Limb salvage following laser-assisted angioplasty for critical limb ischemia: Results of the LACI multicenter trial

John R. Laird, Thomas Zeller, Bruce H. Gray, Dierk Scheinert, Mitar Vranic, Christopher Reiser, Giancarlo Biamino

Research output: Contribution to journalArticle

191 Scopus citations

Abstract

Purpose: To evaluate the effectiveness of laser-assisted angioplasty for patients with critical limb ischemia (CLI) who were poor candidates for surgical revascularization. Methods: A prospective registry at 14 sites in the US and Germany enrolled 145 patients with 155 critically ischemic limbs; the patients were poor candidates for bypass surgery owing to inadequate target vessel or saphenous vein, prohibitive cardiac disease, or significant comorbidities (ASA class 4). Additional comorbid risk factors included diabetes in 66%, hypertension in 83%, previous stroke in 21%, and myocardial infarction in 23%. Endovascular treatment included guidewire traversal and excimer laser angioplasty followed by balloon angioplasty with optional stenting. Results: Occlusions were present in 92% of limbs. A mean of 2.7±1.4 lesions were treated per limb; the total median treatment length was 11 cm (mean 16.2, range 0.2-123). Stents were implanted in 45% of limbs. Procedural success, defined as <50% residual stenosis in all treated lesions, was seen in 86% of limbs. At 6-month follow-up, limb salvage was achieved in 110 (92%) of 119 surviving patients or 118 (93%) 127 limbs. Conclusion: Excimer laser-assisted angioplasty for CLI offers high technical success and limb salvage rates in patients unfit for traditional surgical revascularization.

Original languageEnglish (US)
Pages (from-to)1-11
Number of pages11
JournalJournal of Endovascular Therapy
Volume13
Issue number1
DOIs
StatePublished - Feb 2006
Externally publishedYes

Keywords

  • Critical limb ischemia
  • Excimer laser
  • Laser angioplasty
  • Limb salvage

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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