Feasibility and safety of excimer laser coronary atherectomy in complex higher-risk/and indicated patients

Objective To explore the feasibility and safety of Excimer laser coronary atherectomy(ELCA)in Complex Higher-Risk/and Indicated Patients(CHIP).Methods ELCA was applied in 32 vessels of 31 patients(26 males,mean age:[67.6±11.0]years)during 2017.1-2018.10 in our department.ELCA treated lesions included in-stent restenosis,chronic total occlusion,vein grafts lesions,and severe calcified lesions.The success rate of ELCA in complex coronary lesions,related complications(such as slow flow/no flow,coronary artery perforation,severe coronary dissection,acute vessel occlusion),and in-hospital MACCE(cardiac mortality,myocardial infarction,stroke and urgent CABG)were analyzed.Results(1)Success rate of ELCA was 100%on treating in-stent restenosis(n=18)and vein grafts lesions(n=3),85.7%on treating chronic total occlusion(CTO)lesions(6/7,4 succeed with ELCA,2 succeeded by combined rotational atherectomy,1 failed despite the combined use of rotational atherectomy),100%on severe calcified lesions(n=4,1 succeeded with ELCA,the other 3 lesions were treated with combined ELCA and rotational atherectomy).(2)There was no procedural related complication and in-hospital MACCE.Conclusion The use of ELCA could increase the success rate of PCI in complex lesions,while procedural related complications and in-hospital MACCE were rare.