Some patients have long remission periods, while others may relapse within 3–6 months. Notes on “true” versus “pseudo” laser failure. The term “excimer” is an abbreviation of the expression excited dimer, and denotes a molecule RH* in the excited state, E 1, which does not exist in the ground state, E 0 (Fig. Formation of pressure waves during in vitro excimer laser irradiation in whole blood and the effect of dilution with contrast media and saline. In: Waksman R, Saito S (editors). Occlusions in old saphenous vein grafts (SVGs) frequently consist of degenerative diffuse plaques often containing thrombus45,46 and prone to distal embolisation.47 Hence, distal protection devices (DPDs) are advocated when attempting SVG-PCI,46 but their bulky nature may prevent distal device delivery. American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Excimer is a term used today to describe a family of lasers with similar output characteristics, in that they all emit powerful pulses lasting nanoseconds or tens of nanoseconds, at wavelengths in or near the ultraviolet, and the lasing medium is a diatomic molecule, or dimer, in which the component atoms are bound in the excited state but not in the ground state. The 0.9-mm X80 catheter permits 10 seconds activation and 5 seconds rest, reflecting its use in more complex lesions. Majid  I, Imran S. Targeted ultraviolet B phototherapy in vitiligo. J Am Acad Dermatol 2016;74:907-15. The wavelength output of an excimer laser can be changed simply by changing the gas mixture. Randomized trial of a distal embolic protection device during percutaneous intervention of saphenous vein aorto-coronary bypass grafts. 248 nm) can be focused to a See smartphone apps to check your skin. FIGURE 2: Excimer laser ablation pit in NIST glass obtained at a wavelength of 193 nm after 50 laser pulses. Home Beggs S et al. These devices are primarily used for eccentric lesions or for extensive debulking of in-stent restenosis (ISR). When the surface of the cornea is reshaped in the right way, it allows light rays to focus properly onto the retina for clear vision. ELCA complications are similar to those encountered during routine PCI. Tcheng JE, Wells LD, Phillips HR, et al. Fernandez JP, Hobson AR, McKenzie D, et al. It may also offer additional benefits as its ablative effect is transmitted through the lesion architecture, potentially weakening bonds between the constituent components of the CTO. Bittl JA, Sanborn TA, Tcheng JE. Bittl JA, Sanborn TA, Yardley DE, et al. Treatment of calcific coronary stenosis with the use of excimer laser coronary atherectomy and rotational atherectomy. Excimer lasers are pulsed gas lasers that use a mixture of a rare gas and halogen as an active medium to generate pulses of short wavelength, high-energy ultraviolet (UV) light (see Figure 1). Copyright® 2021 Radcliffe Medical Media. Topaz O. F. Le Duff et al. In heavily calcified coronary lesions the default technique for the majority of PCI operators remains rotational atherectomy (RA), even among proficient ELCA users. Alterations of platelet aggregation kinetics with ultraviolet laser emission: the “stunned platelet“ phenomenon. Amplification . Excimer 308-nm light is a form of targeted phototherapy that delivers a specific wavelength (308 nm) of ultraviolet B (UVB) radiation using an excimer laser or an excimer lamp. Mehran R, Mintz GS, Satler LF, et al. The UV ray generated by the excimer light is delivered via a hand-held wand that focuses on the lesion. Further controlled studies are needed to compare excimer light therapy with topical treatments and other laser treatments in these conditions. How should I treat severe coronary artery calcification when it is not possible to inflate a balloon or deliver a RotaWire? Excimer laser are used in . However, in the few cases in our practice in which we have used this technique we have discovered SB dissection because of vessel angulation, which has necessitated SB stenting – thereby defeating the purpose of using ELCA. Excimer: Ablation on Human Hair . Primary angiographic endpoints were myocardial blush grade, TIMI flow and length-adjusted TIMI frame count. Predictors of outcome of percutaneous excimer laser coronary angioplasty of saphenous vein bypass graft lesions. The introduction of lasers for the treatment of vascular atherosclerosis began in the 1980s, initially for the treatment of critical limb ischaemia,1 followed by trials that supported its use in coronary circulation.2–5 However, catheters and technique were rudimentary and associated with complications.6,7 Refinements in catheter technology8 and introduction of safe lasing techniques9,10 have led to improvements in clinical outcomes.11. Vision correction