Endoluminal laser-assisted vascular anastomosis—an in vivo study in a pig model
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Microvascular surgery is time consuming and requires high expertise. Laser-assisted vascular anastomosis (LAVA) is a promising sutureless technique that has the potential to facilitate this procedure. In this study, we evaluate the handling of our soldering material and the 1-week patency rate in a porcine model. Six pigs were subjected to LAVA. For each pig, the saphenous artery on one side was transected while the contralateral side was used as control. A porous polycaprolactone scaffold soaked in 40% (w/w) bovine serum albumin solution in combination with 0.1% (w/w) indocyanine green was wrapped at the anastomosis site and at the control site. Both sides were then soldered with a diode laser coupled into a light diffuser fiber emitting radiation with a wavelength of 808 nm and a power of 2–2.2 W. Vessels were successfully soldered with a 100% immediate patency rate. The 1-week patency rate was 83% for the anastomoses versus 67% for the control side. Vessels irradiated for 80 to 90 s tended to maintain the highest patency rate. Macroscopically, there was no difference between the two sides. The patch was easy to handle provided that the environment could be kept dry. This study shows the potential and the limitations of endoluminal LAVA as a one-step procedure without the use of stay sutures. Further studies are needed to improve the soldering material, the long-term patency rate, and standardized irradiation parameters. The long-term effects of laser soldering on the vessel wall remain to be determined.
KeywordsLAVA Soldering Sutureless anastomoses
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Role of funding source
This study was supported by a grant of the Swiss National Science Foundation (project number 108447).
This article does not contain any studies with human participants performed by any of the authors.
All animal experimentations were performed after approval from the animal care committee of the Canton of Bern, Switzerland (Nr. BE72/07) and in agreement with international guidelines and the guidelines for the care and use of experimental animals of the National Institutes of Health.
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