Technical frontiers for the vascular surgeon: Laser anastomotic welding and angioscopy-assisted intraluminal instrumentation Rodney A. White, M.D. Journal.

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Presentation transcript:

Technical frontiers for the vascular surgeon: Laser anastomotic welding and angioscopy-assisted intraluminal instrumentation Rodney A. White, M.D. Journal of Vascular Surgery Volume 5, Issue 4, Pages 673-680 (April 1987) DOI: 10.1016/0741-5214(87)90252-7 Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 Sutured (A) and argon laser—welded (B) arteriotomies at 4 weeks. Sutured wound shows disorientation of elastic fibers, whereas lasered wound has no foreign body response and reorienting elastic fibers. Luminal surface is on the right side of the photographs (Verhoeffvan Gieson stain; original magnification × 100). (From White RA, et al. Comparison of laser—welded and sutured arteriotomies. Arch Surg 1986;121:1134.) Journal of Vascular Surgery 1987 5, 673-680DOI: (10.1016/0741-5214(87)90252-7) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Technique for performing laser welding of vein-artery anastomoses. Sutures are placed at the apices of the incisions and at the middle of the posterior wall (A); tension on the suture at the middle of posterior wall opposes the edges of the repair for welding (B); suture is placed in the middle of the anterior wall and opposes the edges for welding (C). Journal of Vascular Surgery 1987 5, 673-680DOI: (10.1016/0741-5214(87)90252-7) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 Sutured (A) and argon laser—welded (B) arteriovenous fistulas at 8 weeks. Sutured wound has a marked intimal hyperplastic response (Verhoeff-van Gieson stain; original magnification × 40). Journal of Vascular Surgery 1987 5, 673-680DOI: (10.1016/0741-5214(87)90252-7) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Angioscopy-assisted placement of the hot-tip laser probe to perform in situ vein valvulotomy. A = probe placement; B = valve perforation; C = valvulotomy completed (arrow indicates direction of angioscope introduction). Journal of Vascular Surgery 1987 5, 673-680DOI: (10.1016/0741-5214(87)90252-7) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions