End-to-side anastomosis without occlusion of the recipient artery utilizing the excimer laser

Cees A. F. Tulleken M.D.; Rudolf M. Verdaasdonck

doi:10.1117/12.137343

1 June 1992 End-to-side anastomosis without occlusion of the recipient artery utilizing the excimer laser

Cees A. F. Tulleken M.D., Rudolf M. Verdaasdonck

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Proceedings Volume 1643, Laser Surgery: Advanced Characterization, Therapeutics, and Systems III; (1992) https://doi.org/10.1117/12.137343
Event: OE/LASE '92, 1992, Los Angeles, CA, United States

Abstract

A new technique has been developed which enables the creation of an end-to-side anastomosis between arteries with zero or an extremely short occlusion time (2 min) of the recipient artery for ischemic sensitive areas. The feasibility of the technique was studied in a rabbit model. The right common carotid artery was connected with the exterior of the left common carotid artery. Through an artificial sidebranch, which was connected with the donor artery proximally from the anastomosis, a laser catheter was introduced in contact with the recipient arterial wall. The laser was activated to create a hole in this wall and the artificial sidebranch was subsequently occluded. Meanwhile no occlusion of the donor artery was necessary. In a series of 100 rabbits using a coated hemispherical contact probe (1.8 or 2.2 mm diameter) coupled to a Nd:YAG laser (one 0.5 s, 18 W pulse) a 95% patency rate was obtained. In a recent series of 20 rabbits an Excimer-laser (Technolas, XeCl 308 nm, 120 ns, 20 Hz, 25 mJ/pulse) was used. The hole was created with a custom designed multifibercatheter of 2.2 mm diameter consisting 140 laserfibers in a flat circular configuration. A patency rate of 100% was obtained. Scanning electron microscopy of the anastomosis site through eight weeks showed a perfect endothelialization. The advantage of the Excimer based multifiber catheter compared with the Nd:YAG-based contact probe, is the absence of thermal effects at the site of the anastomosis. A pilot study is in progress in a series of patients, where an extra- intracranial bypass is indicated.

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Cees A. F. Tulleken M.D. and Rudolf M. Verdaasdonck "End-to-side anastomosis without occlusion of the recipient artery utilizing the excimer laser", Proc. SPIE 1643, Laser Surgery: Advanced Characterization, Therapeutics, and Systems III, (1 June 1992); https://doi.org/10.1117/12.137343

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KEYWORDS

Arteries

Excimer lasers

Brain

Thermal effects

Laser therapeutics

Scanning electron microscopy

Neodymium

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