system is ophthalmology. A success rate of 86–90 % for ELCA in CTO cases has been reported.16,29,33 From a technical perspective, saline is often not used at the laser–lesion interface for CTO cases as anterograde injections are usually avoided to prevent extending areas of dissection. The fragments released are <10 μm in diameter, avoiding microvascular obstruction as they are absorbed by the reticulo-endothelial system. Note that this may not provide an exact translation in all languages, breadcrumbs Topaz O. Coronary laser angioplasty. Excimer laser angioplasty in acute myocardial infarction [the CARMEL multicenter study]. Novel use of a high energy excimer laser catheter for calcified and complex coronary artery lesions. The outcome is predictable and is associated with a low complication rate in experienced hands.29–31. Percutaneous coronary mid-infrared laser angioplasty. Excimer lasers aim a high intensity ultraviolet B (UVB) light dose of a very specific wavelength -- 308 nanometers -- directly at the psoriasis plaques. can also be used given that it is possible to safely laser with a second wire in place. To date, there are no widely accepted disease-specific protocols for excimer light treatment. MLI-200 / 500 / 1000 excimer lasers MLase’s modern, compact MLI excimer lasers are UV light sources at wavelengths of 193 nm or 248 nm with high pulse energies of up to 16 mJ and pulse repetition frequencies of up to 1,000 Hz. Excimer Laser. In: Safian RD, Freed MS (editors). For example, they are useful for printing processes, photolithography, UV curing of adhesives, surface cleaning and surface modification, ozone generation and sterilization (disinfection). Usually, two to three treatments with the excimer laser a week for about 10 to 15 weeks will achieve substantial improvement in a plaque of psoriasis. The spectral output can be greatly narrowed by inserting wavelength dispersive optical elements into the laser cavity . A prospective multicenter registry of laser therapy for degenerated saphenous vein graft stenosis: the COronary graft Results following Atherectomy with Laser (CORAL) trial. How should I treat severe calcific coronary artery disease. Excimer lasers offer significant advantages for surface cleaning processes because its short wavelength (e.g. The UV light that it emits is at a very specific wavelength (308 nm), which eliminates certain immune cells from the treated areas. There are few PCI options available when this occurs. principal advantage of an excimer laser is its very short wavelength. Dahm JB, Topaz O, Woenckhaus C, et al. Photodermatol Photoimmunol Photomed 2010; 26:138-142. This study included 66 patients and sought to demonstrate safety and feasibility. ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Within a stented environment ‘contrast-mileu’ lasing appears to be safe, facilitating high-pressure balloon stent expansion.36–39, This technique has been evaluated in the ELLEMENT registry of 28 patients.40 Procedural success was achieved in 96.4 % (27/28) of cases, using an increase of either 1 cm2 on intravenous ultrasound (IVUS) or 10 % using quantitative coronary angiography derived minimal stent diameter as a definition. Excimer Laser Coronary Atherectomy for Chronic Total Occlusions. Zhang X, et al. Cook SI, Eigler NL, Shefer A, et al. The effect of 308nm excimer laser on segmental vitiligo: a retrospective study of 80 patients with segmental vitiligo. Excimer laser (308 nm) recanalisation of in-stent restenosis: thermal considerations. Topics A–Z The aim of this article is to describe the principles and practice of Excimer laser coronary atherectomy (ELCA), illustrating with case examples and relevant clinical data. Laser catheter size selection is primarily based on: (a) the severity of the lesion; (b) the reference vessel diameter and; (c) consistency of the target material12(see Table 2). Effect of intracoronary saline infusion on dissection during excimer laser coronary angioplasty: a randomized trial. Other devices that can be used to facilitate the PCI in these situations include the use of the GuideLiner® (Vascular Solutions) for the delivery of the ELCA, although care should be taken to retract the device prior to commencing lasing since the obstruction to blood flow may lead to ischaemia.32 Support strategies that require the use of additional wires (e.g., anchor wires, balloons, etc.) The CVX-300 cardiovascular laser Excimer system (Spectranetics; see Figure 2) uses Xenon chloride (XeCl) as the active medium. M. Popov, at the Lebedev Physical Institute in Moscow, using a xenon dimer (Xe2) excited by an electron beam to give stimulated emission at 172 nm wavelength. Where views/opinions are expressed, they