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August 16, 1985

Laser Angioplasty-Reply

Author Affiliations

St Luke's—Roosevelt Hospital Center New York

JAMA. 1985;254(7):911. doi:10.1001/jama.1985.03360070048018

In Reply.—  Dr Goldberg's comments are appreciated, but they fail to describe the entire panorama of events following intimal damage by a variety of means such as surgical anastomosis, balloon angioplasty, Fogarty catheter endothelial stripping, surgical endarterectomy, or laser recanalization. More than platelet aggregation and release of growth factor occur.Local tissue prostacyclin production leading to lysis of thrombi is another factor that must be considered. Preliminary work by our group with Dr B. Weksler, Cornell University Medical Center, confirms the report by Abela et al1 of increased prostacyclin production after laser irradiation of arterial tissue. This would tend to prevent new thrombus formation.Blood flow velocity over the lasered segment is another factor. Chesebro and Frye2 showed increased incidence of occlusion of bypass vein grafts when flow was less than 40 mL/min. Prioleau et al3 reported blood flow that was reduced to 14 mL/min in vein