J.Jpn. Surg. Soc.. 88(4): 390-400, 1987

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Original article

A NEW METHOD OF VASCULAR ANASTOMOSIS BY CO₂ LASER：EXPERIMENTAL AND CLINICAL STUDY

It is difficult to maintain the long-term patency after conventional anastomosis especially for the small caliber vessels. Since 15 years we have performed aortocoronary bypass with suture materials for the patients with ischemic heart disease. There are some problems in maintaining the long-term patency of the bypass grafts.
Low energy CO₂ laser was utilized to make vascular anastomosis with a few stay sutures. Vascular anastomoses (side-to-side, end-to-end, end-to-side) were carefully made by CO₂ laser in the regions of the femoral arteries and veins, the carotid arteries and jugular veins in dog. A-C bypass was also successfully carried out between the internal mammary artery and the left anterior descending artery under the beating heart in experiment.
Outputs of 20ー40mW and irradiation times of 6ー12 sec/mm were optimal conditions for anastomosis of the small caliber vessels. There were no problems in the intensity and the healing of the anastomotic sites in comparison with the conventional suture method. On the basis of these excellent experimental results a low energy CO₂ laser was employed clinically for vascular anastomosis of the peripheral vessels in 28 patients with angina pectoris or chronic renal failure and cardiac failure. There were no complications such as bleeding and suture line aneurysm after surgery.
In conclusion, vascular anastomosis by laser might be recommended in performing with safety and rapidity for small caliber vessels.

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