Excimer laser(Cool laser)

[Excimer]

I'm a seventy year old white male who underwent a quad-bypass in 3/2000. I have severe coronary artery disease which I have been told is not condusive to further treatment by stents or angioplasty. I'm hypertensive(well under control)have Type II diabetes(well under control.) I have reoccuring episodes of angina which seem to be increasing in intensity. I wear a 0.8 nitor patch which offers some but, limited help. I've recently heard of a improved procedure which is known as Excimer laser coronary angioplasty that may offer me some relief. I'm intrested in finding a competent facility that has had successful experience in employing this procedure. Is it relatively safe at present with a low mortality rate? Any help would be greatly appreciated.

[CCF-M.D.-RCJ]

Excimer,

Thanks for the interesting post.

I had never heard of this technique prior to your post, and thus the delay in my response.  This is not a technique we use at CCF.  I don't know what the reasoning is for not using it, but will find out tomorrow (9/15/03).

I can tell you that this technique is very new.  There is only one report that I could find in a first tier cardiology journal.  In fact, only 14 references were found by me in Medline.

The first tier report was the following:

"Comparison of effectiveness of excimer laser angioplasty in patients with acute coronary syndromes in those with versus those without normal left ventricular function.

Topaz O, Minisi AJ, Bernardo N, Alimar R, Ereso A, Shah R.

Cardiac Catheterization Laboratories, Division of Cardiology, Medical College of Virginia Hospitals, Medical College of Virginia, Virginia Commonwealth University, Richmond 23249, USA. ***@****"

This group looked at 100 patients.  They were able to demonstrate plaque vaporization and improvement in blood flow.  I did not see a description of improvement in angina symptoms.  It might be worth emailing the address I listed above for further inquiry.

I hope that helps -- I'll try to comment tomorrow with additional information.

[bubba-01]

this is my question-my mom had a double bypass in oct 2003, 1 artery is fine and of the 2 arteries repaired, 1 caused a heart attack w/i 2 weeks w/ blood clot, and the other artery is useless. both the cardio and the cardio surgeon don't want to touch her because her lungs are horrid (from living with a smoker, she never smoked) she barely made it through the bypass and was vented for 1 1/2 weeks. the dr put her on topril with her other meds and said that by november if there is no improvement she could look into this new laser surgery. No one seems to know much about it. I am also a nurse and I have to unravel this puzzle but not sure where to start. any info would help. we live in nebraska

[Excimer]

Let me be very clear that I'm not in any way connected to the medical profession but, I will try and fill you in on what I have gleaned from the Internet. The Company that manufactures the "Cool Laser" device is called "Spectranetics".(Colorado Springs, CO.) They have a web page at www.spectranetics.com which should prove helpful. I called them and they literally bent over backwards to give me as much info as a lay person could handle. They're patient info number is 1-800-231-0978. The procedure has been employed on patients in Europe(Helsinki) and the USA. Specifically in the USA by The Medical College of Virginia, Virginia Commonwealth University. Beyond that, I haven't been able to gather further data. I hope this is of some help and I wish you and your mother the best.
Excimer

[CCF-M.D.-RCJ]

Excimer,

Conversations with the interventional cardiologists here at CCF indicate that they have a less than favorable impression of the laser technology for treatment of atherosclerosis.

They tell me that the restenosis rates are higher than that for simple balloon angioplasty.  Most interventionalists think that this is because of the heat produced by the procedure.

They further tell me that this technology has been around since the early 1990s, and has not caught on despite extensive study.

Good luck.