Laser angioplasty delivery systems and tip configurations

Laser energy has the potential to vaporize atherosclerotic arterial disease by photo-thermal and photo-ablative effects. Atraumatic delivery devices have been developed which are capable of efficient energy transfer to the target tissue. Recanalisation of totally occluded arteries is possible using both CW and pulsed lasers but perforation and dissection, at rates of up to 30%, remain a problem. Further developments in the field of steerability and imaging are likely to have the largest impact in improving the success rate of laser recanalisation. It would probably be beneficial if the next generation of delivery devices were able to achieve sufficient removal of occluding atheroma to create a lumen which does not require adjunctive balloon dilatation. Restenosis remains a significant cause of failure during long-term follow up