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A study of the radiological use of laser angioplasty in Britain

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Abstract

Laser recanalization was introduced and developed in Britain in the 1980s in an attempt to deal with the limitations associated with the conventional technique of percutaneous transluminal angioplasty (PTA). Since then, the use of this technique has decreased. This paper reports the findings of a comprehensive literature survey and interviews with a representative sample of British interventional radiologists on the reasons for this decline, and suggests the likely future direction for this technology. It has been determined that the main reasons for the decline are improvements in conventional guidewire and catheter technology, the high cost of the laser system, and the lack of evidence of any improvement in results compared with conventional PTA. However, despite current disenchantment, the majority of radiologists questioned felt that lasers could have a future role to play and that development of these systems should continue.

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References

  1. Faught WE, Lawrence PF. Vascular applications of lasers.Lasers Gen Surg 1992,72:681–704

    Google Scholar 

  2. Borst C. Percutaneous recanalisation of arteries: status and prospects of laser angioplasty with modified fibre tips.Lasers Med Sci 1987,2:137–50

    Google Scholar 

  3. Cragg AH, Gardiner GA, Smith TP. Vascular applications of laser.Radiology 1989,172:925–35

    PubMed  Google Scholar 

  4. Nordstrom LA, Castaneda-Zuniga ER, Young EG. Early clinical experience with direct argon laser angioplasty in peripheral arteries. In: Zeitler E, Seyferth W (eds)Pros & Cons in PTA and Auxiliary Methods. Berlin: Springer-Verlag, 1989

    Google Scholar 

  5. Strikwerda S, Kittrell C, Cothren RM, Feld MS, Kramer JR. The evolving role of laser radiation in the treatment of atherosclerotic vascular disease.J Med Imaging 1987,1:311–8

    Google Scholar 

  6. Perkins R. Lasers in medicine. In: Siegman A, Whinnery J (eds)Lasers: Invention to Application. USA: National Academy Press, 1988:118–22

    Google Scholar 

  7. Mueller G, Harnoss BM, Berlein HP, Biamino G. Feasibility of laser angioplasty: physical and technical problems. In: Zeitler E, Seyferth W (eds)Pros & Cons in PTA and Auxiliary Methods, Berlin: Springer-Verlag 1989:16–25

    Google Scholar 

  8. Fleischer HL, Thompson BW, McCowan TC, Ferris EJ, Reifsteck JE, Barnes RW. Human percutaneous laser angioplasty.Am J Surg 1987,154:6665–70

    Google Scholar 

  9. White RA, White GH, Vlasak J, Fugitani R, Kopchok GE. Histopathology of human laser thermal angioplasty recanalisation.Lasers in Surgery & Medicine 1988,8:469–76

    Google Scholar 

  10. Sanborn TA. Laser angioplasty—what has been learned from experimental studies and clinical trials?Circulation 1988,78:669–74

    Google Scholar 

  11. White RA, White GH. Laser thermal probe recanalisation of occluded arteries.J Vasc Surg 1989,9:598–608

    PubMed  Google Scholar 

  12. Bonn J. Clinical utility of laser recanalisation in occluded peripheral arteries.Radiology 1991,178:323–5

    PubMed  Google Scholar 

  13. Geschwind HJ. Development and experimental application of contact probe catheter for laser angioplasty. (J Am Coll Cardiol 9:101–7.) In:Lasers in Medical Science. London: Balliere Tindall, 1987

    Google Scholar 

  14. Polgar S, Thomas S.Introduction to Research in the Health Sciences. Melbourne: Churchill Livingstone 1989

    Google Scholar 

  15. Sanborn TA, Greenfield AJ. Peripheral laser angioplasty: the need for organised clinical trials.Radiology 1989,172:943

    PubMed  Google Scholar 

  16. Sanborn TA. Technical success, clinical success, and patency in laser angioplasty.Radiology 1989,170:576–8

    Google Scholar 

  17. Sanborn TA. Primary success, long-term patency, reporting standards, and indications for peripheral angioplasty devices.Circulation 1991,83:350–2

    PubMed  Google Scholar 

  18. Nordstorm LA, Casaneda WR, Von Seggern KB. Peripheral arterial obstructions: analysis of patency I year after laser-assisted transluminal angioplasty.Radiology 1991,181:515–20

    PubMed  Google Scholar 

  19. Moore N.How to do Research, 2nd edn. London: Library Association Publishing Ltd, 1987

    Google Scholar 

  20. Bryman A (Ed).Doing Research in Organisations. London: Routledge, 1988:Chap 3

    Google Scholar 

  21. Bryman A.Quantity and Quality in Social Research, 2nd edn. London: Unwin Hyman, 1990

    Google Scholar 

  22. Egerter DE. Laser angioplasty can replace surgery in long occlusions.Diagnostic Imaging. April 1989

  23. Lammer J, Karnel F. Percutaneous transluminal laser angioplasty with contact probes.Radiology 1988,168:733–7

    PubMed  Google Scholar 

  24. Yarborough JM. Taking the confusion out of matching medical lasers to applications.Photonics Spectra (Medical Lasers) Oct 1992

