Laser vascular welding in biologic grafts

This study evaluated the possibility and efficacy of laser welding in biologic vascular grafts. Grafts were anastomosed to 21 canine peripheral (femoral and/or carotid) arteries or coronary arteries with a Nd-YAG laser using the contact method. The laser welds were fashioned using 1-1.5 W power for 1-3 sec. The grafts used were heparinized canine carotid artery cross-linked with polyepoxy compounds. The welding was a success in 92% (22/24) of the peripheral artery and 83% (5/6) of the coronary artery procedures. The early patency rate was 100%. The anastomotic sites were strong enough to withstand high pressure (more than 300 mmHg of arterial pressure). Histologic examination was performed on days 0 and 3, 1 week, 3 weeks, or more than 1 month postoperatively to compare the progression of healing. The laser welded sites had a smooth external surface and minimal damage of the internal layer, with minimal inflammatory response and no pathologic granulation. The welded sites fused strongly after 1 postoperative week. In conclusion, an Nd-YAG laser, using a contact method, could successfully weld peripheral and coronary arteries to biologic vascular grafts.