Editorial
Percutaneous myocardial laser revascularisation
| The first 150 words of the full text of this article appear below. |
In the
vast majority of patients with angina pectoris caused by underlying
coronary artery disease, effective treatment is available. Most
patients respond to antianginal medication, and for the remainder
either percutaneous coronary revascularisation or coronary artery
bypass grafting can be performed. There are, however, an increasing
number of patients who have angina which is not controlled by medical
treatment and have disease which is not suitable for conventional
revascularisation techniques. Typically, such patients have
atherosclerotic disease throughout their coronary arterial tree, with
no "target" lesions for angioplasty and no "target" vessels for
surgery. In recent years, transmyocardial laser revascularisation
(TMLR) has been evaluated as a treatment option in this patient
population. This technique, which is usually performed through a left
anterolateral thoracotomy, uses laser energy to create transmural
channels in the ischaemic myocardium. The initial experience with TMLR
used a high energy carbon dioxide laser. As a result of developments
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