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A novel technique for laser-assisted revascularization: an in vitro pilot study

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Abstract

The common limitation of surgical revascularization procedures for severe tissue ischemia due to cardiovascular diseases is the need to interrupt blood flow during the intervention. We aim to introduce a new technique that allows a sutureless, non-occlusive revascularization. A 3-step technique was developed using rabbit’s aorta to simulate a side-to-side anastomosis model. It enables the creation of a bypass circuit for revascularization. The first step was the soldering of 2 vessels in a side-to-side fashion based on the laser-assisted vascular anastomosis (LAVA) principle using a diode laser emitting irradiation at 810 nm with an albumin-based solder patch between them, followed by the creation of a channel within the patch using either a holmium-doped yttrium aluminum garnet laser (Ho:YAG) at λ = 2100 nm or a xenon-chloride excimer laser (XeCl) at λ = 308 nm. Thereby, a bypass circuit was created, thus allowing a non-ischemic revascularization. The system was deemed functional when a flow was observed across the anastomosis. The highest average tensile strength recorded after side-to-side LAVA using a diode laser power of 3.2 W for 60 s was 2278.6 ± 800 mN (n = 20). The Ho:YAG laser created the channels with less tension on the anastomosis than the excimer laser. Histological analysis showed limited thermal damage and good patch-tissue adaptation. The preliminary results of this feasibility study outline the foundations for an entirely sutureless laser-assisted revascularization procedure. The next studies will evaluate the rheological parameters across the bypass circuit to optimize the post-anastomotic flow.

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Acknowledgments

The authors would like to thank Annemarie Schönfeld for her help with this project.

Funding

This study was supported by a grant of the Swiss National Science Foundation (project number 108447).

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, University Hospital Bern, Freiburgstrasse, 3010, Bern, Switzerland

    Zacharia Mbaidjol & Mihai A. Constantinescu

  2. Division of Veterinary Anatomy, University of Bern, Länggass-Strasse 120, CH-3001, Bern, Switzerland

    Michael H. Stoffel

  3. Department of Biomedical Photonics, Institute of Applied Physics, University of Bern, Sidlerstrasse 5, 3012, Bern, Switzerland

    Martin Frenz

Authors
  1. Zacharia Mbaidjol
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  2. Michael H. Stoffel
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  3. Martin Frenz
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  4. Mihai A. Constantinescu
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Correspondence to Zacharia Mbaidjol.

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Mbaidjol, Z., Stoffel, M.H., Frenz, M. et al. A novel technique for laser-assisted revascularization: an in vitro pilot study. Lasers Med Sci 36, 855–862 (2021). https://doi.org/10.1007/s10103-020-03128-6

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  • DOI: https://doi.org/10.1007/s10103-020-03128-6

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