Suture-free laser-assisted vessel repair using CO2 laser and liquid albumin solder

Wolf-de Jonge, Ingrid C. D. Y. M.; Heger, Michal; van Marle, Jan; Balm, Ron; Beek, Johan F.

doi:doi:10.1117/1.2953531

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Journal of Biomedical Optics / Volume 13 / Issue 4 / Research Papers

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Suture-free laser-assisted vessel repair using CO₂ laser and liquid albumin solder

J. Biomed. Opt. 13, 044032 (Jul 28, 2008); http://dx.doi.org/10.1117/1.2953531

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Abstract

References (46)

Ingrid C. D. Y. M. Wolf-de Jonge and Ron Balm

Academic Medical Center, Department of Vascular Surgery, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

Michal Heger

Academic Medical Center, Laser Center and Department of Experimental Surgery, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

Jan van Marle

Academic Medical Center, Department of Cell Biology and Histology, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

Johan F. Beek

Academic Medical Center, Laser Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands

Numerous studies have shown that the use of proteinic solders during laser-assisted vascular anastomosis (LAVA) and repair (LAVR) can significantly increase welding strength, but these studies combined solder-mediated LAVA/R with the use of stay sutures, thereby defeating its purpose. In an in vitro study, we examined the leaking point pressures (LPPs) and histological damage profile of porcine carotid arteries following albumin solder-mediated CO₂ LAVR without the use of sutures. Longitudinal arteriotomies (9.1±0.8 mm in length) were sheathed with 25% liquid bovine serum albumin solder, and LAVR was performed using a micromanipulator-controlled CO₂ laser operating at 170-mW power and 1.25-mm spot size in continuous wave mode. The welding regime consisted of a transversal zigzag pass followed by one or two longitudinal zigzag passes, producing an irradiance of 13.9 W/cm² and energies of 10.5 J and 11.3 J per mm weld, respectively. LPPs were measured by the fluid infusion technique, and histological analysis was performed with light, fluorescence, and polarization microscopy. The LPP of the two-pass welds was 351±158 mmHg versus 538±155 mmHg for the three-pass welds. Thermal damage was confined primarily to the adventitial layers, with limited heat diffusion into the media below the solder around the coaptation interface.

History

Received Apr 17, 2007
Accepted Feb 12, 2008
Revised Dec 14, 2007
Published online Jul 28, 2008

Digital Object Identifier

http://dx.doi.org/10.1117/1.2953531

Citation

Ingrid C. D. Y. M. Wolf-de Jonge, Michal Heger, Jan van Marle, Ron Balm and Johan F. Beek, "Suture-free laser-assisted vessel repair using CO₂ laser and liquid albumin solder", J. Biomed. Opt. 13, 044032 (Jul 28, 2008); http://dx.doi.org/10.1117/1.2953531