Percutaneous endoluminal balloon angioplasty opened a new area in the field vascular therapeutic. Percutaneous laser angioplasty and mechanical abrasion are logical extension of this new therapeutic approach. A number of patients have been treated by these advanced technics, but their use is not yet of current practice in medical centers. Furthermore, from one center to another there are notable differences between the means used for angioplasty, what reflects the numerous problems which are to be solved: choice of the wavelength : infrared emitted by Nd-YAG lasers, visible by argon lasers or ultraviolet by excime lasers, pulsed or C.W. lasers, control of the desobstruction process, either by radiology, angioscopy, intraluminal vascular ultrasound or fluoroscopy, indications. The problem is still real. A lot of desobstruction have been performed on proximal lesions, but the future of this technics concerns perhaps more distal lesions.