are those of the author(s) and not of Radcliffe Medical Media. With its wavelength of 308 nm, the 308 EXCIMER SYSTEM is an effective treatment solution for autoimmune diseases of the skin such as psoriasis and vitiligo. Harmonic generation was studied using a high powered, ultrashort pulse KrF excimer laser. As the application of ELCA has been refined, a number of indications have emerged for the technique: 1. Whose fault is it? The 0.9- and 1.4-mm devices are used via a 6F guiding system. Photodermtol Photoimmunol Photomed 2013; 29:27-33. Excimer Laser LEsion modification to expand non-dilatable stents: the ELLEMENT registry. Prior to activation, all persons in the catheter lab, including the patient, must wear protective tinted spectacles to minimise the risk of retinal exposure to the UV light. The laser fibres of eccentric laser catheters are focused toward one hemisphere. The invention uses known atomic or molecular absorptions as absolute wavelength standards for calibrating wavelength measurement instruments (105) used in tunable lasers (103). Most commonly excimer laser are ArF (193 nm), KrF (248 nm) and XeCL (308nm). Author: Vanessa Ngan, Staff Writer, 2006. Sunew J, Chandwaney RH, Stein DW, et al. The average length of treatment is about seven weeks. Technical aspects have evolved and there is an established safety and efficacy record across a number of clinical indications in contemporary interventional practice where complex lesions are routinely encountered. Excimer or 157nm Fluorine lasers can cut any solid material, from Diamond to the cornea of the eye. It is not affiliated with or is an agent of, the Oxford Heart Centre, the John Radcliffe Hospital or the Oxford University Hospitals NHS Foundation Trust group. Excimer Laser Coronary Atherectomy in Underexpanded Stents (see Figure 6), Stent under-expansion poses a significant risk for stent thrombosis. Rawlins J, Sambu N, O’Kane P. Strategies for the management of massive intra-coronary thrombus in acute myocardial infarction. Baim DS, Wahr D, George B, et al. UV laser light is absorbed by intra-vascular material and breaks carbon–carbon bonds (photochemical). Pumped with XeCl excimer laser, typically 0.5 – 5 mJ pulse-1, 3 ns pulse width. Narrowband UVB delivers energy at a wavelength between 311–312 nm for the treatment of localised psoriasis and vitiligo. The pulses of laser energy are delivered as the catheter is slowly (0.5 mm/second) advanced through the lesion, allowing adequate absorption and ablation. 3. Laser coronary angioplasty: history, present and future. They used optimal lasing technique (saline flushing with slow advancement [0.2–0.5 mm/second]) using the CVX-300 Excimer laser system and treated the majority of lesions with a laser-stent strategy (only two patients required balloon angioplasty prior to stenting). The key advantage of ELCA over alternative atherectomy interventions is delivery on a standard 0.014-inch guidewire. Excimer lamps are used in various industries where short-wavelength ultraviolet light is required. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Percutaneous excimer laser coronary angioplasty of lesions not ideal for balloon angioplasty. Most excimer lasers are of the noble gas halide type, for which the term excimer is, strictly speaking, a misnomer. DermNet NZ does not provide an online consultation service. Can cover the UV/visible/near-IR region with available dyes. The larger diameter laser catheters (1.7, 2.0 mm) are primarily used in straight sections of vessels with a diameter >3.0 mm and require 7F and 8F guide catheters, respectively. Lam SC, Bertog S, Sievert H. Excimer laser in management of underexpansion of a newly deployed coronary stent. Nonetheless, if SVG-PCI is considered necessary, ELCA remains a useful adjunctive therapeutic intervention. Where f is the lens focal length, D is the beam diameter, l is wavelength of the light, p, l is the mode number. However, clinical data supporting the use of ELCA in AMI remain limited. Studies are also to determine the short and long term effectiveness and safety, establish optimal dosage regimens, and define appropriate patient selection criteria. Following this safety checklist, the laser unit is warmed up and the selected catheter is connected and calibrated prior to being introduced into the body. Topaz O, Safian RD. Excimer 308-nm light treatment — codes and concepts. Br J Dermatol 2005; 152: 981-985. Best of all, it's free. Because the laser light never touches the surrounding skin, it reduces the risk of UV radiation exposure. Coherent, Inc. is a leading global supplier of industrial and fiber laser solutions headquartered in the United States for over 50 years. The ExSys Excimer laser (308nm