Laser energy transmitted through fiberoptic systems can recanalize totally occluded peripheral arteries and improve extremity perfusion in selected patients with
peripheral vascular disease. Such a technique is obviously appealing in that it (1) reduces the morbidity currently associated with the surgical treatment of symptomatic peripheral
atherosclerosis, and (2) allows treatment of patients currently excluded from
therapy by the presence of other severe medical problems or relatively mild symptoms. Unfortunately, current delivery systems allow recanalization of only a small channel by
laser energy alone, and channel enlargement using balloon dilation is usually required. Clinical trials of laser angioplasty (laser-assisted balloon angioplasty) have shown acceptable results in the treatment of
stenosis or short occlusions in the iliac and superficial femoral arteries, but results in patients with long occlusions or disease below the knee remain well below the results achieved by standard surgical
therapy. Thus the impact of laser angioplasty on the treatment of
peripheral vascular disease is limited at present and much work remains to be done to further develop this exciting new
therapy for the treatment of
peripheral vascular disease.