Has adoption of laser atherectomy by peripheral vascular specialists been slow?
I believe the contrary is true. Today, laser atherectomy is more frequently used in peripheral arterial disease than in coronary disease. At one point, laser atherectomy was quite popular in vein graft disease and bifurcations, but over a period of years, its use in the coronary arterial tree has substantially decreased. Its use in peripheral arterial disease has risen substantially. Laser atherectomy has not been a mainstream treatment in peripheral arterial disease, however, which I believe results from the combination of two things. One is the negative stigma that came from the early 1990s, before the appropriate technique was designed and the more flexible and powerful catheters were available. The early experience was mediocre, and it certainly does not represent the current technology. Second, similar to other devices in peripheral arterial disease, there is no level-1 evidence that laser atheterectomy improves total lesion revascularization (TLR) rate in peripheral arterial dise