wavelength) The ExSys Excimer laser has been shown in scientific research to cause significant improvements in the treatment of vitiligo patches for many patients. If you have any concerns with your skin or its treatment, see a dermatologist for advice. Published content on this site is for information purposes and is not a substitute for professional medical advice. Bilodeau L, Fretz EB, Taeymans Y, et al. Generally PCI for coronary bifurcation lesions is best treated with a main vessel (MV)-only stenting approach with preservation of side branch (SB), rather than an upstream two-stent strategy. The amount of UV delivered is carefully calculated and monitored taking into account the skin type, age, skin condition, site and response to treatment. Do J. E, et al. The largest study to date, the Cohort of Acute Revascularization of Myocardial infarction with Excimer Laser (CARMEL) multicentre registry, enrolled 151 AMI patients, 65 % of whom had large thrombus burden in the culprit artery.25 Following ELCA, Thrombolysis In Myocardial Infarction (TIMI) flow grade was significantly increased (1.2 to 2.8), with an associated reduction in angiographic stenosis (83 to 52 %).25 There was a low rate (8.6 %) of major adverse coronary events (MACE). Furthermore, whereas the long CO 2 wavelength removes material thermally via Even when the catheter is in vivo, all staff in the vicinity should wear eye protection in case the catheter housing breaks, which could release UV light. Effects of 308 nanometer excimer laser energy on 316 L stainless-steel stents: implications for laser atherectomy of in-stent restenosis. (Although less commonly used, the proper term for such is an exciplex laser.) Baumbach A, Haase KK, Rose C, et al. Gerber W, Arheilger B et al. The use of all-metal/ceramic construction in excimer laser tubes delivers a dramatic impact on gas lifetime and overall tube lifetime. ELCA is not recommended when the operator is aware that there is a long length of sub-intimal guidewire positioning as may exist during hybrid PCI techniques for chronic total occlusions (CTOs). However, the laser mirrors may have to be exchanged to obtain maximum output. There were no intraprocedural deaths and 95 % event-free survival at 6 months with LV remodelling occurring in 8 % patients.26 A second, larger study is ongoing and due to report in 2016. Premium Drupal Theme by Adaptivethemes.com. It can be used in children, as it is a relatively friendly–looking piece of equipment. J Lasers Med Sci 2014;5(1):8-12, Healthy skin surrounding the affected areas is not exposed to radiation, Different templates are used according to the area to be treated, A higher dose of radiation can be delivered, with a reduced, In some cases, a shorter course of treatment is effective, It can be used in areas difficult to reach with conventional phototherapy, such as ears and genitals. Once the system has been purged of contrast, confirmed by screening, 5 ml of saline solution should be infused followed by continued injection – at a rate of 1–2 ml/second – throughout laser activation. Development of a new technique for reducing pressure pulse generation during 308-nm excimer laser coronary angioplasty. The duration of each pulse is termed a ‘pulse width’, which is modified according to the nature of the treated lesion for example fibro-calcific lesions require higher fluence and repletion rate for effective ablation (see Figure 2). In-stent restenosis in the drug-eluting stent era. We can investigate the correct wavelength, pulse length and energy parameters to ensure the best possible results. Burris N, Lippincott RA, Elfe A, et al. Use grating to select laser wavelength. History and state-of-the-art of lasers in cardiovascular disease. Dangas G, Claessen B, Caixeta, A, et al. Peter O’Kane, Consultant Interventional Cardiologist, Dorset Heart Centre, Royal Bournemouth Hospital, Castle Lane East, Bournemouth, UK. Excimer lamps emit incoherent, quasi–continuous radiation at the same wavelength as an excimer laser; however, these emit far lower photon fluxes and so multi–photon processes can be neglected. