Laser
What is laser?
Laser is a type of therapeutic interventional cardiac procedure
that opens blocked heart arteries. Laser is an acronym for
light amplification by stimulated emission of radiation. The
laser energy is used to evaporate and remove the blockage.
The procedure involves placing a laser catheter in the heart
artery and advancing it to the site of the blockage. The laser
is turned on, and energy is delivered to the blockage to evaporate
it. Then, the laser catheter is removed. Often, angioplasty
is performed after this procedure to improve the results.
What are the risks?
The risks of laser are low. The risks include all of the
complications noted for cardiac catheterization; but some
of the risks, specifically heart attack and emergency bypass
surgery, are higher because laser is a more complex procedure.
The risks include injury or tearing of an artery, which can
cause the artery to close. The risk of injury to the artery
is somewhat higher with laser than with angioplasty. The injuries
are often successfully treated with continued angioplasty.
In rare cases, the tear is difficult to treat. Five percent
of patients may have a heart attack, and two percent may need
emergency bypass surgery. A cardiac surgery team is available
at the Inova Heart Center if needed. In three to five percent
of patients, the procedure is unsuccessful because the catheter
cannot be advanced to the blockage or the artery cannot be
fully opened. This can occur when the artery is small, has
calcium deposits, or has severe bends. Click here to read
more about the Inova Heart Center's outcome indicators regarding angioplasty.
What are the benefits?
Laser will open blocked arteries and improve blood flow
to your heart. It relieves symptoms, improves exercise duration,
and in some cases stops or prevents heart attacks. It may
be more effective than medications in relieving symptoms in
patients with a blockage in one artery. Following a laser,
many patients can stop or reduce their number of heart medications.
How effective is laser?
Laser is initially successful in about 90% of patients.
However, 30 to 60% of patients will develop a recurrence of
the blockage (called restenosis). This occurs because laser
injures the artery. The artery's healing process can cause
an overgrowth of cells and other substances that cause a recurrence
of the blockage. Restenosis usually occurs during the first
six months. Your doctor will follow you closely for a return
of symptoms and may even perform an exercise stress test.
If a blockage returns, you can be treated with medications,
a second laser or other interventional procedure, or possibly
bypass surgery. Click here to read more about the successful outcomes
of angioplasty at the Inova Heart Center.
Is laser right for you?
Laser can be used to treat many types of blockages. However,
it is not used frequently because it is a technically more
complex procedure that has a higher rate of complications
than angioplasty and a similar rate of restenosis compared
to angioplasty. Unfortunately, the evaporation and removal
of the blockage do not lower restenosis rates. Laser is primarily
used in treating blockages that are difficult to treat well
with angioplasty. Laser is useful in treating blockages that
are totally occluded, are very severe and cannot be crossed
with an angioplasty catheter, are located in a bypass graft,
are a restenosis in a previously placed stent, or are located
at an artery origin.
For more specific information regarding before, during and after the procedure, click here.
- Adult Congenital Heart Clinic
- Hospital Care
- Medications
- Lifestyle Changes
- Cardioversion
- Ablation
- Angioplasty
- Directional Coronary Athrectomy
- Laser
- Ratoblator®
- Stents
- Valvuloplasty
- Aortic Aneurysm Repair
- Carotid Endarterectomy
- Coronary Artery Bypass Surgery
- Minimally Invasive Cardiac Surgery
- Cardiac Valve Replacement/Repair
- Transmyocardial Revascularization
- Heart Transplant
- Cryoablation
- Optimzer II
- EECP
- Congenital Defects
