Tissue soldering by use of indocyanine green dye-enhanced fibrinogen with the near infrared diode laser Mehmet C. Oz, MD, Jeffrey P. Johnson, BSE, Sareh.

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Presentation transcript:

Tissue soldering by use of indocyanine green dye-enhanced fibrinogen with the near infrared diode laser Mehmet C. Oz, MD, Jeffrey P. Johnson, BSE, Sareh Parangi, BA, Roy S. Chuck, BSE, Charles C. Marboe, MD *, Lawrence S. Bass, MD, Roman Nowygrod, MD, Michael R. Treat, MD Journal of Vascular Surgery Volume 11, Issue 5, Pages 718-725 (May 1990) DOI: 10.1016/0741-5214(90)90219-Z Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Illustration of rabbit aortotomy model demonstrates repair of the incision with use of a dye-solder mix applied to the site before diode laser exposure. Journal of Vascular Surgery 1990 11, 718-725DOI: (10.1016/0741-5214(90)90219-Z) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Immediately after soldering, fibrinogen (f) lies over the crevice in the repaired aortotomy. The intimal surface, characterized by ridges of endothelial cells, shows no evidence of thermal injury. A few red corpuscles are visible adherent to the fibrinogen amorphous coagulum. (Original magnification by scanning electron microscopy × 910; current magnification 1 cm = 15μm.) Journal of Vascular Surgery 1990 11, 718-725DOI: (10.1016/0741-5214(90)90219-Z) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 A, Two days after soldering, sheets of fibrinogen (f) overlie the aortotomy site. Normal intimal architecture with minimal evidence of thermal injury is seen alongside the fibrinogen. (Original magnification by scanning electron microscopy × 189; current magnification, 1 cm = 194 μm.) B, Higher power view reveals that the thrombotic response has not changed significantly from specimens harvested immediately after welding. (Original magnification by scanning electron microscopy × 620; current magnification 1 cm = 31 μm.) Journal of Vascular Surgery 1990 11, 718-725DOI: (10.1016/0741-5214(90)90219-Z) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Twenty days after soldering, the internal (arrow) and external (e) elastic lamina remain disrupted. Intervening fibrinogen (f) is infiltrated with myofibroblasts and extends from just below the intimal surface to the adventitia. No foreign body reaction is evident. (Hematoxylin, phloxine, saffron staining × 130.) Journal of Vascular Surgery 1990 11, 718-725DOI: (10.1016/0741-5214(90)90219-Z) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 A, Ninety days after soldering, the fibrinogen is completely resorbed. A gap between the internal (arrow) and external (e) elastic lamina at the site of aortotomy remains with fibrous tissue present on the advential side of the external elastic lamina. On the luminal side of the external elastic lamina, myointimal cells with a regenerated media predominate. Mild fibrointimal hyperplasia is evident. (Hematoxylin, phloxine, saffron staining × 130.) B, Normal abdominal wall from the same rabbit demonstrates intact internal (arrow) and external (e) elastic lamina and no fibrointimal hyperplasia. (Hematoxylin, phloxine, saffron staining × 375.) Journal of Vascular Surgery 1990 11, 718-725DOI: (10.1016/0741-5214(90)90219-Z) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Twenty-five days after operation, tissue surrounding a 6-0 polypropylene suture (removed before fixing) appears heaped up and disrupts the smooth flow along the luminal surface. Normal intima is seen adjacent to the suture orifice. (Original magnification by scanning electron microscopy × 630; current magnification, 1 cm = 23 μm.) Journal of Vascular Surgery 1990 11, 718-725DOI: (10.1016/0741-5214(90)90219-Z) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Twenty-five days after soldering, the aortotomy site (arrow) is completely covered with intimal cells and is difficult to distinguish from the surrounding normal rabbit lumen. (Original magnification by scanning electron microscopy × 910; current magnification, 1 cm = 23 μm.) Journal of Vascular Surgery 1990 11, 718-725DOI: (10.1016/0741-5214(90)90219-Z) Copyright © 1990 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions