Laser-assisted microvascular anastomoses: angiographic and anatomopathologic studies on growing microvascular...

A low-powered carbon dioxide laser was used to perform end-to-end anastomoses of growing femoral arteries (mean diameter 1.6 mm) in miniature swine. Five microvascular conventional anastomoses were performed with 10-0 monofilament interrupted sutures. Nine laser-assisted vascular anastomoses were performed. The mean duration of each anastomosis was 30 +/- 3 minutes for the conventional anastomosis and 20 +/- 2 minutes for the laser-assisted vascular anastomosis (p less than 0.05). All anastomoses were patent at the completion of the procedure. Each laser-assisted anastomosis required an average of eight laser pulses of 2 to 4 seconds. After 13 weeks the external diameters of the conventional anastomoses were 1.8 mm (+15%), while the laser-assisted anastomoses averaged 3.0 mm (+81%) (p less than 0.05). All nine laser-assisted anastomoses were patent, functional, and free of stenosis compared with one out of five conventional anastomoses. Histologically the laser induced minimal or no fibrosis, allowing normal physiologic healing and growth patterns. Electron microscopy confirmed that the integrity of the arterial layers had been restored. These findings suggest that a low-energy carbon dioxide laser has potential clinical application for anastomosis of small growing vessels.