CO2 vascular anastomosis of atherosclerotic and calcified arteries

John V. White M.D.; Eric Leefmans; Gwendolyn J. Stewart; Mira L. Katz; Anthony J. Comerota

doi:10.1117/12.17424

1 June 1990 CO₂ vascular anastomosis of atherosclerotic and calcified arteries

John V. White M.D., Eric Leefmans, Gwendolyn J. Stewart, Mira L. Katz, Anthony J. Comerota

Proceedings Volume 1200, Laser Surgery: Advanced Characterization, Therapeutics, and Systems II; (1990) https://doi.org/10.1117/12.17424
Event: OE/LASE '90, 1990, Los Angeles, CA, United States

Abstract

The technique for CO2 laser fusion vascular anastomosis in normal vessels has been well established. Normal arterial wall has a predictable thermal response to the incident laser energy, with rapid heating and cooling of collagen within the arterial wall. Since atherosclerosis involves subendothelial cellular proliferation, lipid and calcium deposition, it may modify the thermal responsiveness of the arterial wall. To this study, CO2 laser fusion anastomoses were attempted in rabbits with non-calcific atherosclerosis and humans with calcific atherosclerosis. All anastomoses were successfully completed without alteration in technique despite the presence of plaque at the site of laser fusion. Histology of rabbit vessels revealed the classic laser fusion cap within the adventitia and persistent atherosclerotic plaque at the flow surface. Duplex imaging of patients post-operatively demonstrated long term anastomotic patency in 2 of 3 fistulae. These results suggest that neither non-calcified or calcified atherosclerosis significantly alters the arterial wall thermal responsiveness to CO2 laser energy or inhibits creation of laser fusion anastomoses. Therefore, this technique may be applicable to the treatment of patients with atherosclerotic occlusive disease.

Citation Download Citation

John V. White M.D., Eric Leefmans, Gwendolyn J. Stewart, Mira L. Katz, and Anthony J. Comerota "CO₂ vascular anastomosis of atherosclerotic and calcified arteries", Proc. SPIE 1200, Laser Surgery: Advanced Characterization, Therapeutics, and Systems II, (1 June 1990); https://doi.org/10.1117/12.17424

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