Excimer Laser Ablation Successfully Treats Peripheral Artery Disease

A laser treatment for peripheral artery disease (PAD) reduces stenosis diameter by over 30% immediately following treatment, according to a new study.

Researchers at Harrisburg Hospital (PA, USA) conducting the CLiRpath Excimer Laser System to Enlarge Lumen Openings (CELLO) study enrolled 65 patients with claudication, or walking impairments caused by PAD. Laser-assisted recanalization with optional balloon angioplasty (BA) or BA + stenting were performed on superficial femoral and popliteal arteries that were at least 70% blocked. The primary endpoint was the reduction in index lesion-percent diameter stenosis (%DS) as measured by Doppler ultrasound. The primary safety endpoint was major adverse events at 6 months.


The results showed that laser ablation reduced the %DS from a median 77% at baseline to 34.7%, which was further reduced to 21% after adjunctive therapy with BA or BA + stenting; 8 (12.3%) patients did not receive post laser adjunctive therapy. There were no major adverse events, and target lesion revascularization was not required in 76.9% of the participants within the one-year follow-up. The study cohort demonstrated a statistically significant improvement in the walking impairment and functional status assessments during follow-up. In all, the study met its primary endpoint by reducing, on average, the percent diameter stenosis from 77.3% to 42.5% immediately post treatment. The study was published in the December 2009 issue of the Journal of Endovascular Therapy.

"Preventing the millions of leg amputations caused by PAD represents an urgent medical imperative,” said lead author Rajesh Dave, M.D. "This study demonstrated the Turbo-Booster's ability to produce larger lumens than what was previously achieved by excimer laser catheters alone. This may help reduce the need for aggressive adjunctive therapy, like stenting.”

The researchers used the Spectranetics (Colorado Springs, CO, USA) Turbo-Booster for the excimer laser-ablation procedures. The treatment delivers pulsed bursts of ultraviolet (UV) energy that vaporizes blockages into tiny particles that are easily dissolved into the bloodstream. In contrast to the long recovery time required for bypass surgery, the excimer laser ablation procedure is performed within one to two hours with only minutes of laser time, followed by one to two days of recovery. Patients typically experience very little, if any, discomfort during the procedure.

Related Links:
Harrisburg Hospital
Spectranetics