Usage of excimer laser in coronary and peripheral artery stenosis – analysis of its safety aspect

Introduction. The technology of laser atherectomy has been known for about 20 years. Initial studies were not encouraging due to similar or lower efficacy compared to conventional angioplasty and greater complication rate. The introduction of new, low-profile catheters with high parameters of transmitted energy, a change in the procedure for performing angioplasty and the proper qualification of the lesions resulted in a reduction of adverse effects. Objective. The aim of the study was to present the current state of knowledge regarding the usage of excimer laser in coronary and peripheral arteries stenosis, its indications and contraindications as well as safety aspect. The article reviews 32 recent publications available on the PubMed and Google Scholar databases. Abbreviated description of the state of knowledge. The excimer laser emits ultraviolet energy and ablates the tissue in a vessel. The main indications for the use of the laser include: restenosis in the stent, ostial lesions, long, calcified lesions >20 mm and moderately and severely calcified lesions. There are isolated reports describing the use of ELCA in the treatment of acute coronary syndromes. Excimer laser also can be applied in a treatment of stenosis of peripheral arteries. Conclusion. Excimer laser coronary atherectomy is a safe and feasible technique for the treatment of ISR and is associated with a relatively low recurrent restenosis compared to scoring balloon dilatation alone. It is a very important and safe alternative to classic treatment methods, but further research assessing the usefulness of this procedure is required.