Hartz R S, McCarthy W J, LoCicero J, Shih S R
J Surg Res. 1987 Aug;43(2):109-13. doi: 10.1016/0022-4804(87)90151-x.
Continuous wavelength laser energy can be used to perform arterial anastomoses, but all experimental series report an incidence of anastomotic aneurysm formation. To elucidate the mechanism of aneurysm production, controlled injuries of the arterial wall were created with a pulsed CO2 laser beam (40-50 mW). One carotid and one femoral artery of 10 New Zealand rabbits were injured with laser and the contralateral vessel was exposed surgically as a sham operation. At reoperation 8 to 11 weeks later, all 40 arteries were patent. None of the carotid shams, one carotid laser, two femoral shams, and eight femoral laser vessels (80%) were aneurysmal. Histologic examination revealed extensive medial necrosis with fragmentation of the internal elastic lamina in the area of these aneurysms. Femoral vessels were significantly smaller than carotids (P less than 0.001) and the high incidence of aneurysm formation in the former may be due to the relatively greater area of injury. This new model of aneurysm formation after laser injury suggests a need for further study prior to clinical application of this technology, especially in vessels smaller than 2 mm in diameter.
连续波长激光能量可用于进行动脉吻合，但所有实验系列均报告了吻合口动脉瘤形成的发生率。为阐明动脉瘤产生的机制，用脉冲二氧化碳激光束（40 - 50毫瓦）对动脉壁进行控制性损伤。对10只新西兰兔的一条颈动脉和一条股动脉进行激光损伤，对侧血管进行手术暴露作为假手术对照。在8至11周后再次手术时，所有40条动脉均通畅。颈动脉假手术组、1条颈动脉激光损伤组、2条股动脉假手术组和8条股动脉激光损伤组（80%）均未出现动脉瘤。组织学检查显示，这些动脉瘤区域存在广泛的中层坏死，内弹性膜破碎。股动脉明显小于颈动脉（P < 0.001），前者较高的动脉瘤形成发生率可能归因于相对更大的损伤面积。这种激光损伤后动脉瘤形成的新模型表明，在该技术临床应用之前需要进一步研究，特别是在直径小于2毫米的血管中。
