OBJECTIVE: Conventional suturing methods of microvascular anastomosis are associated with various degrees of vascular wall damage that can lead to thrombosis and bypass occlusion. An experimental model of double end-to-side venous graft anastomosis on the common carotid artery was set up to compare conventional suturing methods with a low-power diode laser vascular welding technique.METHODS: The experiments were performed on 40 rabbits that underwent implantation of a 15-mm segment of jugular vein on the common carotid artery. The proximal end-to-side suture was performed by eight interrupted stitches; the distal suture, which was done using a laser welding technique, was supported by four stay sutures. The animals were evaluated after 2 days (n = 15), 9 days (n = 15), and 30 days (n = 10). The vascular segments were excised and subjected to histological, immunohistochemical, and ultrastructural evaluation.RESULTS: The average clamping time to perform both anastomoses was 35 minutes. At the end of the follow-up period, one case of complete occlusion was observed after 9 days and one case was observed after 30 days. Surgical observations and pathological evaluation indicated that adoption of the laser welding technique reduced operative time and bleeding. Histologically, a reduction of thrombosis, inflammation, myointimal hyperplasia, and dystrophic calcification was observed in laser-assisted anastomoses. A better preservation of the endothelium was also evident in laser-treated anastomoses. The observed differences were deemed statistically significant (P < 0.05).CONCLUSION: Our study demonstrated the efficacy of diode laser welding in improving surgical techniques of high-flow bypass and in reducing the vascular wall damage observed with conventional methods..

Diode laser-assisted carotid bypass surgery: an experimental study with morphological and immunohistochemical evaluations

Mannocci, Alice;
2006-01-01

Abstract

OBJECTIVE: Conventional suturing methods of microvascular anastomosis are associated with various degrees of vascular wall damage that can lead to thrombosis and bypass occlusion. An experimental model of double end-to-side venous graft anastomosis on the common carotid artery was set up to compare conventional suturing methods with a low-power diode laser vascular welding technique.METHODS: The experiments were performed on 40 rabbits that underwent implantation of a 15-mm segment of jugular vein on the common carotid artery. The proximal end-to-side suture was performed by eight interrupted stitches; the distal suture, which was done using a laser welding technique, was supported by four stay sutures. The animals were evaluated after 2 days (n = 15), 9 days (n = 15), and 30 days (n = 10). The vascular segments were excised and subjected to histological, immunohistochemical, and ultrastructural evaluation.RESULTS: The average clamping time to perform both anastomoses was 35 minutes. At the end of the follow-up period, one case of complete occlusion was observed after 9 days and one case was observed after 30 days. Surgical observations and pathological evaluation indicated that adoption of the laser welding technique reduced operative time and bleeding. Histologically, a reduction of thrombosis, inflammation, myointimal hyperplasia, and dystrophic calcification was observed in laser-assisted anastomoses. A better preservation of the endothelium was also evident in laser-treated anastomoses. The observed differences were deemed statistically significant (P < 0.05).CONCLUSION: Our study demonstrated the efficacy of diode laser welding in improving surgical techniques of high-flow bypass and in reducing the vascular wall damage observed with conventional methods..
2006
cerebral revascularization
diode laser
immunohistochemistry
laser welding
scanning electron microscopy
anastomosis
Surgical
animals
carotid artery
common
cerebral revascularization
jugular veins
laser therapy
rabbits
treatment outcome
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12606/3135
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