Laser-assisted end-to-end vascular anastomosis of elastin heterograft to carotid artery with an albumin stent in vivo.

BACKGROUND DATA: Laser-assisted end-to-end vascular anastomosis of an elastin heterograft to native artery may avoid the problems associated with currently available vascular synthetic grafts and conventional suture anastomosis. METHODS: A total of 21 anastomoses in the carotid arteries of seven domestic pigs were performed with an 800-nm laser and an albumin stent plus solder. There were five artery to artery and 16 elastin heterograft to native artery anastomoses. Operative parameters, vascular patency, and histology of the anastomoses were evaluated. RESULTS: Out of 21 anastomoses, 20 were patent at 3 h. The average amount of total energy used was 212 Joules in artery to artery anastomosis and 273 Joules in elastin heterograft to native artery. Histology shows coagulative necrosis of the adventitia, hypereosinophilic contraction band in the media in native artery, and no change in elastin heterografts. CONCLUSIONS: Laser-assisted vascular anastomosis of elastin heterograft to medium size vessel is possible. Albumin stent played an important role in strength of the anastomosis. Chronic studies are warranted to determine long-term patency and histology of the laser-assisted vascular anastomosis.