Carotid artery anastomosis with albumin solder and near infrared lasers: a comparative study.
OBJECTIVE
Laser tissue-welding has been used for anastomosis of carotid arteries. During welding, thermal injury sustained by the vessel walls should be minimized to prevent thrombosis. Two different types of lasers were used and effects on tissue damage were studied in vitro and in vivo.


METHODS
End-to-end anastomosis of dog carotid arteries (n = 10) was performed by using a human albumin solder (HAS) in conjunction with Nd:YAG or diode lasers (lambda = 1.32 microm and 1.9 microm, respectively). The arteries were evaluated for patency and evidence of histologic injury after 21 days. Another group of arteries was laser soldered in vitro to measure the intimal and adventitial temperatures by using thermocouples.


RESULTS
The arteries repaired with the diode laser sustained significantly less thermal damage than those repaired with Nd:YAG laser, both in vitro and in vivo. In particular, the intimal temperature was significantly lower (P < 0.05) for the diode than for the Nd:YAG repairs (approximately 35 degrees C and approximately 50 degrees C, respectively). In the latter group, the patency rate was 75%, but thrombosis occurred in 75% of the specimens at 21 days. All diode anastomoses were patent and thrombosis developed in only 17% of the arteries.


CONCLUSIONS
Use of the diode laser and albumin solders may provide a means to successfully repair carotid arteries with minimal thermal damage.
Lauto
A
A
Center for Pediatric Urology and Minimal Invasive Urologic Surgery, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York 10021, USA. a_lauto@hotmail.com
Hamawy
A H
AH
Phillips
A B
AB
Petratos
P B
PB
Raman
J
J
Felsen
D
D
Ko
W
W
Poppas
D P
DP
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D017536:Carotid Artery, Common / Q000601:surgery*; D004285:Dogs; D006801:Humans; D066298:In Vitro Techniques; D017075:Laser Coagulation; D012709:Serum Albumin; D014654:Vascular Patency
D012709:Serum Albumin