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Combined percutaneous biosense‐guided laser myocardial revascularization and coronary intervention
Author(s) -
Laham Roger J.,
Baim Donald S.
Publication year - 2001
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.1156
Subject(s) - medicine , revascularization , percutaneous coronary intervention , percutaneous , cardiology , conventional pci , angina , surgery , myocardial infarction
Laser myocardial revascularization is a promising new treatment strategy for patients with severe ischemic heart disease who are not candidates for conventional percutaneous or surgical revascularization. The open chest surgical approach to transmyocardial revascularization has been approved by the FDA for the treatment of angina in inoperable patients, but has had limited use as a stand‐alone procedure. More recently, use of fiber‐optic catheters has made it possible to use a holmium:yttrium aluminum garnet laser to perform percutaneous catheter‐based transmyocardial revascularization. To the extent that many patients have a combination of ischemic sources, some amenable to conventional revascularization and some not, combination or hybrid approaches have been considered. We report herein two patients with class IV angina who underwent laser myocardial revascularization using the Biosense system and complex percutaneous coronary intervention during the same procedure. Areas amenable to conventional percutaneous coronary intervention (PCI) were so treated, and viable but ischemic areas were supplied by totally occluded native vessels and bypass grafts underwent Biosense‐guided laser myocardial revascularization (LMR). As the results of more controlled and blinded studies of laser myocardial revascularization become available (if results continue to be promising) and a better understanding of the mechanism of action of this treatment modality is achieved, LMR‐PTCA hybrid will be performed in increasing frequency. However, even after establishing LMR efficacy, studies of LMR‐PTCA hybrid should be conducted to determine the efficacy of this approach. Cathet Cardiovasc Intervent 2001;53:235–240. © 2001 Wiley‐Liss, Inc.