angioplasty laser

[antoun]

Dear Sirs

What is the difference between laser angioplasty and stent?

[kenkeith]

QUOTE: What is the difference between laser angioplasty and stent?
QUOTE: Quite a number of patients are not really ideal for bypass surgery and conventional ballooning/stenting is not an option either due to the amount of plaque.

>>> When revasculariztion with either angioplasty (stent) or bypass surgery is not an option, there is laser revascularization... TMR (transmyocardium revascularzation).

According to the Cleveland Clinic,TMR is a treatment aimed at improving blood flow to areas of the heart that were not treated by angioplasty or surgery. A special carbon dioxide (CO 2) laser is used to create small channels in the heart muscle, improving blood flow in the heart. TMR is a surgical procedure. The procedure is performed through a small left chest incision or through a midline incision. Frequently, it is performed with coronary artery bypass surgery, but occasionally it is performed independently.

Laser angio is done with the CO 2 Heart Laser that uses a computer to direct laser beams to the appropriate area of the heart in between heartbeats, when the ventricle is filled with blood and the heart is relatively still. This helps to prevent electrical disturbances in the heart.

Thanks for your question and if you have any followup questions or comments you are welcome to respond. Take care.

[ed34]

I assumed that a stent was inserted after laser. The laser is set to the right frequency to obliterate plaque into microscopic particles which are they naturally flushed away by the body. I believe they use a saline solution now with laser to get the particles moving. Sometimes a balloon is used before the laser to assist with the process and obtain better results. I'm not certain, but a metal mesh tube (stent) is surely required after plaque has been removed because there will undoubtably be some irregularities along the lining of the vessel, which will promote clotting and restenosis. Quite a number of patients are not really ideal for bypass surgery and conventional ballooning/stenting is not an option either due to the amount of plaque. As well as laser, there is a Rotational atherectomy procedure where a high speed diamond tipped cutter is run along a guide wire to obliterate the plaque. This is a bit more risky because larger pieces can break off ahead of the cutter, forming a blockage in a smaller vessel. So far results with lasers have had no such problems, because light is used to break up the plaque, so there is no actual pushing force, breaking away larger chunks. Results of the newer lasers have been outstanding, especially at cleaning up the left main artery or left anterior descending.