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Percutaneous transluminal intervention techniques are playing an increasingJy important role in the treatment of peripheral vascular disease. Conventional balloon angioplasty remains the most commonly used method, correctly enlarging the huninaJ narrowing in the majority of cases by impacting the atheroma plaque in the wall. This method has, however, its limitations, particularly in segmented occlusions which are sometimes impoSS1ble to traverse by traditional mechanical means, even when using the new hydrophilic guides. The same applies to certain stenoses which are very dense, fibrous, long, ec.centric, and often calcified, and which cannot be traversed by the dilatation guide or balloon. It is for this reason that laser energy has been used over the last few years to recanalire the artery, thereby creating a small channel for balloon angioplasty to be carried out. Different types of laser have been proposed to recsmali:ze an artery (5). They can be distinguished by their source or their transmission time (pulsed or continuous). Various sources are used: solid laser (ND YAG), continuous emission (Argon) or pulsed (Excimer) gas laser, holmium laser, and dye lasers. The transmission of laser energy can currently be achieved through small gauge optical fibres, allowing percutaneous endovascular use (2, 4, and 6). Thermic lasers have, until the present time, been the most widely used in clinical practice (7). It has not yet been demonstrated that pulsed lasers, which have a more selective ablative effect, produce better results in the shorter and longer term. As the use of bare fibres was not without its drawbacks (8), fixing a synthetic sapphire at the end of the fibre seemed to facilitate and improve the procedure (9 - 10). The experience gained in a medico-surgical centre orientated towards the treatment of vascular diseases, since the introduction in May 1988 of sapphire laser angioplasty into the range of intervention radiology techniques used, is presented in this article.
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