Endovascular laser methods in the treatment of arteriosclerotic cardiovascular diseases

Employment of laser for restoration of adequate blood flow in atherosclerotic vessels is a radically new approach to treatment of cardiovascular diseases of atherosclerotic genesis. Since 1983, wide-scale experimental work has been done at A.N. Bakulev Institute of Cardiovascular Surgery, USSR Academy of Medical Sciences, which has formed the basis for transluminal laser angioplasty (vascular recanalisation with high-intensity laser beam), laser atherolysis (regression of atherosclerotic formations under low-intensity laser beam), and their combinations. Clinical application of these procedures was started in 1985. Sixty-two patients with ischaemic heart disease, Takayasu's and Leriche's syndromes, chronic occlusion of pelvic and lower-limb arteries, and with combined lesions of the arterial bed were exposed to targeted transluminal laser. Laser endovascular therapy alone and in combination with balloon angioplasty or bypass surgery was used. Application of these methods showed their high efficacy. Successful recanalisation and restoration of adequate flow (confirmed by Doppler echography and angiography) were achieved in 93 per cent cases; results were poor (no effect, complications) in 7 per cent cases.