Anastomose carotídea usando laser diodo de diferentes comprimentos de onda e a avaliação da resistência da parede em suínos.

• Ano de defesa: 2018
• Autor(a) principal: Andrade, Luciane Basilio Alledi [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• dARK ID: ark:/48912/001300002480c
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Surgical anastomosis; Carotid arteries; Semiconductor lasers; Pigs; Anastomose cirúrgica; Artérias carótidas; Lasers semicondutores; Suinos
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6446340; https://repositorio.unifesp.br/handle/11600/52426

Objective: due to the advantages of LAVA (less occurence of miointimal hyperplasia with better hemodynamic evolution, shorter surgical time, absence of diameter incompatibility, absence of anaphylaxis, easy execution) the evaluation of the ideal diode laser wavelength to perform these anastomosis without solder is a great advance in the surgical practice. Method: End-to-end anastomosis was performed on the common carotid arteries of swines, bilaterally, using diode lasers by the wavelengths: 808 nm (n=16), 980 nm (n=16), 1470 nm (n=16) and 1908 nm (n=16) with the same parameters (CW, spot size=2mm, P≅5,1W, t=26s, E= 132,6J, I= 164,51 W/cm2, F= 4277,4 J/cm2). Following, the occurrence of bleeding was verified. When the anastomosis did not bleed a mechanical resistance test was performed. Results: In group 808 nm, there was no welding of the vessels. In group 1908 nm, carbonization of all arterial edges was observed. In groups 980 nm and 1470 nm, the anastomosis results were satisfactory. In group 980 nm, 50% of the anastomosis cases exhibited bleeding and the medium leaking point pressure was 155 ± 56,3 mmHg. In group 1470 nm, 31,3% of the anastomosis cases exhibited bleeding and the medium leaking point pressure was 179,1 ± 37,0 mmHg. There was no statistically significant difference in leaking point pressures between the groups 1470 nm and 980 nm (p=0,094). Based on the physiological blood pressure levels for group 980 nm, the bleeding risk was higher and the survival probability was lower than that of group 1470 nm (p=0,022). Conclusions: The best results for anastomosis in carotid arteries without solder were achieved with 980 nm and 1470 nm. The higher survival probability with lower bleeding risk was obtained by 1470nm anastomosis on carotid arteries.