Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Lammer, J; Pilger, E; Decrinis, M; Quehenberger, F; Klein, GE; Stark, G.
Pulsed excimer laser versus continuous-wave Nd:YAG laser versus conventional angioplasty of peripheral arterial occlusions: prospective, controlled, randomised trial.
Lancet. 1992; 340(8829):1183-1188
Doi: 10.1016/0140-6736(92)92891-I
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- Co-Autor*innen der Med Uni Graz
- Klein Guenther
- Pilger Ernst
- Quehenberger Franz
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- Abstract:
- Early clinical studies of coronary and peripheral laser angioplasty showed that arterial occlusions could be recanalised by continuous-wave lasers delivered with contact probes and by pulsed lasers applied with multifibre catheters. However, whether laser-assisted angioplasty improves success rates in reopening occlusions and in long-term patency rates is unclear. We have compared the primary recanalisation and long-term patency rates after laser-assisted and conventional percutaneous transluminal angioplasty (PTA) of femoropopliteal artery occlusions in 116 consecutive symptomatic patients (excimer laser 37, Nd:YAG laser 40, PTA 39). Primary recanalisation was achieved in 81 patients (70%). The primary recanalisation rate achieved with the excimer laser was significantly lower than that with the Nd:YAG laser (49% vs 78%, p < 0.01) or with PTA (82%, p < 0.003). The overall angiographic recanalisation rate (primary and secondary recanalisation) after laser and PTA was 89%. After 3 months, clinical improvement was recorded in 76% of patients. Clinical long-term results were available in 94 (91%), and angiographic long-term results in 77 (75%), of 103 successfully recanalised patients. Life-table analysis of the long-term results revealed no significant difference of the restenosis rate between the three treatment groups. The 12-month patency rate was 60% as assessed clinically and 39% as judged by angiography. Primary and secondary recanalisation rates and long-term patency rates were significantly correlated with length of the occlusion. Our results suggest that PTA of femoropopliteal artery occlusions is only indicated if the occlusion is short (< 8 cm) and that laser-assisted angioplasty should only be used after failure of conventional PTA.
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- Aged -
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- Arterial Occlusive Diseases - surgery
- Female - surgery
- Femoral Artery - surgery
- Humans - surgery
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- Peripheral Vascular Diseases - surgery
- Popliteal Artery - surgery
- Postoperative Complications - epidemiology
- Prospective Studies - epidemiology
- Recurrence - epidemiology
- Reoperation - epidemiology
- Treatment Outcome - epidemiology
- Vascular Patency - epidemiology
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