Med. 2014; 15(1): 29–34. https://doi.org/10.1016/j.carr....
15.
Fernandez JP, HobsonAR, McKenzie DB, et al. How should I treat severe calcific coronary artery disease?. EuroIntervention. 2011 Jul; 7(3): 400–7. https://doi.org/10.4244/EIJV71....
16.
Shibata N, Takagi K, Morishima I, et al. The impact of the excimer laser on myocardial salvage in ST-elevation acute myocardial infarction via nuclear scintigraphy. Int J Cardiovasc Imaging. 2020 Jan; 36(1): 161–170. https://doi.org/10.1007/s10554....
17.
Yagishita A, Goya M, Sekigawa M, et al. Transvenous excimer laser-assisted lead extraction of cardiac implantable electrical devices in the Japanese elderly population. J Cardiol. 2020 Apr; 75(4): 410–414. https://doi.org/10.1016/j.jjcc....
18.
Zhao X, Jing, QM, Wang ZF, et al. Effect of excimer laser coronary atherectomy in the interventional treatment of acute coronary syndrome. Chinese journal of cardiovascular diseases. 2018 Oct 24; 46(10): 795–798. https://doi.org/10.3760/cma.j.....
19.
Ambrosini V, Golino L, Niccoli G, et al. The combined use of Drug-eluting balloon and Excimer laser for coronary artery Restenosis In-Stent Treatment: The DERIST study. Cardiovasc Revasc Med. 2017 Apr-May; 18(3): 165 –168. https://doi.org /10.1016/j.carrev.2016.12.012.
20.
Lee T, Shlofmitz RA, Song L, et al. The effectiveness of excimer laser angioplasty to treat coronary in-stent restenosis with peri-stent calcium as assessed by optical coherence tomography. EuroIntervention. 2019 Jun 12; 15(3): e279-e288. https://doi.org/10.4244/EIJ-D-....
21.
Andreou AY, Kyriakou T, Mavroudis C. Excimer laser-facilitated stent expansion: The effect of contrast enhancement. Hellenic J Cardiol. 2017 Jul-Aug; 58(4): 303–305. https://doi.org/10.1016/j.hjc.....
22.
Mintz GS, Intravascular Imaging of Coronary Calcification and Its Clinical Implications, JACC: Cardiovascular Imaging, 2015 Apr; 8(4): 461–471. https://doi.org/10.1016/j.jcmg....
23.
Fernandez JP, Hobson AR, McKenzie D, et al. Beyond the balloon: excimer coronary laser atherectomy used alone or in combination with rotational atherectomy in the treatment of chronic total occlusions, non-crossable and non-expansible coronary lesions. EuroIntervention. 2013; 9: 243–50.
24.
Mohandes M, Rojas S, Moreno C, et al. Excimer Laser in Percutaneous Coronary Intervention of Device Uncrossable Chronic Total and Functional Occlusions. Cardiovascular Revascularization Medicine. 2020; 21(5): 657–660. https://doi.org/10.1016/j.carr....
25.
Hajibandeh S, Hajibandeh S, Antoniou SA, et al. Treatment strategies for in-stent restenosis in peripheral arterial disease: a systematic review. Interact Cardiovasc Thorac Surg. 2019 Feb 1; 28(2): 253–261. https://doi.org/10.1093/icvts/....
26.
Liu H, Gu Y, Yang S, et al. Excimer laser atherectomy combined with drug-coated balloon angioplasty for the treatment of chronic obstructive femoropopliteal arterial disease. Exp Ther Med. 2020 Mar; 19(3): 1887–1895. https://doi.org/10.3892/etm.20....
27.
Dippel EJ, Makam P, Kovach R, et al. Randomized controlled study of excimer laser atherectomy for treatment of femoropopliteal in-stent restenosis: initial results from the EXCITE ISR trial (EXCImer Laser Randomized Controlled Study for Treatment of FemoropopliTEal In-Stent Restenosis). JACC Cardiovasc Interv. 2015 Jan; 8(1 Pt A): 92–101. https://doi.org/10.1016/j.jcin....
28.
Geach T. Peripheral artery disease: Laser light show--targeting in-stent restenosis in peripheral arteries with excimer laser atherectomy. Nat Rev Cardiol. 2015 Feb; 12(2): 63. https://doi.org/10.1038/nrcard....
29.
Mahmud E, Naghi J, Ang L, et al. Demonstration of the safety and feasibility of robotically assisted percutaneous coronary intervention in complex coronary lesions: Results of the CORA-PCI Study (Complex Robotically Assisted Percutaneous Coronary Intervention). JACC Cardiovasc Interv. 2017 Jul 10; 10(13): 1320–1327. https://doi.org/10.1016/j.jcin....
30.
Mahmud E, Dominguez A, Bahadorani J. First-in-human robotic percutaneous coronary intervention for unprotected left main stenosis. Catheter Cardiovasc Interv. 2016 Oct; 88(4): 565–570. https://doi.org/10.1002/ccd.26....
31.
Mahmud E, Schmid F, Kalmar P, et al. Feasibility and safety of robotic peripheral vascular interventions: Results of the RAPID trial. JACC Cardiovasc Interv. 2016 Oct 10; 9(19): 2058–2064. https://doi.org/10.1016/j.jcin....
32.
Mahmud E, Pourdjabbar A, Ang L, et al. Robotic technology in interventional cardiology: Current status and future perspectives. Catheter Cardiovasc Interv. 2017 Nov 15; 90(6): 956–962. https://doi.org/10.1002/ccd.27....
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