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

188 Citations (Scopus)

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

Fingerprint

Laser-Assisted Balloon Angioplasty
Limb Salvage
Multicenter Studies
Ischemia
Extremities
Excimer Lasers
Laser Angioplasty
Balloon Angioplasty
Saphenous Vein
Stents
Germany
Registries
Comorbidity
Heart Diseases
Pathologic Constriction
Stroke
Myocardial Infarction
Hypertension

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Limb salvage following laser-assisted angioplasty for critical limb ischemia : Results of the LACI multicenter trial. / Laird, John R.; Zeller, Thomas; Gray, Bruce H.; Scheinert, Dierk; Vranic, Mitar; Reiser, Christopher; Biamino, Giancarlo.

In: Journal of Endovascular Therapy, Vol. 13, No. 1, 02.2006, p. 1-11.

Research output: Contribution to journalArticle

Laird, John R. ; Zeller, Thomas ; Gray, Bruce H. ; Scheinert, Dierk ; Vranic, Mitar ; Reiser, Christopher ; Biamino, Giancarlo. / Limb salvage following laser-assisted angioplasty for critical limb ischemia : Results of the LACI multicenter trial. In: Journal of Endovascular Therapy. 2006 ; Vol. 13, No. 1. pp. 1-11.
@article{eb7099945cb24a9ea605def23ee5b923,
title = "Limb salvage following laser-assisted angioplasty for critical limb ischemia: Results of the LACI multicenter trial",
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.",
keywords = "Critical limb ischemia, Excimer laser, Laser angioplasty, Limb salvage",
author = "Laird, {John R.} and Thomas Zeller and Gray, {Bruce H.} and Dierk Scheinert and Mitar Vranic and Christopher Reiser and Giancarlo Biamino",
year = "2006",
month = "2",
doi = "10.1583/05-1674.1",
language = "English (US)",
volume = "13",
pages = "1--11",
journal = "Journal of Endovascular Therapy",
issn = "1526-6028",
publisher = "International Society of Endovascular Specialists",
number = "1",

}

TY - JOUR

T1 - Limb salvage following laser-assisted angioplasty for critical limb ischemia

T2 - Results of the LACI multicenter trial

AU - Laird, John R.

AU - Zeller, Thomas

AU - Gray, Bruce H.

AU - Scheinert, Dierk

AU - Vranic, Mitar

AU - Reiser, Christopher

AU - Biamino, Giancarlo

PY - 2006/2

Y1 - 2006/2

N2 - 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.

AB - 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.

KW - Critical limb ischemia

KW - Excimer laser

KW - Laser angioplasty

KW - Limb salvage

UR - http://www.scopus.com/inward/record.url?scp=33244457018&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33244457018&partnerID=8YFLogxK

U2 - 10.1583/05-1674.1

DO - 10.1583/05-1674.1

M3 - Article

C2 - 16445313

AN - SCOPUS:33244457018

VL - 13

SP - 1

EP - 11

JO - Journal of Endovascular Therapy

JF - Journal of Endovascular Therapy

SN - 1526-6028

IS - 1

ER -