@entity3278 :yttrium- XXXX -garnet laser fusion of endarterectomy flaps.

@entity1 @entity3278 @entity3775 @entity32 @entity235 @entity7502
PURPOSE: This study evaluated the efficacy of @entity3278 :yttrium- @entity3775 -garnet laser welding of flaps in @entity235 arteries and in securing the distal flap during @entity1 carotid endarterectomy. METHODS: Endarterectomy flaps were created in both common carotid and both common femoral arteries in 12 @entity235 . The flaps were repaired with either the neodymium:yttrium- @entity3775 -garnet laser or with 6-0 @entity7502 sutures. The arteries were removed after duplex scanning at either 7 or 28 days. Eighteen high carotid endarterectomy flaps in 16 @entity1 have been subsequently secured with the laser welding technique. RESULTS: Laser repairs (125 +/- 19 joule) of the @entity235 arteries were completed more quickly than suture repairs (mean 25 seconds vs 135 seconds, respectively; p < 0.04). Duplex ultrasonography revealed no discernable differences between the two groups of arteries. Arteries studied at 7 days revealed three microscopic flaps (two suture, one laser), more subintimal fibroblastic proliferation in suture than laser-repaired carotid arteries (3: 1, p = 0.0530), and similar amounts of @entity32 in suture- and laser-repaired arteries. Arteries studied at 28 days revealed one microscopic intimal flap (suture-repaired); equal fibroblastic and inflammatory responses in suture- and laser-repaired vessels; and no evidence of laser thermal injury. Eighteen carotid endarterectomy flaps have been successfully fused with no immediate or long-term complications in 16 @entity1 (follow-up of 0 to 24 months). CONCLUSION: Laser fusion appears to be a safe and effective method for securing distal carotid endarterectomy flaps.
