In vivo laser assisted microvascular repair and end-to-end anastomosis by means of indocyanine green-infused chitosan patches

A pilot study

Giuseppe Esposito, Francesca Rossi, Paolo Matteini, Alba Scerrati, Alfredo Puca, Alessio Albanese, Giacomo Rossi, Fulvio Ratto, Giulio Maira, Roberto Pini

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background and Objectives Laser-based repairing techniques offer several advantages respect to standard suturing in microsurgery. In this work we evaluate the applicability and feasibility of two innovative laser-based approaches for microvascular repair and anastomoses: (1) laser-assisted vascular repair (LAVR); (2) laser-assisted end-to-end vascular anastomosis (LAVA). All these procedures have been executed by the use of diode laser irradiation and chitosan-patches infused with Indocyanine Green (ICG). Study Design/Materials and Methods Experiments were performed on 30 rabbits. Twenty animals underwent LAVR and 10 end-to-end LAVA procedures. In the LAVR group, a 5-mm longitudinal cut was performed on the common carotid artery (CCA), then an ICG-infused chitosan patch was topically applied and laser-soldered over the arterial lesion. In the LAVA group the end-to-end anastomosis was executed on CCA by means of application of the three interrupted sutures and subsequent laser soldering of the ICG-infused patch. Animals underwent different follow-up periods (2, 7, 30, and 90 days). At the end of every follow-up, the animals were re-anesthetized and a microdoppler analysis was performed in order to check patency of the treated vessels. Then soldered segments were excised and subjected to histological and ultrastructural evaluations. Results At the end of surgery no bleeding from the treated segment was observed; all the treated vessels were patent. At the end of follow-up periods, no signs of perivascular haemorrhage were found. An intraoperative microdoppler evaluation assessed the patency of all the treated vessels. Histology showed a good reorganization of the vascular wall structures and an early endothelial regeneration was observed by SEM. Conclusions Our study demonstrated the efficacy of laser tissue soldering by means of ICG-infused chitosan patches for the in vivo repairing of microvascular lesions and end-to-end anastomoses. This approach offers several advantages over conventional suturing methods and is technically easy to perform, minimizing the surgical trauma to vessels.

Original languageEnglish
Pages (from-to)318-325
Number of pages8
JournalLasers in Surgery and Medicine
Volume45
Issue number5
DOIs
Publication statusPublished - Jul 2013

Fingerprint

Indocyanine Green
Chitosan
Lasers
Blood Vessels
Common Carotid Artery
Hemorrhage
Semiconductor Lasers
Microsurgery
Sutures
Regeneration
Histology
Rabbits
Wounds and Injuries

Keywords

  • biomaterials
  • laser tissue soldering
  • microvascular surgery
  • vessels repair

ASJC Scopus subject areas

  • Surgery
  • Dermatology

Cite this

In vivo laser assisted microvascular repair and end-to-end anastomosis by means of indocyanine green-infused chitosan patches : A pilot study. / Esposito, Giuseppe; Rossi, Francesca; Matteini, Paolo; Scerrati, Alba; Puca, Alfredo; Albanese, Alessio; Rossi, Giacomo; Ratto, Fulvio; Maira, Giulio; Pini, Roberto.

In: Lasers in Surgery and Medicine, Vol. 45, No. 5, 07.2013, p. 318-325.

Research output: Contribution to journalArticle

Esposito, Giuseppe ; Rossi, Francesca ; Matteini, Paolo ; Scerrati, Alba ; Puca, Alfredo ; Albanese, Alessio ; Rossi, Giacomo ; Ratto, Fulvio ; Maira, Giulio ; Pini, Roberto. / In vivo laser assisted microvascular repair and end-to-end anastomosis by means of indocyanine green-infused chitosan patches : A pilot study. In: Lasers in Surgery and Medicine. 2013 ; Vol. 45, No. 5. pp. 318-325.
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AU - Esposito, Giuseppe

AU - Rossi, Francesca

AU - Matteini, Paolo

AU - Scerrati, Alba

AU - Puca, Alfredo

AU - Albanese, Alessio

AU - Rossi, Giacomo

AU - Ratto, Fulvio

AU - Maira, Giulio

AU - Pini, Roberto

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N2 - Background and Objectives Laser-based repairing techniques offer several advantages respect to standard suturing in microsurgery. In this work we evaluate the applicability and feasibility of two innovative laser-based approaches for microvascular repair and anastomoses: (1) laser-assisted vascular repair (LAVR); (2) laser-assisted end-to-end vascular anastomosis (LAVA). All these procedures have been executed by the use of diode laser irradiation and chitosan-patches infused with Indocyanine Green (ICG). Study Design/Materials and Methods Experiments were performed on 30 rabbits. Twenty animals underwent LAVR and 10 end-to-end LAVA procedures. In the LAVR group, a 5-mm longitudinal cut was performed on the common carotid artery (CCA), then an ICG-infused chitosan patch was topically applied and laser-soldered over the arterial lesion. In the LAVA group the end-to-end anastomosis was executed on CCA by means of application of the three interrupted sutures and subsequent laser soldering of the ICG-infused patch. Animals underwent different follow-up periods (2, 7, 30, and 90 days). At the end of every follow-up, the animals were re-anesthetized and a microdoppler analysis was performed in order to check patency of the treated vessels. Then soldered segments were excised and subjected to histological and ultrastructural evaluations. Results At the end of surgery no bleeding from the treated segment was observed; all the treated vessels were patent. At the end of follow-up periods, no signs of perivascular haemorrhage were found. An intraoperative microdoppler evaluation assessed the patency of all the treated vessels. Histology showed a good reorganization of the vascular wall structures and an early endothelial regeneration was observed by SEM. Conclusions Our study demonstrated the efficacy of laser tissue soldering by means of ICG-infused chitosan patches for the in vivo repairing of microvascular lesions and end-to-end anastomoses. This approach offers several advantages over conventional suturing methods and is technically easy to perform, minimizing the surgical trauma to vessels.

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