Document Detail


Minimally occlusive laser vascular anastomosis (MOLVA): experimental study.
MedLine Citation:
PMID:  19266153     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Temporary occlusion of an intracranial artery during microvascular anastomosis is a major risk factor in cerebrovascular surgery. A new laser vascular welding technique that minimizes the occlusion time of the recipient vessel has been developed and is described in this report. METHOD: A new minimally occlusive technique of end-to-side microvascular anastomosis was developed employing a diode laser in association with the application of a chromophore in our experimental model of double end-to-side anastomosis. The implantation of a vein graft on the patent carotid artery was obtained through the application of three interrupted sutures at each anastomotic site; the carotid was then clamped, two arteriotomies were performed, followed by the application of a fourth suture and of the laser welding procedure on each anastomosis. Monitoring of the temperature at the site of the anastomosis was introduced in order to control the welding technique. FINDINGS: The time of the clamping of the carotid artery was 12 min to perform two end-to-side anastomoses (i.e., 6 min for each anastomosis). All bypasses were patent after a follow-up of 90 days and histological study confirmed good preservation of the vascular wall. CONCLUSIONS: Our laser-assisted technique of vascular anastomosis reduces the duration of the clamping of the recipient artery down to 6 min. This technique can minimize the risk of cerebral ischemia associated with occlusion of a recipient artery in intracranial bypass procedures, promoting an improved vascular healing process with a lower risk of thrombosis and occlusion.
Authors:
Alfredo Puca; Giuseppe Esposito; Alessio Albanese; Giulio Maira; Francesca Rossi; Roberto Pini
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Publication Detail:
Type:  Journal Article     Date:  2009-03-07
Journal Detail:
Title:  Acta neurochirurgica     Volume:  151     ISSN:  0942-0940     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-24     Completed Date:  2009-06-26     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  363-8; discussion 368     Citation Subset:  IM    
Affiliation:
Institute of Neurosurgery, Catholic University, Largo A Gemelli, Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Animals
Carotid Arteries / anatomy & histology,  surgery
Cerebral Revascularization / instrumentation,  methods*
Indicators and Reagents / therapeutic use
Intracranial Thrombosis / etiology,  physiopathology,  prevention & control*
Laser Therapy / instrumentation,  methods*
Lasers, Semiconductor / therapeutic use
Microvessels / anatomy & histology,  surgery*
Models, Animal
Postoperative Complications / etiology,  physiopathology,  prevention & control*
Rabbits
Surgical Procedures, Minimally Invasive / instrumentation,  methods
Transplants
Treatment Outcome
Veins / radiation effects,  transplantation
Chemical
Reg. No./Substance:
0/Indicators and Reagents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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