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Excimer laser coronary atherectomy during complex PCI: An analysis of 1,471 laser cases from the British Cardiovascular Intervention Society database.

Protty, Majd B.; Hussain, Hussain I.; Gallagher, Sean; Al-Raisi, Sara; Aldalati, Omar; Farooq, Vasim; Sharp, Andrew S. P.; Egred, Mohaned; O'Kane, Peter; Ludman, Peter; Anderson, Richard A.; Mamas, Mamas A.; Kinnaird, Tim


Majd B. Protty

Hussain I. Hussain

Sean Gallagher

Sara Al-Raisi

Omar Aldalati

Vasim Farooq

Andrew S. P. Sharp

Mohaned Egred

Peter O'Kane

Peter Ludman

Richard A. Anderson

Tim Kinnaird


INTRODUCTION: Excimer laser coronary atherectomy (ELCA) is a recognized adjunctive therapy utilized in the percutaneous management of complex coronary lesions. Studies examining its safety and utility have been limited by small sample sizes. Our study examines the determinants and outcomes of ELCA. METHODS: Using the British Cardiac Intervention Society database, data were analyzed on all PCI procedures in the UK between 2006-2016. Descriptive statistics and multivariate logistic regressions were used to examine baseline, procedural and outcome associations with ELCA. RESULTS: We identified 1,471 (0.21%) ELCA cases out of 686,358 PCI procedures. Baseline covariates associated with ELCA use were age, BMI, number of lesions, CTO or restenosis attempted and history of prior MI, CABG or PCI. Procedural co-variates associated with ELCA were the use of glycoprotein inhibitors, intravascular imaging, rotational atherectomy, cutting balloons, microcatheters and intra-aortic balloon pumps. Adjusted rates of in-hospital major adverse cardiac/cerebrovascular events (MACCE) or its individual components (death, peri-procedural MI, stroke and major bleed) were not significantly altered by the use of ELCA. However, there were higher odds of dissection (OR 1.52, 95% CI 1.17-1.98), perforation (OR 2.18, 95% CI 1.44-3.30), slow flow (OR: 1.67, 95% CI 1.18-2.36), reintervention (OR: 2.12, 95% CI 1.14-3.93) and arterial complications (OR: 1.63, 95% CI 1.21-2.21). CONCLUSIONS: ELCA use during complex PCI is associated with higher risk baseline and procedural characteristics. Although increased rates of acute procedural complications were observed, ELCA does not increase likelihood of in-hospital MACCE or its individual components.

Journal Article Type Article
Acceptance Date Aug 2, 2020
Online Publication Date Sep 18, 2020
Publication Date Apr 1, 2021
Journal Catheterization and Cardiovascular Interventions
Print ISSN 1522-1946
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 97
Issue 5
Pages E653-E660
Publisher URL