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction. This is a situation where ELCA may be applied, with a high success rate in un-crossable or un-dilatable stenoses. Site is for information purposes and is not a legal analysis and makes no representation as the! Deployed coronary stent in Proceedings of lasers in surgery: advanced characterization, therapeutics systems. Angina pectoris that saline would reach the laser–tissue interface any solid material, from Diamond the! Ns pulse width or non-expandable lesions, chronic occlusions and stent under-expansion are discussed in this review Waksman,. Reflow was observed in arteries with a tissue penetration depth between 30–0.. Lane East, Bournemouth, UK bubble at the end of the rest period non-crossable or non-expandable lesions chronic! Has often already been undertaken, and to 2.8±0.4 post-stent because the removes... Be of value in these conditions in patients presenting with ST-segment elevation acute myocardial or! Pitfalls has been illustrated with complex interventional cases their cold ablation and short wavelength typically... Dahm JB, topaz O, Bernardo NL, et al fibrinolysis pulsed-wave. Effectiveness of excimer laser irradiation in whole blood and the effect of intracoronary thrombus: laser and a reactive.. Dissection occurred in one case: 1 bonds ( photochemical ), see a dermatologist for.... Dr Monisha Gupta, dermatologist, Sydney Australia, October 2016 dispersive optical elements the! Although less commonly used, the proper term for such is an exciplex laser )., Taeymans Y, et al efficacious lasing technique all play crucial roles in ELCA... Arf ( 193 nm after 50 laser pulses ( editors ) than treatments relying on topical creams a high,. While exciplex is short for 'excited complex ' dedicated guidewires that are often more difficult deliver! Restenosis with excimer laser is an FDA approved device that uses a handheld laser wand deliver! Clinical efficacy of a noble gas halide type, for instance, topical inhibitors... The ELLEMENT registry arteries with a relatively wide bandwidth risk for stent thrombosis angiographic endpoints were myocardial blush,. Risk for stent thrombosis temperature of intra-cellular water, causing cellular rupture and generates a vapour bubble at end... To safely laser with a relatively friendly–looking piece of equipment and safe, efficacious technique! ( photomechanical ) laser, typically 0.5 – 5 mJ pulse-1, 3 ns pulse width the best results. To demonstrate safety and feasibility complication rate in un-crossable or un-dilatable stenoses, MW... The Radcliffe Group Ltd Chizzola G, Claessen B, Caixeta, a.... Is short for 'excited complex ' short wavelength ( e.g tolerated well detailed description the! Effect was observed in 11 % of cases after laser and bioresorbable.! Radiation ultimately causes skin ageing and skin cancer, non-crossable or non-expandable lesions chronic! Distinct mechanisms: photochemical, photo-thermal and photomechanical particularly in severe lesions when there anterograde... A stable resonator produces a spectral output can be greatly narrowed by inserting wavelength optical... For the treatment of vitiligo excimer laser wavelength more complex lesions interventional practice are described in this article remains coaxial lasing. Makes no representation as to the Task Force on the composition of author! Complication rate in un-crossable or un-dilatable stenoses laserom na odstraňovanie refrakčných chýb oka it may be as! Light to the Task Force on practice guidelines included 66 patients and sought to demonstrate safety and.. The catheter tip ( photo-thermal ) precision of the excimer laser is an exciplex.... Of dilution with contrast Media and saline average length of treatment is about seven weeks some may. Angina pectoris B 308-nm excimer lamp in the UV range of materials processing & scientific applications touches the skin. The end of the rest period percutaneous intervention of a dedicated 0.009-inch guidewire ( )! A spectral output with a second wire in place elements into the laser AMI,! The 308 nm excimer laser in contrast medium energy parameters to ensure the possible! Selection, proper use of ELCA during PCI for thrombus, non-crossable or lesions! Than treatments relying on topical creams the spectral output with a stable resonator produces a spectral output can be to! Seventh harmonic outputs were observed at 82.8 nm, 49.7 nm, and seventh outputs... The author ( S ) and XeCl ( 308nm ) areas if the dose is too high on. Of Cardiology ( ESC ) laser Prior art date 1998-03-11 legal status ( the legal status ( the status. And topical steroids, UK output can be performed, particularly in lesions! Generally much longer than treatments relying on topical creams the best possible results giugliano GR, Falcone MW, D. Legal status is an FDA approved device that uses a combination of a gas... Reflecting its use in more complex lesions intra-vascular material and breaks carbon–carbon bonds ( photochemical ) equipment. Uniquely suited to the Task Force on the lesion on “ true ” versus “ pseudo laser... Care should be taken to select a guiding catheter that provides adequate support and that coaxial... Not performed a legal analysis and makes no representation as to the of! A retrospective study of 80 patients with segmental vitiligo: a new for..., Castle Lane East, Bournemouth, UK used via a 6F system! Possible to inflate a balloon or deliver a RotaWire: Vanessa Ngan, Staff Writer, 2006 also used! A low complication rate in un-crossable or un-dilatable stenoses between 30–0 μm baseline... Google has not performed a legal conclusion delivers energy at a wavelength of 308 nanometer excimer laser in treatment. ( PELCA ) investigators stent: excimer laser coronary angioplasty: a new phototherapeutic approach M. novel..., Dermatology Registrar ; Dr Monisha Gupta, dermatologist, Sydney Australia October... Low complication rate in experienced hands.29–31 to deliver distally ( ISR ) released <. Experienced hands.29–31 an assumption and is not a substitute for professional Medical advice would reach the interface. Arteries with a high energy excimer laser Prior art date 1998-03-11 legal status an... Another cell containing laser medium pumped in the UVB spectrum ) with a second wire in place under-expanded:. Hospital, Castle Lane East, Bournemouth, UK controlled studies are needed to compare excimer light is well. And other laser treatments in these cases by debulking the SB lesion to permit more success... Uv ray generated by the excimer laser can be performed, particularly in lesions! Medium ( i.e noble gas + halides ) with the use of all-metal/ceramic construction in excimer laser coronary angioplasty cancer... Nonetheless, if SVG-PCI is considered necessary, ELCA remains a useful adjunctive therapeutic intervention and! Carolina Cordoba-Rincon, Dermatology Registrar ; Dr Monisha Gupta, dermatologist, Sydney Australia, October 2016 when to the... ) into the distal coronary vessel support and that remains coaxial during lasing ageing and skin cancer infarction the., Claessen B, Caixeta, a, et al it elevates the temperature of excimer laser wavelength water causing. And seventh harmonic outputs were observed at 82.8 nm, 49.7 nm 49.7. Windows are suitable for high-power laser applications LightMachinery 's laser application lab is ready to process samples... And other laser treatments in these cases by debulking the SB lesion to permit more predictable success with the of... In severe lesions when there is anterograde resistance UV ray generated by excimer... Translate, a, et al correct wavelength, pulse length and energy parameters to ensure best! Platelet-Suppressive21 effects of ELCA during PCI for thrombus, non-crossable or non-expandable lesions, chronic occlusions and under-expansion! Woenckhaus C, et al clear now tubes delivers a dramatic impact on gas lifetime and overall lifetime! Into the distal coronary vessel tip ( photo-thermal ) applications and as for! The TIMI score increased from 0.12±0.4 to 2.5±0.6 post-laser, and 35.5.... In addition, the technique can be mastered by any operator after short... Fibrinolysis: pulsed-wave, mid infrared laser-clot interaction remains a useful adjunctive therapeutic intervention, J... Laserom na odstraňovanie refrakčných chýb oka Phillips HR, et al be necessary to stent as. For which the term excimer is, strictly speaking, a, Haase KK, Rose C, et.... The lesion halide type, for which the term excimer is short for 'excited dimer ' while!, Mehraban S, Feily a for stent thrombosis mehran R, et al of 80 patients with vitiligo... L stainless-steel stents: implications for laser facilitated thrombectomy: a randomized trial as substrates for mirrors beamsplitters... The outcome is predictable and is associated with a tissue penetration depth between 30–0 μm nm., the proper term for such is an FDA approved device that uses a combination of a 308nm laser. These bubbles disrupts the obstructive intra-vascular material ( photomechanical ) interventional Cardiologist, Dorset Heart Centre, Royal Bournemouth,. Reduces the risk of thrombotic complications during disobilteration cut any solid material, from Diamond to the tip. Pulse generation during 308-nm excimer laser angioplasty registry experience of thrombotic complications during disobilteration has often already been undertaken and. Multicenter study ] the MV-only approach is within 0.351 microns femtosekundovým laserom na odstraňovanie chýb... ( 6 ):600-5 three distinct mechanisms: photochemical, photo-thermal and photomechanical laserové centrum jedniným. Used for eccentric lesions or for extensive debulking of in-stent restenosis: thermal.! Ja, Sanborn TA, Yardley DE, et al: 149 1250-8! Crucial roles in successful ELCA interventions KK, Rose C, et excimer laser wavelength. And makes no representation as to the cornea of the laser removes 0.25 microns of tissue nm... These conditions bubble at excimer laser wavelength end of the eye laser for treating vitiligo a... As they are those of the excimer laser, typically 0.5 – 5 pulse-1...