Optimal dye concentration and power density for laser assisted vascular anastomosis (LAVA)

Laser tissue welding with albumin solder/indocyanine green (ICG) dye is an effective technique in surgical reconstruction. This study was carried out in vitro to find optimal ICG concentration and power density (PD) in laser assisted vascular anastomosis (LAVA). Fresh porcine carotid arteries incised into vascular strips (n = 120) were welded by diode laser in end-to-end with 50% albumin solder of 0.01, 0.1, and 1.0 mM ICG and at power density of 27.7, 56.7, and 76.9 W/cm². Direct temperature was measured by inserting thermocouples outside and inside vessel. Tensile strength was tested immediately and histological study was performed. Temperature (both outside and inside vessel) significantly gradually decreased (p < 0.01) with the increasing of ICG concentration at PD 56.7 W/cm². Tensile strength significantly gradually decreased (p < 0.01) with increasing of ICG concentration at PD 56.7 W/cm². Histological study showed minimal thermal injury limited to adventitia of vessels and no appreciable difference in all groups. We find that ICG concentration within solder is most important factor affecting both tissue temperature and tensile strength during laser vessel welding. The optimal balance between stronger strength and minimal thermal injury of vessel may be achieved primarily by using PD 56.7 W/cm ² at 0.01 mM ICG within solder during LAVA.