Back M R, Kopchok G E, White R A, Cavaye D M, Donayre C E, Peng S K
Department of Surgery, Harbor-UCLA Medical Center, Torrance 90509.
Lasers Surg Med. 1994;14(2):111-7. doi: 10.1002/1096-9101(1994)14:2<111::aid-lsm1900140203>3.0.co;2-f.
This preliminary report describes formation of femoral arterio-venous fistulas (n = 10) in six dogs using a 1.32-microns wavelength Nd:YAG laser welding technique. Stay sutures (6-0 polypropylene) were placed at 5-7 mm intervals along the anastomoses for vessel apposition. Delivery of laser energy through a 400-microns diameter fiber optic was controlled by a new computer-based software system. At 3 mm distance above the anastomosis, energy fluences of 110-260 J/mm2/cm length of anastomosis were used for laser welding. One or two additional hemostatic sutures were required in seven of the ten anastomoses. Flow was maintained for 1-2 hours prior to tissue harvesting. No thrombosis or delayed anastomotic failures were observed after initial welding and repair. Histologic examination revealed good apposition and adherence between wall layers and a fibrinous coagulum at the intimal junctions. Mild thermal injury of the wall was present at some anastomoses. This early investigation suggests that a 1.32 microns Nd:YAG laser welding technique can successfully create large vessel arteriovenous fistulas in the canine.
本初步报告描述了使用1.32微米波长的Nd:YAG激光焊接技术在6只犬中形成股动静脉瘘（n = 10）的情况。沿着吻合口以5 - 7毫米的间隔放置定位缝线（6-0聚丙烯缝线）以实现血管对合。通过直径400微米的光纤传输激光能量由一个新的基于计算机的软件系统控制。在吻合口上方3毫米处，使用110 - 260 J/mm²/吻合口厘米长度的能量密度进行激光焊接。在十个吻合口中，有七个需要额外缝合一到两根止血缝线。在组织采集前维持血流1 - 2小时。初次焊接和修复后未观察到血栓形成或吻合口延迟失败。组织学检查显示壁层之间对合良好且有粘连，内膜交界处有纤维蛋白凝块。一些吻合口存在壁层轻度热损伤。这项早期研究表明，1.32微米Nd:YAG激光焊接技术能够在犬类中成功创建大血管动静脉瘘。
