Large-Artery Welding With a Milliwatt Carbon Dioxide Laser

Abstract

• Microvascular laser welding can be effectively used in large-diameter artery techniques. The carotid arteries of 12 anesthetized mongrel dogs were exposed. Following heparinization, the carotid arteries were transected, cleaned along their edges, and repaired on the right side by laser and on the left side by suture. The laser-assisted vascular anastomosis (LAVA) required four stay sutures and laser power for welding. Six-week patency for LAVA vs suture anastomosis was 100% vs 92%, respectively. Anastomotic time requirements were less with LAVA (seven vs 25 minutes). Intimal healing for both techniques immediately demonstrated an intraluminal thrombus, which resolved showing complete endothelial repair by four weeks. The laser seal demonstrated little inflammation compared with the giant cell reaction of suture anastomosis. Immediate wall tensions of 6 to 18×10⁵ dynes/cm² were tolerated after both techniques. Laser-assisted vascular anastomosis of large-diameter arteries is feasible, strong, and associated with minimal inflammation. (Arch Surg 1987;122:673-677)