Excimer laser angioplasty during aortocoronary bypass grafting.

Laser coronary angioplasty using the 308-nm Excimer laser was successfully performed intraoperatively during coronary artery bypass grafting. It achieved a reduction of the left anterior descending artery stenosis from 99% to 25% as seen on angioscopy, without evidence of vascular perforation or intimal disruption. The Excimer laser offers the opportunity for intraoperative endovascular remodeling and recanalization and has a potential role as an adjunct to existing standard coronary artery bypass grafting protocol.

Angioscopy for intraoperative management of thromboembolectomy.

Our experience with angioscopy suggests that direct visualization of the arterial lumen during thromboembolectomy procedures would provide a more reliable method of assessing luminal morphologic characteristics than angiography alone. We inspected 32 grafts (seven aortobifemoral, 18 infrainguinal bypass, and seven dialysis access fistula grafts) in 32 patients. Thirty-one patients had thrombotic events and one patient had an acute embolus.

Falloposcopy: a microendoscopic technique for visual exploration of the human fallopian tube from the uterotubal ostium to the fimbria using a transvaginal approach.

A transvaginal microendoscopic technique has been developed for safely exploring the human fallopian tube from the utero tubal ostium to the fimbria and adjacent peritoneal cavity. Falloposcopy was performed without complication or evidence of endotubal damage in 44 women, 38 of whom also underwent a concurrent laparoscopy. Eight women with normal tubes served as controls and 36 women with tubal damage underwent falloposcopy in an attempt to document endotubal defects.

Interventional cardiovascular therapy by laser and thermal angioplasty.

The advent of balloon angioplasty as a clinical device crystallized the concept of nonsurgical revascularization. The problems of restenosis, diffuse disease, and total occlusions persist despite the demonstrated efficacy of balloon angioplasty. During the past 5 years, a variety of laser devices and catheter designs have demonstrated usefulness in the treatment of peripheral vascular disease.

Percutaneous excimer-laser and excimer-laser-assisted angioplasty of the lower extremities: results of initial clinical trial.

Percutaneous peripheral excimer-laser angioplasty at 308 nm was used for treatment of 30 patients with peripheral vascular disease. Twenty-eight patients underwent laser-assisted balloon angioplasty, and two patients underwent laser angioplasty alone. Acute angiographic and clinical success was achieved in 24 of 31 (77%) femoropopliteal stenoses and occlusions.

Intraoperative decisions based on angioscopy in peripheral vascular surgery.

We describe the technique of intraoperative angioscopy for delineation of peripheral vascular anatomy. Angioscopes with outer diameters of 0.85-2.

Pulsed laser angioplasty: wavelength power and energy dependencies relevant to clinical application.

Despite the theoretical advantages of submicrosecond pulsing for clinical laser angioplasty systems, the optimal laser parameters for clinical application are undefined. Further, the enormous peak powers achieved by submicrosecond pulses destroy available fiberoptics. We irradiated 797 segments of cadaver atherosclerotic aorta with nanosecond pulses at 266, 308, 355, 532, and 1064 nanometers.