Microvascular end-to-side arterial anastomosis using the Nd: YAG laser.
End-to-side, laser-assisted vascular anastomosis (LAVA) using a Nd: YAG laser was successfully performed on rat carotid arteries. A midline neck incision allowed isolation and approximation of both carotid arteries in an end-to-side fashion using four 10-0 nylon stay sutures. The laser parameters used for vessel fusion were 0.3-second 5-W pulses at a spot size of 600 microns. Anastomoses were analyzed at various time intervals from 1 day to 6 months by angiogram and histological examination. The anastomotic patency was 86%. Aneurysm formation occurred in 23%. Histological examination revealed an acute/subacute transmural injury both at the anastomotic site and several hundred microns away, with delayed re-endothelialization and some attempt at muscular and elastic regeneration. Histological assessment of the aneurysms demonstrated a total loss of the internal elastic lamina and muscularis. A brief discussion comparing Nd: YAG LAVA to other LAVA techniques follows.
Shapiro
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Department of Neurosurgery, Indiana University School of Medicine, Indianapolis.
Sartorius
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C
Sanders
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Clark
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S
D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D002339:Carotid Arteries / Q000601:surgery*; D002532:Intracranial Aneurysm / Q000209:etiology; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D051381:Rats; D011919:Rats, Inbred Strains