Treatment of myocardial abnormalities with laser therapy

Laser angioplasty using excimer lasers at 308 nm is approved for treatment of sphenous bypass grafts, ostial lesions, long lesions (>20 mm), moderately calcific lesions, total occlusions traversable by a guide wire, and lesions which have previously failed balloon angioplasty. Limitations of this technology include arterial dissection (20%) and a small lumen site. Direct myocardial perfusion by transmyocardial revascularization (TMR) with lasers is currently undergoing clinical investigation. The feasibility of revascularization of areas of the myocardium which cannot be bypassed may provide additional means for reperfusion. Basic studies currently being done have demonstrated benefit after several weeks following the TMR procedure.