A preliminary study of laser tissue soldering as arterial wall reinforcement in an acute experimental aneurysm model.
OBJECTIVE
Aneurysm formation results from destruction of structural arterial wall connective tissue, leading to wall weakening and rupture. The purpose of this study was to demonstrate that reinforcement of the arterial wall using laser tissue soldering contributes to arterial wall stabilization and rupture prevention in an acute experimental model.


METHODS
Elastase (10 U/mg protein, Sigma-Aldrich Co., St. Louis, MO) was applied with a fine paint brush on femoral artery segments to cause fusiform aneurysm formation. After aneurysms formed (approximately 45 minutes after treatment), elastase was rinsed out and indocyanine green (ICG) and albumin soldering mixture (2.5 mg/ml ICG in 50% albumin) was delivered to the arterial segment, followed by laser irradiation at 830 nm, (15mW output for 20 minutes). In situ pressure burst measurements were then performed.


RESULTS
In situ burst pressures were > 503 mmHg for normal arteries and 181 +/- 26.0 mmHg, for Elastase treated segments. (P < 0.0001) Treatment of experimental aneurysms laser tissue soldering returned burst strengths to > 503 mmHg.


CONCLUSIONS
These results indicate laser tissue soldering reinforcement of weak arterial walls, is possible and may reduce the likelihood of acute rupture. Further development of this technique for aneurysm management is warranted.
Oskoui
Philip
P
The Laser Center and Department of Surgery, Rochester General Hospital, Rochester, New York 14621, USA.
Stadler
Istvan
I
Lanzafame
Raymond J
RJ
D000208:Acute Disease; D000418:Albumins / Q000627:therapeutic use; D000783:Aneurysm / Q000139:chemically induced / Q000601:surgery*; D017542:Aneurysm, Ruptured / Q000517:prevention & control*; D000818:Animals; D004396:Coloring Agents / Q000627:therapeutic use; D004338:Drug Combinations; D010450:Endopeptidases / Q000009:adverse effects; D005260:Female; D005263:Femoral Artery; D007208:Indocyanine Green / Q000627:therapeutic use; D053685:Laser Therapy / Q000379:methods*; D023421:Models, Animal; D010196:Pancreatic Elastase / Q000009:adverse effects; D051381:Rats; D017207:Rats, Sprague-Dawley; D014014:Tissue Adhesives / Q000627:therapeutic use
D000418:Albumins; D004396:Coloring Agents; D004338:Drug Combinations; D014014:Tissue Adhesives; D010450:Endopeptidases; D010196:Pancreatic Elastase; D007208:Indocyanine Green