Thermal laser-assisted balloon angioplasty of the superficial femoral artery: a multicenter review of 602 cases.

Abstract

A multicenter review of 602 procedures was performed to evaluate the effects of thermal laser-assisted balloon angioplasty on the superficial femoral artery. Four hundred thirty-nine (73%) patients underwent laser-assisted balloon angioplasty for claudication, and 163 (27%) underwent the procedure for limb salvage. Two hundred ninety-two laser-assisted balloon angioplasty procedures were performed for multifocal stenotic disease (greater than 80%) diameter reduction), 258 for total occlusion, and 52 procedures for both superficial femoral artery stenosis and occlusion. The initial recanalization rate was 89% (538/602) depending on the length of the lesion. Success of laser-assisted balloon angioplasty was verified by angioscopy or arteriography, and all patients underwent segmental Doppler studies before discharge and during midterm follow-up extending to 30 months (mean, 11.3 months). Complications occurred in 62 (10%) patients, but only one limb amputation occurred because of a complication related to a laser-assisted balloon angioplasty. Overall, 60% of initially successful procedures have remained patent, but long segment (greater than 7 cm) occlusions have fared poorly (25% patency at 30 months). This minimally invasive technology affords the opportunity to treat short segment (less than 7 cm) symptomatic superficial femoral artery occlusive disease with minimal risk. Initial success and midterm patency rates for appropriate lesions appear to make laser-assisted balloon angioplasty a viable adjunct in the treatment of superficial femoral artery occlusive disease.