Abstract 2496: First Human Experience with Intracoronary Red Light Irradiation for the Treatment of High Risk Non-Culprit Atheromatic Plaques
Intraluminal low-power red laser light (LPRLL) irradiation has been used for the prevention of restenosis after percutaneous coronary intervention. Except from the antiproliferative properties of LPRLL recent studies have shown that also enhances reendothelialization by promoting nitric oxide production. We hypothesized that by LPRLL irradiation of high risk plaques, as detected by coronary thermography, stabilization of these plaques may occur.
Methods. We included patients with ≥2 angiographically significant lesions at different vessels. Culprit lesions were identified in all patients by a combination of ECG, wall motion abnormalities, scintigraphic perfusion defects, and/or coronary angiogram. The non-culprit lesions were intermediate producing 50 –75% stenosis. In non-culprit lesions coronary thermography was performed by a dedicated thermography catheter (Epiphany, Medispes S.W., ZUG, Switzerland). The temperature difference (DT) was assigned as the difference between the atherosclerotic plaque and the proximal vessel wall. If DT was >0.05OC irradiation with LPRLL was performed. Low power red light was transmitted from a diode laser (650 nm) at an energy level of 10 mW. The system uses the CL Illuminator cold red laser light balloon catheters At the end of LPRLL irradiation repeat temperature measurement was performed.
Results. We included 11 patients in the study with 11 non-culprit lesions. The percentage of stenosis was 67±12%. Temperature measurement in the non-culprit lesions and application of LPRLL irradiation was performed without any complication. The mean DT at baseline was 0.09±0.08 oC. Immediately after LPRLL irradiation DT was reduced to 0.05±0.04 oC (p<0.02). In all patients there were no major adverse cardiac events at 30 days. Four month clinical, angiographic, IVUS and thermography follow-up will be available at the time of presentation.
Conclusions. In this first application of LPRLL for the treatment of high risk plaques, as recognized by coronary thermography, the immediate results were promising. Further studies are required to evaluate this method for the treatment of high risk plaques.