CO2 and argon laser vascular welding: Acute histologic and thermodynamic comparison

✍ Scribed by George E. Kopchok; Rodney A. White; Geoffrey H. White; Roy Fujitani; Jerry Vlasak; Leon Dykhovsky; Warren S. Grundfest

• Publisher: John Wiley and Sons
• Year: 1988
• Tongue: English
• Weight: 499 KB
• Volume: 8
• Category: Article
• ISSN: 0196-8092
• DOI: 10.1002/lsm.1900080608

✦ Synopsis

<XI2 and argon lasers have been used successfully for vascular welding in both experimental and clinical settings. This study compared the thermodynamics during COz and argon laser welding of 1-cm longitudinal arteriotomies in a canine model. Continuous recordings using an AGA 782 digital thermographic system with spatial and thermal resolution of f0.2 mm and &0.2"C, respectively, were analyzed. A HGM argon laser using a 300-~m optic fiber held a t 1 cm from the vessel edges (spot diameter = 2.8 mm) with concomitant room temperature saline irrigation (1 drop/sec) was used for argon welds. Total exposure time was 150 sec/cm. COz welds were performed with a Sharplan C02 laser (spot diameter = 0.22 mm) with no irrigation for total exposure time of 10 sec/cm. Thermodynamic results and laser parameters are summarized as follows: Argon-n = 20; power = 500 mW; energy fluence = 1,400 .J/cmZ; Tmax = 48.8"C; T mean & S.1). = 45.1 -+ 2.7"C; COz-n = 20; power = 150 mW; energy fluence = 3,000 J/cm ; Tmax 84.0"C; T mean & S.1). = 60.7 f 9.8%. There was a significant difference ( P < .05) in thermal measurements between successful C 0 2 and argon vascular welds. Temperdture rise during the argon welds was limited by saline irrigation. In contrdst, during CO2 laser welding, the temperature rose quickly to its maximum and was maintained at a relatively high level as the laser progressed (0.1 cm/sec) along the anastomosis. Histologic examination revealed charring at the COz weld site but absence of thermal damage at the argon laser weld. These thermodynamic differences may account for the different welding mechanisms currently described.