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MUSC uses laser treatment to clear artery blockages  MUSC is the first facility in the Lowcountry and Midlands to use laser treatment to clear blockages of the coronary artery. An MUSC cardiologist did the first procedure early in July and has done 20 to date. Standard treatment of blocked coronary arteries is to use a catheter to deliver a balloon covered with a wire mesh stent to the blocked portion of the coronary artery. The balloon is inflated which pushes plaque against the walls of the artery. The stent remains after the balloon is removed and holds the vessel open, allowing blood to flow freely through the artery.  “The body's natural inflammation response causes tissue to cover the stent, completing the repair,” said Christopher D. Nielsen, M.D., director of adult cardiac catheterization laboratories. “However, some 10 to 20 percent of the people who have a blocked artery treated with a stent find that after about six months excessive tissue begins to block the stent, making it no longer effective.” The laser treatment is effective in clearing this blockage. The laser is also used in cases where a blood vessel is very calcified or hard and can't be opened with the traditional balloon and in cases the catheter equipment can't get down to the blood vessel.  The laser allows doctors to “laser away” a channel and then put in a balloon and stent.  Along the same line are blockages that physicians call chronic total occlusions. These are blockages that have been there for many years. They get hard and calcified and are very difficult to open up. The laser can go in and essentially disintegrate this plaque, and then a balloon and stent can be inserted. “The laser treatment is not a stand-alone procedure,” said Nielsen. ”It doesn't replace stents or balloons, but allows us to better use these devices.”  Additionally, after the stent is cleared out, frequently the area of the stent is treated with radioactive material to keep the stent from blocking up again.  “There are other methods of clearing out blockages in stents,” explained Nielsen. “The laser is another tool that we have on our shelf at MUSC to open blocked arteries that are difficult to open with other methods. Sometimes just a balloon can be used and a cutting balloon is even better. But the laser gets rid of a lot more tissue and lessens the chance of the vessel narrowing back down. There are ongoing studies looking at how much better the laser is than the balloon. We know it is better, but some of us think it's a lot better.”  The history of laser angioplasty goes back about 10 or 12 years. But early attempts were not successful and even dangerous. With advances in technology and methodology, the treatment has been perfected.   Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.