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Laser thrombolysis in acute myocardial infarction: results of a clinical feasibility study.

Abstract：

:Laser thrombolysis is a new, experimental, catheter based intervention aimed at selectively removing intracoronary thrombus. This first clinical study was performed to assess the feasibility and safety of laser thrombolysis, as well as its potential therapeutic place in acute myocardial infarction. Eighteen patients with acute myocardial infarction, who were either noncandidates for, or failures on, intravenous fibrinolytic therapy were included for treatment with laser thrombolysis followed by balloon angioplasty. As a result of catheter and technical failures, the laser was actually fired in only 12 patients. Improvement in TIMI flow from grade 0-1 to grade 2-3 was observed in 10 of these 12 patients after laser application. The overall results of 18 patients were: increase in TIMI grade flow from 0.33 +/- 0.49 after wire passage to 1.28 +/- 1.23 (P = 0.0051) after attempted laser application, and to 2.67 +/- 0.97 after PTCA (P = 0.0004). Two patients with previous infarctions died from left ventricular failure despite successful laser thrombolysis. One patient died during emergency bypass surgery after a failed recanalization attempt. Perforation or laser related dissection did not occur. The concept of selective laser thrombus ablation seems to be safe and feasible, but substantial improvements of the laser delivery catheters are needed. Laser thrombolysis is not an effective stand-alone therapy in acute myocardial infarction, but other possible applications warrant further research and development efforts for this potentially useful interventional tool.

journal_name

J Interv Cardiol

journal_title

Journal of interventional cardiology

authors

den Heijer P,van Dijk RB,Pentinga ML,Hillege HL,Lie KI

doi

10.1111/j.1540-8183.1994.tb00492.x

subject

Has Abstract

pub_date

1994-12-01 00:00:00

pages

525-34

issue

6

eissn

0896-4327

issn

1540-8183

journal_volume

7

pub_type

临床试验,杂志文章,多中心研究

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