CO2-welded venous anastomosis: Enhancement of weld strength with heterologous fibrin glue

✍ Scribed by Dolores F. Cikrit; Michael C. Dalsing; Todd S. Weinstein; Kevin Palmer; Stephen G. Lalka; Joseph L. Unthank

• Book ID: 102935282
• Publisher: John Wiley and Sons
• Year: 1990
• Tongue: English
• Weight: 768 KB
• Volume: 10
• Category: Article
• ISSN: 0196-8092
• DOI: 10.1002/lsm.1900100611

✦ Synopsis

The milliwatt CO, laser was used to perform end-to-end anastomoses in canine jugular veins. There was a high disruption rate (50%) in laser-welded veins (n = 10). Fibrin glue (n = 17), formed from human fresh-frozen plasma, enhanced the weld strength decreasing the disruption rate US%), resulting in an 82% patency which nearly equaled the contralateral sutured vein patency (93%). The bursting strength was improved with fibrin glue. Transmural necrosis was present initially in all groups but extended for a longer distance in the vessel wall in laser-welded anastomoses. Sutured anastomoses exhibited a greater inflammatory response. In laser-welded anastomoses endothelial cells were not as confluent as in sutured anastomoses by six weeks.

Carbon dioxide laser-welded end-to-end vein anastomoses appear to be impractical because they disrupt too easily. However, the addition of heterologous fibrin glue to the weld results in a reasonably strong anastomosis with histologic properties that may be beneficial in vein bypass grafts.