Following the advent of percutaneous balloon vel oped and are available for clinical use, as well angioplasty, interventional cardiovascular pro­ as those that are still in investigational phases. cedures have become of great interest to the Clinical case reports are presented by expert in­ cardiologist, radiologist, and cardiovascular vestigators on the use of various catheter systems surgeon. One of the most extensively explored in the coronary and peripheral circulation. alternatives to bypass surgery is laser-mediated Part V (Chapters 17-23) is the most up-to­ angioplasty. The fascination with laser radia­ date review of the clinical experience with vari­ tion has greatly contributed to its popularity, ous laser delivery systems. There is an emphasis but has also burdened it with unrealistic ex­ on patient selection, criteria for lesion choice, pectations. Many commercial laser systems are and follow-up data. A detailed description of available to the clinician and the researcher, laser recanalization techniques is presented for which often makes the choice of a laser system the various systems in the clinical setting.

I. Historical Background.- 1. The History and Development of the Medical Laser.- 2. Historical Background, Development, and Future Trends of Lasers in Cardiovascular Disease.- II. Laser Physics in Medical Applications.- 3. Laser Physics and its Relevance to Applications in Medicine.- 4. Laser Sources for Angioplasty.- 5. The Excimer Laser-Tissue Interactions and Early Clinical Results.- 6. Laser Physics and Thermal Properties.- 7. Thermal Analysis of Laser Ablation of Cardiovascular Tissue.- 8. Light Distribution, Optical Properties, and Cardiovascular Tissues.- III. Experimental Studies: Laser- Tissue Interaction, Protodynamic Therapy, Spectroscopy, Electrophysiology.- 9. Immediate and Chronic Effects of Laser Angioplasty.- 10. Photosensitizer-Enhanced Laser Angioplasty.- 11. Laser-Induced Arterial Fluorescence Spectroscopy.- 12. Laser Balloon Angioplasty: Experimental In-Vivo and In-Vitro Studies.- 13. Laser Catheter Ablation of Arrhythmias.- IV. Laser Delivery Systems.- 14. Optical Fibers.- 15. Laser Angioplasty with Optically Modified Fiber Tips.- 16. Catheter Systems for Laser Angioplasty.- V. Clinical Experience with Laser Angioplasty.- 17. Clinical Experience with Laser Angioplasty.- 18. Laser Recanalization and Treatment of Peripheral Atherosclerosis: A Vascular Surgeon's Perspective.- 19. Intraoperative Use of the Laser for Coronary Artery Disease.- 20. Laser Thermal Angioplasty with an Argon-Laser-Heated, Metallic-Capped Fiber optic.- 21. Laser Angioplasty Using a Special Sapphire-Tip Catheter: Preliminary Clinical Trial.- 22. Laser Angioplasty: New Modalities.- 23. Evaluation, Treatment, and Care of the Laser Angioplasty Patient: A Nursing Perspective.- VI. Additional Clinical Experience with Other Cardiovascular Laser Applications.- 24. Laser Modificationof the Myocardium for the Treatment of Cardiac Arrhythmias: Background, Current Results, and Future Possibilities.- 25. Laser Endarterectomy.- 26. Vascular Tissue Bonding Using Laser Energy.- 27. Percutaneous Laser Myoplasty for Treatment of Hypertrophic Cardiomyopathy.- 28. Direct Myocardial Revascularization: Preliminary Experience.- VII. Angioscopy and Ultrasound Guidance.- 29. Percutaneous Cardiovascular Angioscopy.- 30. Angioscopy of Congenital Cardiac Lesions.- 31. Intravascular Ultrasound Imaging.- VIII. Industrial, Regulatory and Population Analysis.- 32. Safety and Effectiveness in Clinical Trials Involving Lasers: Food and Drug Administration Perspective.- 33. Market Trends and Business Considerations.- 34. The Acceptance of Percutaneous Transluminal Angioplasty and Laser Angioplasty.