Carotid artery anastomosis with albumin solder and near infrared lasers: Acomparative study

Background and Objective: Laser tissue-welding has been used for anastomosi s of carotid arteries. During welding, thermal injury sustained by the vess el walls should be minimized to prevent thrombosis. Two different types of lasers were used and effects on tissue damage were studied in vitro and in vivo. Study Design/Materials and Methods: End-to-end anastomosis of dog carotid a rteries (n = 10) was performed by using a human albumin solder (HAS) in con junction with Nd:YAG or diode lasers (lambda = 1.32 mum and 1.9 mum, respec tively). The arteries were evaluated for patency and evidence of histologic injury after 21 days. Another group of arteries was laser soldered in vitr o to measure the intimal and adventitial temperatures by using thermocouple s. Results: The arteries repaired with the diode laser sustained significantly less thermal damage than those repaired with Nd:YAG laser, both in vitro a nd in vivo. In particular, the intimal temperature was significantly lower (P < 0.05) for the diode than for the Nd:YAG repairs (<similar to>35 degree sC and similar to 50 degreesC, respectively). In the latter group, the pate ncy rate was 75%, but thrombosis occurred in 75% of the specimens at 21 day s. All diode anastomoses were patent and thrombosis developed in only 17% o f the arteries. Conclusion: Use of the diode laser and albumin solders may provide a means to successfully repair carotid arteries with minimal thermal damage. Lasers Surg. Med. 28: 50-55, 2001 (C) 2001 Wiley-Liss, Inc.