LASER ANGIOPLASTY
You may know someone who's had angioplasty. It's a type of surgery that opens a blocked artery in the heart. But sometimes blockages are too tough for the doctors' traditional tools. Now, new laser technology is getting the job done.
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Each year, more than one million people in the United States will undergo angioplasty to open a blocked artery.
Last year, Harry Linton had shortness of breath, indigestion and chest pain - all symptoms of a heart attack.
Harry Linton
Had a heart attack
"Pretty much in disbelief until I found out I had 98% blockage in one of my main arteries."
Angioplasty cleared the blockage, but some patients aren't fortunate enough to be helped by the standard technique.
Lamaris Simons joined a research study at the Medical University of South Carolina in Charleston to receive a new type of angioplasty using a laser.
It starts like standard angioplasty by feeding a tube into the blocked artery, but instead of using balloons or stents to open the blockage, a laser destroys the plaque.
Christopher Nielsen, M.D.
Cardiologist
Medical University of South Carolina
Charleston, SC
"The difference with the laser is that it actually gets rid of the plaque, turns it into molecular elements that just flow away in the blood."
Doctor Christopher Nielsen can actually see the results on this monitor.
Christopher Nielsen, M.D.
"And you can see this artery is nice and full of dye here and then there's this area of open space that's the very tight blockage."
After the laser is used, blood flow is restored.
Christopher Nielsen, M.D.
"In the patients that need to have a blockage taken out, this is a perfect technology."
A new tool that's helping to put all heart patients back on track.
Doctors say this new technology can also cut down on the need for a second angioplasty. The laser reduces the build up of scar tissue that can form around a stent during a traditional angioplasty. That can be a problem for about 20% of angioplasty patients.
BACKGROUND: Angioplasty relieves chest pain and improves blood flow to the heart. It is often done after a heart attack. A heart attack occurs when the blood supply to part of the heart muscle itself is severely reduced or stopped. The reduction or stoppage happens when one or more of the coronary arteries supplying blood to the heart muscle is blocked. This is usually caused by the buildup of plaque, a process called atherosclerosis. The plaque can eventually burst, tear or rupture, which creates a "snag" where a blood clot forms and blocks the artery.
STANDARD ANGIOPLASTY: The procedure does not always work to open clogged arteries. Sometimes, blockages are too tough for the traditional tools doctors use. Standard treatment of blocked coronary arteries uses a catheter to deliver a balloon covered with a wire mesh stent to the blocked portion of the coronary artery. The balloon is inflated which pushes plaque against the walls of the artery. The stent remains after the balloon is removed and holds the vessel open, allowing blood to flow freely through the artery.
LASER ANGIOPLASTY: The history of laser angioplasty goes back 10 or 12 years. However, early attempts were not successful and even dangerous. The treatment has been perfected with advances in technology and methodology. Laser angioplasty begins like standard angioplasty by feeding a tube into the blocked artery. Instead of using balloons or stents to open the blockage, a laser destroys the plaque. Christopher Nielsen, M.D., from the Medical University of South Carolina in Charleston, says, "The difference with the laser is it actually turns [plaque] into the molecular elements that flow away in the blood." After the laser is used, blood flow is restored. Doctors say the new procedure can cut down on the need for a second angioplasty. The laser reduces the build up of scar tissue that can form around a stent during a traditional angioplasty. That can be a problem for about 20 percent of angioplasty patients.
OTHER USES: The laser is also used in cases where a blood vessel is very calcified or hard and cannot be opened with the traditional balloon. It's also used when catheter equipment cannot get to the blood vessel. The laser allows doctors to "laser away" a channel and then put in a balloon and stent. They can also help blockages physicians call chronic total occlusions. These are blockages that have been present for many years. They get hard and calcified and are very difficult to open up. The laser can go in and essentially disintegrate this plaque, and then a balloon and stent can be inserted.
Christopher Nielsen, M.D.
Division of Cardiology
Medical University of South Carolina
135 Rutlege Avenue, Suite 1201
Charleston, SC 29425
(843) 792-0680
Copyright © 2003 Ivanhoe Broadcast News, Inc.
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