Temperature Feedback and Collagen Cross-Linking in Argon Laser Vascular Welding

A preliminary single-animal study of in vivo argon laser vascular welding was conducted using a canine model. The effects of temperature feedback control and saline drip cooling on patency and collagen cross-linking were investigated. The surface temperature at the centre of the laser spot was monitored using a two-colour infrared thermometer. The surface temperature was limited by either a saline drip or feedback control of the laser. Acute patency was evaluated and collagen cross-link assays were performed. Though both protocols yielded successful tissue fusion, welds maintained at a surface temperature of 50°C using feedback control had an elevated cross-link count compared to controls, whereas tissues irradiated without feedback control experienced a cross-link decrease. Simulations using the LATIS (LAser-TISsue) computer code suggest that drip-cooled procedures achieve significantly higher temperatures beneath the tissue surface than temperature feedback-controlled procedures. Differences between the volumetric heating associated with drip-cooled and feedback-controlled protocols may account for the different effects on collagen cross-links. Covalent mechanisms may play a role in argon laser vascular fusion. Paper received 20 August 1997; accepted in final form 16 September 1997.