With the exception of severely calcified lesions and, perhaps, lesions with a heavy thrombus burden, laser therapy is similar to atherectomy in offering little benefit over balloon angioplasty because
laser therapy increases the risk of procedural
complications.85,87,93,96,97 Percutaneous transmyocardial laser revascularization yields no clinical improvement and promotes an additional risk of MI.95 Also as in rotational atherectomy, specific lesions or circumstances may warrant its use (Fig.