  25. Michaels J, Cross FW, Shaw P, Raphael M, Bowker T, Bown S, Adiseshiah M, Marston A. Laser angioplasty with a pulsed Nd-YAG laser: early clinical experience.Br J Surg 1989,76:921–4

    PubMed  Google Scholar 

  26. Dietrich EB, Timbadia E, Bahadir I. Applications and limitations of laser-assisted angioplasty.Eur J Vasc Surg 1989,3:61–70

    PubMed  Google Scholar 

  27. Cross FW, Bowker TJ, Bown SG. Arterial healing in the dog after intraluminal delivery of pulsed Nd-YAG laser energyBr J Surg 1987,74:430–5

    PubMed  Google Scholar 

  28. Lammer J, Pilger E, Karnel F, Schurawitzki H, Horvath W, Riedl M, Umek H, Ilein G, Schreyer H, Kretschmer G, Haidinger D, Partsch H. Laser angioplasty—results of a prospective, multicentre study at 3-year follow-up.Radiology 1991,178:335–7

    PubMed  Google Scholar 

  29. Dietrich EB, Timbadia E, Bahadir I. Applications and limitations of laser-assisted angioplasty.Eur J Vasc Surg 1989,3:61–70

    PubMed  Google Scholar 

  30. Murray A, Basu R, Wells J, Wood RFM. Defining parameters for peripheral laser angioplastyEur J Vasc Surg 1989,3:31–6

    PubMed  Google Scholar 

  31. Belli AM & Cumberland DC. Editorial—lasers in radiology.Clin Radiol 1990,41:75–6

    PubMed  Google Scholar 

  32. Litvack F, Grundfest WS, Segalowitz J, Papaioanniou T, Goldenberg T, Laudensleger J, Hesrin L, Forrester JS, Eigler NA, Cook S. Interventional cardiovascular therapy by laser and thermal angioplasty.Circulation 1990,81 (Suppl. IV):109–16

    Google Scholar 

  33. Cross FW, Bowker TJ. Percutaneous laser angioplasty with sapphire tips.The Lancet 1987,I:330

    Google Scholar 

  34. Dixon JA. Surgical Application of Lasers, 2nd edn. USA: Year Book Medical Publishers Inc., 1987

    Google Scholar 

  35. Pilger E, Lammer J, Berturch H, Stark G, Decrinis M, Pfeiffer KP, Krejs GJ. ND:Yag laser with sapphire tip combined with balloon angioplasty in peripheral arterial occlusions—long-term results.Circ. 1991,83:141–7

    Google Scholar 

  36. Jeans WD, Murphy P, Hughes AO, Horrocks M, Baird RN. Randomised trial of laser-assisted passage through occluded femoro-popliteal arteries.B J R 1990,63:19–21

    Google Scholar 

  37. Doueck PC, Leon MB, Geschwind H, Cook PS, Selzer P, Miller DL, Bonner RF. Occlusive peripheral vascular disease—a multi-centre trial of fluorescenceguided, pulsed-dye laser-assisted balloon angioplasty.Radiology 1991,180:127–33

    PubMed  Google Scholar 

  38. Michaels JA, Cross FW, Bowker TJ, Brown SG, Samson G, Aita M, Adisehiah M, Marston A. Assessment of a new device for laser angioplasty.Eur J Vasc Surg 1989,3:71–7

    PubMed  Google Scholar 

  39. Belli A, Procter AE, Cumberland DC. Peripheral vascular occlusions: mechanical recanalisation with a metal laser probe after guidewire dissection.Radiology 1990,176:539–41

    PubMed  Google Scholar 

  40. Allen B, Loflin TG, Embry BM, Gaskin TA, Isobe JH, Martin RG. Occluded peripheral arteries—clinical utility of argon laser recanalisation.Radiology 1990,176:543–7

    PubMed  Google Scholar 

  41. Alart IP, Gerlach A, Grass HG. Laser-assisted balloon angioplasty in complete femoro-popliteal occlusions—preliminary results.Cardiovasc Intervent Radiol 1991,14:233–7

    PubMed  Google Scholar 

  42. Carswell H. Flaws limit progress of laser angioplasty.Diagnostic Imaging April 1990, 85–93

  43. Mitchell DC, Murray A, Wood RFM, Grasty M, Smith RE, Dacie JE, Walters TK, Cotton G. Laser-assisted angioplasty for arterial occlusions of the lower limb.Br J Surg 1992,79:81–5

