Diode laser and microvascular carotid anastomosis: A preliminary study

A crossed carotid end-to-end anastomosis was performed in 20 Wistar rats by means of a diode laser device (wavelength 830 nm and power output 3 W in continuous wave). The diode laser energy was delivered into a micromanipulator coupled to an OPMI 1 Zeiss operating microscope with a focused spot of 300 μm diameter. The vessel sealing was effected on common carotids (0.8–1.2 mm) using laser shots (average 9) of 680 mW power and 4.5 s duration and 962 W cm⁻² irradiance each. The good vascular flow was confirmed by Doppler spectral analysis and angiography performed on days 0, 10 and 30. Light and scanning electron microscopy showed that reendothelialization was complete on day 10 whilst collagenous fusion of media and adventitia was obvious. The patency rate was 90% impaired by a lethal thrombosis. The efficiency of the diode laser was compared to that of other types of LAVA and to manual microanastomosis.