VERGLEICH ZWISCHEN ARGON- UND EXCIMERLASER-ANGIOPLASTIE BEI PATIENTEN MIT LASIONEN DER A. FEMORALIS UND A. POPLITEA: KLINISCHE UND ANGIOGRAPHISCHE ERGEBNISSE NACH 1 JAHR

The aim of this study was to compare acute and long term results of thermic argon laser versus athermic XeCl-excimer laser for recanalization of femoropopliteal lesions in 43 patients with peripheral vascular diesease stage IIb to IV according to Fontaine. The argon laser system was applied in 29 lesions (9 stenoses, 20 occlusions up to 31 cm length) and an excimer laser was used in 28 lesions (10 stenoses, 18 occlusions up to 30 cm length). In all cases balloon dilatation followed laser recanalization to achieve a sufficient primary result (<25% stenosis rate). Primary success was obtained in 86% with both laser systems. After 1 year 62.5 of there canalized vessels with excimer laser and 56% with argon laser were still patent. Neither acute nor long term results showed significant differences between both laser systems. Compared to the argon laser, the procedure with the excimer laser was of shorter duration which may be advantageous under routine conditions. After one year, combining the results of both systems, the reocclusion rates of stenoses amounted to 22%, the reocclusion rates of short distance occlusions to 35% and that of long occlusions more than 10 cm length to 71%. With regard to the high reocclusion rate after reopening of long occlusions the laser systems seem to be of advantage, compared to balloon angioplasty mainly in critical stenosis and short occlusions which cannot be passed with the guide-wire.