Basic science and clinical considerations in TMR and PMR

Clinical trials with various laser systems have shown reduction in angina and improved work capacity following transmyocardial laser revascularization (TMR). Additional trials using fiberoptically delivered laser energy are now exploring the role of percutaneous myocardial laser revascularization (PMR) in the treatment of severe angina and end stage atherosclerotic coronary artery disease. Optimization of the hole drilling method (laser, mechanical or other) depends upon the desired histologic result and the outcome of healing from the hole drilling process.