A lot of my patients were asking me whether he / she should be referred for it. Below is an article from medscape. It is really a nail in coffin for this therapy.. Furthermore, what a waste of public funding..
Lasers Vaporised from NICE Guideline Recommendations for Refractory Angina
Posted: 10/04/2010; Br J Cardiol. 2010;17(4):159-160
Introduction
As from May 2009 the National Institute for Health and Clinical Excellence (NICE) have removed transmyocardial laser revascularisation (TMLR) from the list of treatments for refractory angina.[1] From their analysis of efficacy they found no evidence of improved myocardial perfusion, ejection fraction or prognosis. There was also no evidence for improvement in exercise tolerance or Canadian Cardiovascular Society (CCS) class when compared with other treatments. Furthermore, looking at the data on safety, randomised controlled trials showed evidence of increased myocardial infarction in the TMLR-treated patient group, as well as evidence of left ventricular perforation.
There have been reservations regarding this technique for many years and it would seem to be a valid decision on behalf of the specialist advisers. It seems appropriate, therefore, to look at how to best treat this complex group of patients.
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