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Percutaneous angioplasty of chronic arterial obstruction by a temperature-controlled Nd:YAG laser system

Feasibility of an Nd:YAG laser system with an automatic controller of hot-tip temperature was examined in 15 segments of the ileo-femoral artery of 13 patients. Before lasing, the temperature of the hot-tip to be attained was preset. Also, the upper limit temperature at which lasing was to be stopped was preset. A 1.8 mm hot-tip was introduced into the obstructed segments (14.7 +/- 6 cm in length) and lasing was performed. The temperature actually attained and the arterial luminal changes were monitored by monitor television and angioscopy, respectively. Complete recanalization was obtained without any complications in all segments. No thermal effects below 50 degree(s)C, coagulation at 100 degree(s)C, carbonization at 200 degree(s)C, and sticking of the hot-tip at 300 degree(s)C, could be observed by angioscopy. Rapid recanalization was obtained at 200 - 300 degree(s)C. The results indicate that the temperature-controlled laser system is feasible and tip temperature of 200 degree(s)C - 300 degree(s)C is maximal for treatment of chronic arterial obstruction.