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Anastomosis of bypass grafts using a low‐powered CO 2 laser
Author(s) -
Frazier O. H.,
Shehab S. Anne,
Zirl Robert,
Radovancevic Branislav,
Nakatani Takeshi,
Bossart Mattie I.,
Parnis Steven M.
Publication year - 1989
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.1900090107
Subject(s) - anastomosis , medicine , surgery , apposition , external jugular vein , vein , common carotid artery , jugular vein , carotid arteries , artery , intimal hyperplasia , anatomy , smooth muscle
Abstract The purpose of this study was to evaluate the feasibility of using a low‐powered CO 2 laser to perform end‐to‐side anastomoses of bypass grafts. The internal jugular veins of 13 domestic swine were removed and used as grafts to bypass their ligated carotid arteries. Each end of the vein graft was apposed to the artery with four to six temporary stay sutures, and a waveguide delivery CO 2 laser with a power density of 900 mW/mm 2 was used to perform the anastomoses, after which the sutures were removed. The animals were sacrificed postoperatively at five time intervals: 2 to 4 hours, 5 days, 1 month, 3 months, and 5 months. Of the 10 anastomoses studied at 2 to 4 hours, 70% were fully patent, none thrombosed, and 30% disrupted. Of the 16 anastomoses studied between 5 days and 5 months postoperatively, 88% were patent, 12% thrombosed, and none disrupted. None of the animals developed aneurysms at any stage of this investigation. Histologic analysis of acute studies revealed thermal damage such as charring of tissue, unraveling of the collagen fibrils, and the formation of microvacuoles. Within 3 months, the anastomotic sites showed localized healing with intimal fibromuscular proliferation and dense fibrous tissue. Good apposition of tissue was found to be of great importance in achieving patency of vessels in this procedure.