Laser-assisted microsurgical anastomoses in traumatized blood vessels

Technological advances have made CO2 laser-assisted microvascular anastomoses (LAMA) feasible. This study seeks to compare results of LAMA versus CSMA (conventional suture microsurgical anastomosis) in traumatized vessels. Using a rat model, femoral arteries and veins were either crushed and transected or divided by avulsion and then repaired by either LAMA or CSMA. LAMA resulted in higher patency rates than CSMA at early postoperative observation periods. With time, the patency rates improved in both groups and, by the end of the study, the patency rates were equivalent. These findings indicate that the laser technique may be a better option when working with traumatized vessels because of the critical nature of early patency rates. The improved results may be due to a reduction of suture material at the anastomotic site when using the laser technique. Some physiologic aspects of vessel thrombosis, recanalization, and the role of collateral circulation are discussed.