    PubMed  Google Scholar 

  44. Sanborn TA. Coronary laser angioplasty—developing the optimum laser wavelength, fibre optics and catheter design.Optics and Photonics News 1992,3:14–5

    Google Scholar 

  45. Harrington ME, Schwartz ME, Sanborn TA, Mitty HA, Miller CA, McGinnis K, Harrington EB. Expanded indications for laser-assisted balloon angioplasty in peripheral arterial disease.J Vasc Surg 1990,11:146–55

    PubMed  Google Scholar 

  46. Cross FW, Mills TN, Bown SG. Pulsed Nd-YAG laser effects on normal and atheromatous aorta in vitro.Lasers in the Life Sciences 1987,1:193–211

    Google Scholar 

  47. Cumberland DC, Belli AM. Laser-assisted angioplasty. In: Zeitler E, Seyferth W (eds)Pros & Cons in PTA and Auxiliary Methods. Berlin: Springer-Verlag, 1989:91–100

    Google Scholar 

  48. Cross FW, van Gemert MJC. A thermal appraisal of the ablation process in canine aorta in vivo using a 100μsec pulsed Nd-YAG laser.Lasers Med Sci 1991,6:373–8

    Google Scholar 

  49. Strandness E, Barnes RW, Ring EJ. Indiscriminate use of laser angioplasty.Radiology 1989,172:945–6

    PubMed  Google Scholar 

  50. Litvack F, Warren S, Grundfest WS, Papaioannou T, Mohr FW, Jakubowski AT, Forrester JS. Role of laser and thermal ablation devices in the treatment of vascular diseasesAm J Cardiol 1988,61:81G-6G

    PubMed  Google Scholar 

  51. Wholey MH. Advances in balloon technology and reperfusion devices for peripheral circulation.Am J Cardiol 1988,61:87G-95G

    PubMed  Google Scholar 

  52. Spies JB, Lequire MH, Brantley SD, Williams JE, Beckett WC, Mills JL. Camparison of balloon angioplasty and laser thermal angioplasty in the treatment of femoro-popliteal atherosclerotic disease—initial results of a prospective randomised trial.JVIR 1990,1:39–42

    PubMed  Google Scholar 

  53. Levy JM, Hesel SJ, Horsley WW, Cook GC, Dickey JE. Value of laser-assisted angioplasty in the community hospital.Radiology 1989,170:1017–8

    PubMed  Google Scholar 

  54. Belli AM, Cumberland DC, Procter AE, Welsh CL. Follow-up of conventional angioplasty versus laser thermal angioplasty for total femoropopliteal artery occlusions: results of randomised trial.JVIR 1991,2:485–8

    PubMed  Google Scholar 

  55. Belli AM, Cumberland DC, Procter AE, Welsh CL. Total peripheral artery occlusions: conventional versus laser thermal recanalisation with a hybrid probe in percutaneous angioplasty—results of a randomised trial.Radiology 1991,181:57–60

    PubMed  Google Scholar 

  56. Lammer J, Pilger E, Klein GE, Karnel FJ, Decrinis M, Thurnher S. Prospective randomised trial of excimer lasers versus ND-YAG, laser conventional percutaneous transluminal angioplasty. Final report. (SS)Radiology (RSNA Edn) 1992,185:179

    Google Scholar 

  57. Geschwind HJ, Aptecar E, Boussignac G, Dubois-Rande JL, Zelinsky R, Poirot G, Tomaru T. Results and follow-up after percutaneous pulsed laser-assisted balloon angioplasty guided by spectroscopy.Circulation 1991,83:787–96

    PubMed  Google Scholar 

  58. Isner JM, Clarke RH. Laser angioplasty—unravelling the Gordian Knot.JACC 1986,7:705–7

    PubMed  Google Scholar 

  59. Raithel D. Arguments against percutaneous endovascular stents. In: Zeitler E, Seyfreth W (eds)Pros & Cons in PTA and Auxiliary Methods. Germany: Springer-Verlag, 1989:210–4

    Google Scholar 

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Authors and Affiliations

  1. School of Life Sciences, Kingston University, Kingston, Surrey, UK

    N. J. Mark

  2. School of Applied Physics, Kingston University, Penrhyn Road, KT1 2EE, Kingston, Surrey, UK

    A. T. Augousti

  3. St George's Hospital, Tooting, London, UK

    A. -M. Belli

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  1. N. J. Mark
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  2. A. T. Augousti
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  3. A. -M. Belli
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Mark, N.J., Augousti, A.T. & Belli, A.M. A study of the radiological use of laser angioplasty in Britain. Laser Med Sci 11, 79–95 (1996). https://doi.org/10.1007/BF02133205

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