Key result
Excimer laser PCI achieves ~82% success, favoring thrombus and plaque debulking over lesion compliance modification.
Why the study?
Is excimer laser application effective and safe across different lesion types in complex percutaneous coronary interventions?
Observational (n=100)
No
Is excimer laser application effective and safe across different lesion types in complex percutaneous coronary interventions?
p-value: p=0.001
Excimer laser application during complex PCI is safe and effective, with better immediate success and midterm outcomes for thrombus vaporization and plaque debulking compared to calcified lesions.
Supports laser use for thrombus and plaque debulking during complex PCI; leaves open its comparative.
OBJECTIVE: To assess the efficacy and safety of laser-assisted percutaneous coronary interventions (PCI) in an unselected population. METHODS: One hundred consecutive patients, who underwent a laser assisted PCI between January 2008 and March 2012, were included in the present study. Fifty-one patients underwent laser ablation for thrombus vaporization (Group 1), 36 patients for neointima/plaque debulking (Group 2) and 13 patients for lesion compliance modification in calcified lesions (Group 3). RESULTS: The rate of in-hospital serious events was 2%. The cumulative laser success was 82%, and it was significantly higher for Group 1 and Group 2 in comparison with Group 3 (p = 0.001). Furthermore, the need for repeat revascularization was significantly higher in the Group 3 compared with the others two groups (46% vs. 8% for Group 1 and 11% for Group 2, p = 0.03). The MACE rate was 14%. There was a trend toward a higher MACE rate in the Group 3 compared with others two groups (p = 0.05). CONCLUSIONS: Laser ablation is an effective and safe tool for complex PCI. Patients underwent laser for thrombus vaporization or for neointima/plaque debulking had better immediate success and better outcome at follow-up than patients underwent laser for lesion compliance modification.
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Tarsia et al. (2013) conducted an observational in Complex coronary lesions requiring percutaneous coronary intervention (n=100). Excimer laser-assisted percutaneous coronary intervention vs. Comparison between indication groups (thrombus vaporization, plaque debulking, compliance modification) was evaluated on Cumulative laser success (p=0.001). Excimer laser-assisted percutaneous coronary intervention achieved an 82% cumulative success rate, with significantly higher success for thrombus vaporization and plaque debulking compared to lesion compliance modification.
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