AI Article Synopsis
- The ELANA technique allows for the creation of vascular anastomoses without temporarily blocking blood flow and has been studied using varying laser energy levels to assess effects on recipient vessel health.
- An experiment on rabbits tested laser energies of 10, 13, and 15 mJ, revealing that while the tunica media and adventitia were mostly unaffected, increased energy led to significant damage to the endothelial layer at 15 mJ.
- The study concludes that while 12 and 13 mJ appear safe for the endothelial lining, raising the energy to 15 mJ may cause notable damage, prompting the need for future research on long-term impacts.
Article Abstract
Background And Objective: The excimer laser-assisted non-occlusive anastomosis (ELANA) technique is a way of making an anastomosis of vessels without temporal occlusion that is used for cerebral revascularization. Currently, 10 mJ of laser energy is used during the ELANA procedure. We have recently demonstrated that increasing the laser energy may increase flap retrieval rate. The aim of the present study was to study the acute effect of increased laser energy during the ELANA procedure on the recipient vessel wall.
Materials And Methods: The ELANA technique was performed on the abdominal aortas of rabbits under anesthesia using three categories of laser energy (two laser episodes of 10, 13, and 15 mJ, respectively). The rabbits were subsequently sacrificed and the anastomoses were removed. A non-lased rabbit aorta was used as control. Recipient arteries were studied using histopathology and transmission electron microscopy.
Results: In all three categories of laser energy and in the control group, the tunica media and adventitia adjacent to the anastomosis were intact, apart from damage caused by sutures. In the control group, the endothelium was fully intact. In the 10 and 13 mJ subgroups, the endothelium was mostly intact [92% (range 85-98) and 87% (range 80-90) for 10 and 13 mJ, respectively]. In the 15 mJ subgroup, most of the endothelium was absent [32% (range 20-40) of endothelium intact], predominantly at the side opposed to the anastomosis.
Conclusion: Increasing the laser energy during the ELANA procedure from 10 to 13 mJ does not cause additional acute damage to the vessel wall. Increasing the laser energy from 13 to 15 mJ results in increased acute damage of the endothelium, whereas tunica media and adventitia remain unaffected. Further studies are required to assess the long-term effects of increased laser energy during the ELANA technique.
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| http://dx.doi.org/10.1002/lsm.21075 | DOI Listing |
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