Recanalization of Occluded Peripheral Arteries by "Hot Tip" Laser System

Abstract

Recanalization of long-segment arterial occlusion is not feasible with the standard angioplasty technique, because of the inability to cross the occlusion. To restore the patency of the vessel the "hot tip laser system" was used. The hot tip laser recanali zation was performed on 41 patients (aged forty to seventy-eight, mean sixty). Thirty-nine patients had a complete femoral-popliteal occlusion — measuring 3 to 45 cm long, mean 17.4 cm, and 2 had an iliac occlusion 1-2 cm long. Eleven patients showed severe and 22 mild to moderate calci fications. After unsuccessful attempts to cross the occlusion by the wire, a 2-2.5 mm hot tip coupled to a 12 Watts argon laser was used. The laser procedure was always followed by balloon angioplasty. A successful re canalization was obtained in 28 of 41 occluded arteries (68%). In 7 patients the occlusion, heavily calcified, could not be crossed. In 1 patient there was intimal dissection with acute throm bosis on the first day. In 5 patients (12%) with long calcified occlusion the procedure was complicated by perforation. The hot tip system is ef fective in the recanalization of long occlusions. Inability to cross the oc clusion and perforation are more common in heavily calcified vessels.