S B Self1, D A Coe, J M Seeger. 1. Department of Surgery, University of Florida, Gainesville 32610, USA.
Abstract
BACKGROUND AND OBJECTIVE: Laser welding of vascular anastomoses has been shown to be feasible, but the clinically relevant advantages of this technique remain to be demonstrated. STUDY DESIGN/ MATERIALS AND METHODS: To determine whether laser welding decreases initial anastomotic thrombogenicity, argon laser-welded aortic and venacaval anastomoses were constructed in 15 New Zealand white rabbits. Low temperature welding was done in one-half of welded anastomoses using low power ( < 0.7W) and increased irrigation with saline during welding. Anastomotic surface temperature, bursting strength, procedure time, and surface thrombogenicity (111Indium labeled platelet accumulation) were determined at 24 hours and compared to sutured anastomoses. RESULTS: Aortic and vena caval low temperature laser-welded anastomoses were significantly less thrombogenic than sutured or higher temperature laser-welded anastomoses. In addition, bursting strength of welded anastomoses exceeded physiologic requirements and vessel closure time was less with welding than with suture techniques. CONCLUSION: Low temperature laser welding limits anastomotic thrombogenicity, which may improve early patency of venous and small arterial bypass grafts.
BACKGROUND AND OBJECTIVE: Laser welding of vascular anastomoses has been shown to be feasible, but the clinically relevant advantages of this technique remain to be demonstrated. STUDY DESIGN/ MATERIALS AND METHODS: To determine whether laser welding decreases initial anastomotic thrombogenicity, argon laser-welded aortic and venacaval anastomoses were constructed in 15 New Zealand white rabbits. Low temperature welding was done in one-half of welded anastomoses using low power ( < 0.7W) and increased irrigation with saline during welding. Anastomotic surface temperature, bursting strength, procedure time, and surface thrombogenicity (111Indium labeled platelet accumulation) were determined at 24 hours and compared to sutured anastomoses. RESULTS: Aortic and vena caval low temperature laser-welded anastomoses were significantly less thrombogenic than sutured or higher temperature laser-welded anastomoses. In addition, bursting strength of welded anastomoses exceeded physiologic requirements and vessel closure time was less with welding than with suture techniques. CONCLUSION: Low temperature laser welding limits anastomotic thrombogenicity, which may improve early patency of venous and small arterial bypass grafts.