Early outcome of high energy Laser (Excimer) facilitated coronary angioplasty ON hARD and complex calcified and balloOn-resistant coronary lesions: LEONARDO Study

Cardiovasc Revasc Med. 2015 Apr-May;16(3):141-6. doi: 10.1016/j.carrev.2015.02.002. Epub 2015 Feb 11.

Abstract

Aim: An innovative xenon-chlorine (excimer) pulsed laser catheter (ELCA X80) has been recently used for the treatment of complex coronary lesions, as calcified stenosis, chronic total occlusions and non-compliant plaques. Such complex lesions are difficult to adequately treat with balloon angioplasty and/or intracoronary stenting. The aim of this study was to examine the acute outcome of this approach on a cohort of patients with coronary lesions.

Methods and results: Eighty patients with 100 lesions were enrolled through four centers, and excimer laser coronary angioplasty was performed on 96 lesions (96%). Safety and effectiveness data were compared between patients treated with standard laser therapy and those treated with increased laser therapy. Laser success was obtained in 90 lesions (93.7%), procedural success was reached in 88 lesions (91.7%), and clinical success in was obtained in 87 lesions (90.6%). There was no perforation, major side branch occlusion, spasm, no-reflow phenomenon, dissection nor acute vessel closure. Increased laser parameters were used successfully for 49 resistant lesions without complications.

Conclusions: This study suggests that laser-facilitated coronary angioplasty is a simple, safe and effective device for the management of complex coronary lesions. Furthermore, higher laser energy levels delivered by this catheter improved the device performance without increasing complications.

Keywords: Complex coronary lesions; Coronary angioplasty; Hard calcified stenosis; Xenon–Chlorine laser.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary / methods
  • Angioplasty, Balloon, Laser-Assisted* / methods
  • Atherectomy, Coronary* / methods
  • Coronary Angiography* / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Revascularization / methods
  • Stents*
  • Time Factors
  • Treatment Outcome