An alternative method of vascular anastomosis by laser: experimental and clinical study.

In vascular surgery, it is now very difficult to maintain the long-term patency after a conventional vascular anastomosis, especially for small-caliber vessels. A low-energy CO2 laser was experimentally employed to make a vascular anastomosis with only a few sutures. Subsequently, it could be confirmed that optimal conditions for vascular anastomosis by laser were 20-40 mW in output and 6-12 sec/mm in irradiation time. On the other hand, pressure tolerance test as well as tensile strength test and microscopic examinations at the sites of anastomoses by laser were compared with the conventional suture method. There were no significant differences between laser and suture methods. On the basis of the excellent results of this study, the laser was clinically applied for anastomoses of the peripheral vessels in 35 patients. The first clinical laser application in the world was successful in a 44-year-old female patient with chronic renal failure in 1985. All patients are doing well without any complications from vascular anastomosis by laser. From these experimental and clinical studies, it can be concluded that anastomosis by laser should be recommended for small-caliber vessels such as aortocoronary bypass surgery.