Niijima K H, Yonekawa Y, Handa H, Taki W
Department of Neurosurgery, National Cardiovascular Center, Osaka, Japan.
J Neurosurg. 1987 Oct;67(4):579-83. doi: 10.3171/jns.1987.67.4.0579.
Anastomosis of rat common carotid artery was performed without sutures, using a neodymium (Nd)-YAG laser at 20 W for 100 msec; this power and exposure had been found optimal in preliminary experiments. An intraluminal intervascular splint made of water-soluble polyvinyl alcohol, which dissolved and disappeared within a few minutes after recirculation of blood, was used for precise "intima-to-intima" coaptation. No stay sutures or glue were required during the procedure. There was a 92% patency rate 24 hours after surgery, and the anastomosed vessels were still patent on the 7th and 30th postoperative days. Complications such as aneurysm formation or stenotic change were negligible. The fusion of the muscle layer and collagen fibers of the media in the anastomosis was confirmed histologically. A tensile strength test immediately following operation and 1 week later showed that this anastomosis was significantly better than that achieved with the usual manual suture method. The major advantages of this technique, combined with use of a water-soluble polyvinyl alcohol splint, are rapidity, consistency of results, and firm fusion with no residual foreign body.
使用钕（Nd）-YAG激光以20W功率照射100毫秒，在不缝合的情况下进行大鼠颈总动脉吻合术；在初步实验中已发现此功率和照射时间为最佳参数。使用由水溶性聚乙烯醇制成的管腔内血管间夹板，其在血液再循环后几分钟内溶解并消失，用于精确的“内膜对内膜”贴合。手术过程中无需使用定位缝线或胶水。术后24小时通畅率为92%，吻合血管在术后第7天和第30天仍保持通畅。动脉瘤形成或狭窄改变等并发症可忽略不计。组织学证实吻合处中膜的肌肉层和胶原纤维融合。术后立即及1周后进行的拉伸强度测试表明，这种吻合术明显优于常规手工缝合方法。该技术结合使用水溶性聚乙烯醇夹板的主要优点是操作迅速、结果一致性好，且融合牢固，无残留异物。
