Carotid anastomosis using diode lasers of different wavelengths and the evaluation of the arterial wall resistance in swine

Luciane Basilio Aledi*, Djalma José Fagundes and Helio Plapler

Objective: due to the advantages of Laser Assisted Vascular Anastomosis (less occurrence of myointimal hyperplasia with better hemodynamic evolution, shorter surgical time, absence of diameter incompatibility, absence of anaphylaxis, easy execution) the evaluation of the ideal diode laser wavelength to perform anastomosis in elastic arteries, without solder, is a great advance in the surgical practice. 

Method: End-to-end anastomosis was performed on the common carotid arteries of swines, bilaterally, using diode lasers by the wavelengths: 808 nm (n=16), 980 nm (n=16), 1470 nm (n=16) and 1908 nm (n=16) with the same parameters (CW, spot size= 2mm, P≅ 5,1W, t=26s, E= 132,6J, I= 164,51 W/cm2, F= 4277,4 J/cm2). Following, the occurrence of bleeding was verified. When the anastomosis did not bleed a mechanical resistance test was performed. Results: In group 808 nm, there was no welding of the vessels. In group 1908 nm, carbonization of all arterial edges was observed. In groups 980 nm and 1470 nm, the anastomosis results were satisfactory. In group 980 nm, 50% of the anastomosis cases exhibited bleeding and the medium leaking point pressure was 155 ± 56,3 mmHg. In group 1470 nm, 31,3% of the anastomosis cases exhibited bleeding and the medium leaking point pressure was 179,1 ± 37,0 mmHg. There was no statistically significant difference in leaking point pressures between the groups 1470 nm and 980 nm (p=0,094). Based on the physiological blood pressure levels for group 980 nm, the bleeding risk was higher and the survival probability was lower than that of group 1470 nm (p=0,022). 

Conclusions: The wavelength that presented the best results for anastomosis in elastic arteries without solder, in experimental swine model, was 1470 nm. The higher survival probability and lower bleeding risk was achieved on anastomosis using 1470nm. Further studies are required to investigate the other laser dosimetry parameters. 

Keywords: Laser assisted vascular anastomosis; Arterial wall resistance; Diode laser; Leaking point pressure; Carotid anastomosis

Published on: Dec 27, 2018 Pages: 4-9

Full Text PDF Full Text HTML DOI: 10.17352/2455-5452.000031
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