CO_2 Laser Soldering of Arteriotomy Incisions in Blood Vessels of Rats, Using a Temperature Controlled Fiberoptic System

摘要

Background and objectives: Conventional methods for microvascular anastomosis are normally based on suturing, using special thin nylon sutures. These methods suffer from major drawbacks, which include: anastomosis, which is not watertight, and sutures or clips that cause an inflammatory response. In order to obtain better results, we introduced a procedure based on CO_2 laser soldering. We tested the system on arteriotomy incisions in rat blood vessels, in vivo. Materials and methods: We used a fiber optic based laser soldering system, with a temperature control capability. Arteriotomy incisions of lengths 4 +- 1mm were performed on the femoral arteries of 48 wistar rats: 24 rats in the control group (suture) and 24 rats in the test group (laser soldering). We conducted two follow-up periods: 7 days and 21 days after the surgical procedure, for each group. Flow tests and histology examination were done in order to evaluate the quality of the procedures. Results: The patency rate was 84% for both groups, soldered and sutured. The sutured group showed a significant foreign body reaction (p< 0.05), which was not observed in the soldered group. We found no evidence of thermal damage in the soldered blood vessels. Conclusions: We can conclude that laser soldering is a less traumatic procedure, compared with the conventional suturing technique. It is potentially a faster technique and easier to master.