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CO 2 and argon laser vascular welding: Acute histologic and thermodynamic comparison
Author(s) -
Kopchok George E.,
White Rodney A.,
White Geoffrey H.,
Fujitani Roy,
Vlasak Jerry,
Dykhovsky Leon,
Grundfest Warren S.
Publication year - 1988
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.1900080608
Subject(s) - argon , fluence , materials science , laser , welding , analytical chemistry (journal) , optics , metallurgy , chemistry , physics , organic chemistry , chromatography
CO 2 and argon lasers have been used successfully for vascular welding in both experimental and clinical settings. This study compared the thermodynamics during CO 2 and argon laser welding of 1‐cm longitudinal arteriotomies in a canine model. Continuous recordings using an AGA 782 digital thermographic system with spatial and thermal resolution of ±0.2 mm and ±0.2°C, respectively, were analyzed. A HGM argon laser using a 300‐μm optic fiber held at 1 cm from the vessel edges (spot diameter = 2.8 mm) with concomitant room temperature saline irrigation (1 drop/sec) was used for argon welds. Total exposure time was 150 sec/cm. CO 2 welds were performed with a Sharplan CO 2 laser (spot diameter = 0.22 mm) with no irrigation for total exposure time of 10 sec/cm. Thermodynamic results and laser parameters are summarized as follows: Argon–n = 20; power = 500 mW; energy fluence = 1,400 J/cm 2 ; Tmax = 48.8°C; T mean ± S.D. = 45.1 ± 2.7°C; CO 2 –n = 20; power = 150 mW; energy fluence = 3,000 J/cm 2 ; Tmax 84.0°C; T mean ± S.D. = 60.7 ± 9.8°C. There was a significant difference ( P < .05) in thermal measurements between successful CO 2 and argon vascular welds. Temperature rise during the argon welds was limited by saline irrigation. In contrast, during CO 2 laser welding, the temperature rose quickly to its maximum and was maintained at a relatively high level as the laser progressed (0.1 cm/sec) along the anastomosis. Histologic examination revealed charring at the CO 2 weld site but absence of thermal damage at the argon laser weld. These thermodynamic differences may account for the different welding mechanisms currently described.