Argon laser—welded arteriovenous anastomoses

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Presentation transcript:

Argon laser—welded arteriovenous anastomoses Rodney A. White, M.D., George Kopchok, B.S., Carlos Donayre, M.D., Geoffrey White, M.D., Richard Lyons, M.D., Roy Fujitani, M.D., Stanley R. Klein, M.D., Jouni Uitto, M.D., Ph.D.  Journal of Vascular Surgery  Volume 6, Issue 5, Pages 447-453 (November 1987) DOI: 10.1016/0741-5214(87)90302-8 Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 Technique of laser welding of vein-artery anastomoses. Sutures are placed at the apexes of the incisions and at the middle of the posterior wall (A); tension on the suture at the middle of the posterior wall opposes the edges of the repair for welding (B); suture is placed in the middle of the anterior wall and apposes the edges for welding (C). Journal of Vascular Surgery 1987 6, 447-453DOI: (10.1016/0741-5214(87)90302-8) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Gross appearance of argon laser-welded, canine arteriovenous fistula at 8 weeks. S = traction sutures; I = 1 cm length of laser fusion. Journal of Vascular Surgery 1987 6, 447-453DOI: (10.1016/0741-5214(87)90302-8) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 Verhoeff-van Gieson stain of arteriovenous fistulas at 8 weeks: suture (A), argon laser-sealed (B), and argon laser-sealed at the site of a traction suture (C). In each illustration the artery is on the top and the vein is on the bottom. Note that sutured areas in both the suture control (A) and lasered specimen at the site of a traction suture (C) were associated with a marked intimal response. (Arrows mark line of artery-vein fusions; IE = internal elastic laminae; IH = intimal hyperplasia; S = suture holes). (Original magnifications × 40.) Journal of Vascular Surgery 1987 6, 447-453DOI: (10.1016/0741-5214(87)90302-8) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Tensile strength of arteriovenous fistulas closed by suture (———) or laser (——) welding at 1, 2, 4, and 8 weeks. Graphs depict the load (kg) vs. extension (mm) of the repairs. The top of the curve on the y-axis corresponds to the load at breaking. Control tensile strength of both normal vein and artery are represented by the respective labeled lines (—.——.—.—). Journal of Vascular Surgery 1987 6, 447-453DOI: (10.1016/0741-5214(87)90302-8) Copyright © 1987 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions