Abstract：In the last decade, with the improvement of equipments and techniques (low wavelength, low pulse energy, Heparin saline infusion technique and design of catheter in multiple sizes), excimer laser coronary atherectomy (ELCA) is increasingly used in the adjuvant treatment of complex coronary artery disease. ELCA dissolves arterial plaques by photochemical, photothermal and photomechanical processes to obtain larger arterial lumen area. Optical coherence tomography imaging demonstrates that the most important mechanism of ELCA is tissue ablation, facilitation of pressure delivery to the vessel and tissue compression. In addition, laser pulses could weaken the connection between tissues, and thus promote tissues to stretch. At present, ELCA is mainly applied in patients with chronic total occlusion, severe calcification lesions, severe instent restenosis, no access of balloon or stent(balloon) incomplete intumescence, and complex coronary artery lesions including saphenous vein graft disease and acute thrombotic disease. It not only improves the success rate of percutaneous coronary intervention, but also reduces the complications, which shows significant advantages in treating complex and refractory coronary artery diseases.
