Long-Term Follow-up of Laser-Assisted Angioplasty: Analysis of Factors Influencing Restenosis and Patency

Abstract

In a prospective study 24 successful laser recanalizations of femoropopliteal occlusions (mean length, 10.4 cm ± 6.6) were followed up. Before recanaliza tion all patients were classified according to the Rutherford classification and after one year grouped as a clinical success or failure. From the present, the Rutherford classification appears to be useful in predicting long-term patency. The patients classified in the Rutherford categories 1 and 2 showed a long-term patency of 86%. The patients classified in the categories 3, 4, and 5 had a mean patency of only 30%. This difference was statistically significant.

The length of the occlusion influenced neither the patency nor the restenosis rate. The mean occlusion length in the vessels that remained patent was 10.3 cm ± 6.6, compared with a mean occlusion length of 10.5 cm ± 6.7 for the vessels that showed a restenosis.

Directly after the procedure, the mean patency of the successes was 83% and that of the failures was 63%. It is postulated that the influence of the laser and 20% overdilation can contribute to a better long-term patency.

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References

HF, De Odink Valois JC , Eikelboom BC : Femoropopliteal arterial occlusions: Laser-assisted versus conventional percutaneous transluminal angioplasty. Radiology 181:61-66, 1991.

Odink HF , De Valois JC , Eikelboom BC : Femoropopliteal arterial occlusions: Long-term follow-up of laser-assisted versus conventional percutaneous transluminal angioplasty. JVIR 1993; accepted for publication.

Rutherford RB , Flanigan DP , Gupta SK , et al: Suggested standards for reports dealing with lower extremity ischemia. Ad Hoc Committee on Reporting Standards, Society for Vascular Surgery/North American Chapter, International Society for Cardiovascular Surgery. J Vasc Surg 4:80-94, 1986.

Diakuzono N. , Joffe SN : Artificial sapphire probe for contact photocoagulation and tissue vaporization with the Nd:YAG laser. Med Instr 19:173-178, 1985.

Geschwind HJ , Kern MJ , Vandormael MG , et al: Efficiency and safety of optically modified fiber tips for laser angioplasty. J Am Coll Cardiol 10:655-661, 1987.

Lammer J. , Kleinert R. , Pilger E. , et al: Contact probes for intravascular laser recanalization: Experimental evaluation. Invest Radiol 24:190-195, 1989.

Borst C. , Verdaasdonk RM , Boulanger Lhma , et al: Comparison of hot tip and sapphire tip recanalization. In: Advances in Laser Medicine, ed. by Biamino G , Muller HJ. Berlin: Ecomed, 1988, pp 70-80.

Baker JD , Dix D. : Variability of Doppler ankle pressures with arterial occlusive disease; an evaluation of ankle index and brachial-ankle pressure gradient. Surgery 89:134-137, 1981.

Eikelboom BC , HF, De Odink ValoisJC : Percutaneous transluminal angioplasty. In: Surgical Management of Vascular Diseases, ed. by Bell PRF , Jamieson CW , Ruckley CV. London; Baillière Tindall, 1992, pp 469-490.

10.

Rutherford RB , Becker GJ : Standards for evaluating and reporting the results of surgical and percutaneous therapy for peripheral arterial disease . Radiology 181:277-281, 1991.

11.

Murray RR , Hewes RC , White RJ , et al: Long-segment femoropopliteal stenoses: Is angioplasty a boon or a bust? Radiology 162:473-476, 1987.

12.

Krepel VM , Van Andel GJ , Van Erp Wfm , et al: Percutaneous transluminal angioplasty of the femoropopliteal artery: Initial and long-term results. Radiology 156:325-328, 1985.

13.

Lammer J. , Pilger E. , Karnel F. , et al: Laser angioplasty: Results of a prospective, multicenter study at 3-year follow-up. Radiology 178:335-337, 1991.