Percutaneous translurninal balloon angioplasty (PTA) is being currently used in patients with coronary artery disease. Laser irradiation (LI) has been effective in vaporizing atherosclerotic plaques. The purpose of this work was twofold: 1) to compare PTA and LI techniques in the recanalization of experimental obstructive arterial lesions, and 2) to evaluate the possibility of reducing the failures and local complications and increasing the success rate of PTA by the combined use of LI. Atherosclerotic iliac stenoses were induced in 27 rabbits; lesions were evaluated angiographically before and after intervention and were studied histologically and by electron microscopy. Argon-ion LI delivered through microlens-tip optic fibers reduced the stenotic area from 64.2 f 21.8% to 40.3 f 10.7% (n = 10. P < .Ol) and PTA from 60.7 & 15.9% to 30.4 f 7.7% (n = 9, P < .01).
However. percentage reduction was higher in PTA-treated stenoses (48.4 f 10. I % vs 34.5 f 13.5%, P < .0125). In eight more rabbits, low power LI (4.55 & 1.25 J) was delivered after PTA in dilated segments. Post-PTA LI further decreased stenoses (from 31.2 f 7.8% to 29.1 f 8.1%. P < ,0125); laser-irradiated segments showed diffuse carbonization of the disrupted intimal layer. The normalized transtenotic pressure gradient decreased significantly in all groups: LI reduced the gradient from .40 f .25 to .I7
.07 (P = .005); PTA from .37 .14 to . I 1
.04 (P = .OOI); LI after PTA from .40 k .I6 to .I2 f .06 (P = .001).
Thus, LI is effective (less than PTA) in relieving experimental atherosclerotic stenoses and seems useful when combined with PTA.