Microvascular carotid end-to-end anastomosis with a compact diode laser equipped with an auto-stop system: a preliminary study

Diode laser assisted microvascular anastomosis (LAMA) versus control ateral conventional suture microanastomosis (CMA) were performed in 50 rats. The laser source (830 nm) was included into a micromanipulator without optical fiber connection. The beam was directly focused on a deviating mirror giving a 200 micrometers spot size. The LAMA was performed on the left common carotid by means of 3 laser shots of 360 mW power and 8 s exposure time regulated by an auto-stop system, the irradiance being 1,146 W/cm2. CMA was performed on the right carotid by means of size 10.0 Ethilon stitches (BV 70, Ethnor, Neuilly, France). The anastomoses were evaluated by macroscopic controls and Doppler spectral analysis (D0 to D60). After LAMA, light and scanning electron microscopy visualized the rapid re-endothelialization of the anastomotic line with longitudinal migration of endothelial cells, while the media was repaired by collagen network due to tissular fusion. The procedure demonstrated the usefulness and the adaptability of our new laser system. The prototype, characterized by low weight (2,500 g), small size 30 X 10 X 6 cm), good laser transmission, equipped with a feed-back system is well adapted to microsurgery.