Large-artery welding with a milliwatt carbon dioxide laser
E. M. Ashworth, M. C. Dalsing, J. F. Olson, W. P. Hoagland, S. Baughman and J. L. Glover
Microvascular laser welding can be effectively used in large-diameter
artery techniques. The carotid arteries of 12 anesthetized mongrel dogs
were exposed. Following heparinization, the carotid arteries were
transected, cleaned along their edges, and repaired on the right side by
laser and on the left side by suture. The laser-assisted vascular
anastomosis (LAVA) required four stay sutures and laser power for welding.
Six-week patency for LAVA vs suture anastomosis was 100% vs 92%,
respectively. Anastomotic time requirements were less with LAVA (seven vs
25 minutes). Intimal healing for both techniques immediately demonstrated
an intraluminal thrombus, which resolved showing complete endothelial
repair by four weeks. The laser seal demonstrated little inflammation
compared with the giant cell reaction of suture anastomosis. Immediate wall
tensions of 6 to 18 X 10(5) dynes/cm2 were tolerated after both techniques.
Laser-assisted vascular anastomosis of large-diameter arteries is feasible,
strong, and associated with minimal inflammation.
