Initial attempts to clear obstructed arteries using laser angioplasty have shown the method to be feasible, but both safety and efficacy were limited due to laser or mechanical perforation of the arterial wall and insufficient width of the tunnels through the occlusions. Recent progress includes better detection of atheromatous plaques with fluorescence spectrometry or improved angioscopy and more precise delivery of laser energy via optical fibers. There is also a tendency to replace the formerly used bar fiber tips with tips protected by a sapphire probe, or to use quartz-shielded fiber bundles, in order to protect the arterial wall from mechanical perforation and the fiber tip from backburning. The most commonly used laser sources are argon, Nd-YAG and CO2.However, excimer and dye-pulsed lasers are attractive because the former creates smooth-edged lesions without thermal injury to the adjacent tissue, and the latter permits selective ablation of atheromatous tissue. Lasers are also being used in human peripheral artery disease to heat a metal probe at the fiber tip to melt the arterial obstructions. Although the above devices were able to penetrate arterial occlusions, complementary balloon angioplasty was required to obtain effective recanalization, regardless of the laser device used.