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Morphological study of the healing process after diode laser-assisted end-to-end microanastomosis: comparison with conventional manual suture

A series of carotid end-to-end diode laser assisted microvascular anastomosis (LAMA) versus control ateral conventional suture microanastomosis (CMA) were performed in 120 Wistar rats (in the same animal, LAMA performed in the left side and CMA in the right). The optic and scanning electron microscopic examinations were assessed from day 0 to day 210. The results revealed that on day 0 LAMA gave rise to proteins deneturation and collagens fusion of the media and adventitia in the arterial wall. Re-endothelialization of anastomotic line began at day 3, as well as a large number of inflammatory aggregated in the adventitia. On day 10 the endothelial cells were restored on the anastomotic site and collagenous network developed in the media. On day 90 proliferation and disorientation of the elastic fibers appeared. A part of elastic laminae had been reconstructed on day 210. In the group CMA, the re- endothelialization developed later than LAMA, and the reconstruction of the elastic laminae failed to happen until day 210. These data suggest that the results of long term healing process after diode LAMA is better than that of CMA in normal artery repair.