Laser energy effect on blood cells, vacsular endothelium and thrombosis

Gennadiy G. Khubulava, Andrey B. Sazonov, Ruslan A. Ahadov, Kirill V. Kitachov, Roman O. Nagibovich

Medical Military Academy St.Petersburg, St.Petersburg, Russia

Date, time and location: 2018.05.26 13:30, Exhibition area, 1st Floor. Zone – B

Abstract

Objective: Endovenous laser ablation (EVLA) is a popular minimally invasive alternative to classical surgical vein stripping in the treatment of saphenous vein reflux. The objective of study is evaluate the effect of high-energy laser on blood cells, vascular endothelium and thrombosis

Methods: Sterile box with goat's blood, polyvinyl chloride tubes (D - 3/8 (9.5 mm)), blood salvage system, syringes were used to access laser thermal effects. EVLA system (ALPH-01 - DIOLAN) were used on 980 nm with 20 Watt maximum energy emission. Laser ablation were made typically with 16-18 Wat power settings and constant wave mode. First blood sampling were made along with ablation procedure in place before filter. Second sampling were made from the free end of the salvage system tube. Coal-like substrate were collected and morphologically analyzed.

Results: In all cases the main signs were blood vaporization, vesiculation, microthrombi and smell of burning. Visible microthrombi grew on the syrigne wall in each case. Coal-like substrate were concentrated before salvage system filters. Hemolyzed erythrocytes were found under the microscope examination (sluge).

Conclusions: High-temperature laser ablation leads to deformation, adhesion and destruction of blood cells. In addition it starts formation of thrombi and coal-like substrate. These elements will migrate to the saphenofemoral junction and pulmonary part of circulation system which can cause embolia. In this case, combination of the Troyanov-Trendelenburg operation and EVLA will reduce postoperative complications by interrupt venous circulation at the saphenofemoral junction.