Laser를 이용한 새로운 미세혈관 문합술의 실험적 연구

Experimental Study of Laser Assisted Microvascular Anastomosis(LAMA) Using the Nd:YAG Contact Laser

A comparative study was undertaken to evaluate the contact Neo-dymium : yttrium aluminum garnet(Nd:YAG) laser system for vascular anastomosis of small caliber blood vessels(diameter 0.5-1.2 mm) in the animal model. In this study 40 femoral arteries and 40 femoral veins of Sprague-Dawley rats were anastomosed by contact laser assisted microvascular anastomosis(LAMA) utilizing 3 stay sutures which were placed 120 degrees apart and the intervals welded with contact Nd:YAG laser unit, conventionally sutured anastomosis(CSA) served as controls. The time needed for vascular anastomosis, patency rate(immediate postoperative, postoperative 2nd day, postoperative 1 week, postoperative 4 weeks), gross and microscopic evaluations were compared to conventional microsurgical suture technique. The results are as follows: 1. Postoperative patency rate was 82.5% for femoral artery and 75% for femoral vein by contact LAMA technique compared to 90% and 75% by CSA technique at postoperative 4 weeks. 2. Less time-consumed for arterial anastomosis by 6 minutes 23 seconds and venous anastomosis by 8 minutes 55 seconds with contact LAMA technique compared to CSA technique. 3. Grossly almost complete healing had taken place by postoperative 1 week by contact LAMA technique. 4. Aneurysm formation was 5% for femoral artery and 15% for femoral vein by contact LAMA technique compared to 5% and 10% respectively by CSA technique. 5. Microscopically, re-endothelization was complete by postoperative 7th day by contact LAMA technique. There was less medial hypertrophy and hyperplasia and also less inflammatory response compared to CSA.