Self S B, Coe D A, Seeger J M
Department of Surgery, University of Florida, Gainesville 32610, USA.
Lasers Surg Med. 1996;18(3):241-7. doi: 10.1002/(SICI)1096-9101(1996)18:3<241::AID-LSM4>3.0.CO;2-S.
Laser welding of vascular anastomoses has been shown to be feasible, but the clinically relevant advantages of this technique remain to be demonstrated.
STUDY DESIGN/MATERIALS AND METHODS: To determine whether laser welding decreases initial anastomotic thrombogenicity, argon laser-welded aortic and venacaval anastomoses were constructed in 15 New Zealand white rabbits. Low temperature welding was done in one-half of welded anastomoses using low power ( < 0.7W) and increased irrigation with saline during welding. Anastomotic surface temperature, bursting strength, procedure time, and surface thrombogenicity (111Indium labeled platelet accumulation) were determined at 24 hours and compared to sutured anastomoses.
Aortic and vena caval low temperature laser-welded anastomoses were significantly less thrombogenic than sutured or higher temperature laser-welded anastomoses. In addition, bursting strength of welded anastomoses exceeded physiologic requirements and vessel closure time was less with welding than with suture techniques.
Low temperature laser welding limits anastomotic thrombogenicity, which may improve early patency of venous and small arterial bypass grafts.
血管吻合的激光焊接已被证明是可行的，但该技术在临床上的相关优势仍有待证实。
研究设计/材料与方法：为确定激光焊接是否能降低初始吻合口的血栓形成倾向，对15只新西兰白兔进行了氩激光焊接的主动脉和腔静脉吻合术。在一半的焊接吻合口中采用低功率（<0.7W）进行低温焊接，并在焊接过程中增加盐水冲洗。在24小时时测定吻合口表面温度、破裂强度、手术时间和表面血栓形成倾向（111铟标记的血小板聚集），并与缝合吻合口进行比较。
主动脉和腔静脉低温激光焊接吻合口的血栓形成倾向明显低于缝合或高温激光焊接吻合口。此外，焊接吻合口的破裂强度超过生理需求，且焊接时的血管闭合时间比缝合技术短。
低温激光焊接可限制吻合口的血栓形成倾向，这可能会改善静脉和小动脉旁路移植的早期通畅率。
