[Vascular microanastomosis with diode laser. Control study and morphological results]

Area of Science:

• Vascular Surgery
• Biomedical Engineering
• Laser Medicine

Context:

• Microvascular surgery often relies on manual suturing techniques.
• Challenges in microanastomosis include prolonged operating times, tissue trauma, and potential for thrombosis.
• Direct diode laser offers a potential alternative for precise tissue fusion.

Purpose:

• To compare the efficacy and morphological outcomes of direct diode laser carotid microanastomosis versus conventional manual suture microanastomosis (CMA).
• To evaluate patency rates, complication rates, and arterial wall healing characteristics.
• To assess the technical advantages and potential benefits of diode laser technology in microvascular procedures.

Summary:

• Direct diode laser microanastomosis and CMA were performed on 70 Wistar rats, with similar patency (93%) and complication rates.
• Microscopic analysis revealed superior reendothelialization by day 3 and medial collagen restructuring by day 10 in laser-treated vessels.
• CMA resulted in delayed arterial wall repair and fibrotic scarring, while laser anastomosis showed faster, more organized healing.

Impact:

• Laser microanastomosis offers morphological superiority, characterized by faster reendothelialization and improved collagen restructuring.
• Reduced operating time (13 min vs. 22 min) with laser anastomosis minimizes organ ischemia and thrombogenic risk.
• The technical advantages of diode lasers, including miniaturization and decreasing costs, position them as a promising tool for future microvascular applications.