{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:12:40Z","timestamp":1789625560507,"version":"build-2803163510"},"reference-count":0,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fetal Diagn Ther"],"published-print":{"date-parts":[[2017]]},"abstract":"<b><i>Objective:<\/i><\/b> To assess the impact of laser power and firing angle on coagulation efficiency for closing placental anastomoses in the treatment of twin-twin transfusion syndrome. <b><i>Methods:<\/i><\/b> We used an ex vivo blood-perfused human placenta model to compare time to complete coagulation using 30 vs. 50 W of neodymium-doped yttrium aluminum garnet laser power and using a firing angle of 90\u00b0 vs. 45\u00b0. Placentas were perfused with pig blood at 5 mL\/min. Differences were analyzed using independent-samples <i>t<\/i> test, Mann-Whitney U test, or &#x03C7;<sup>2<\/sup> test as appropriate. <b><i>Results:<\/i><\/b> Coagulation took less time and energy using 50 W (<i>n<\/i> = 53) compared to 30 W (<i>n<\/i> = 52), 11 vs. 22 s (<i>p<\/i> < 0.001), and 557 vs. 659 J (<i>p<\/i> = 0.007). Perpendicular coagulation (<i>n<\/i> = 53) took less time and energy compared to a 45\u00b0 angle (<i>n<\/i> = 21), 11 vs. 17 s (<i>p<\/i> = 0.004), and 557 vs. 871 J (<i>p<\/i> = 0.004). Bleeding complicated 2 (3%) measurements in the 50-W group, 5 (10%) in the 30-W group, and 3 (14%) in the 45\u00b0 group. <b><i>Discussion:<\/i><\/b> In a highly controlled model, a 50-W laser power setting was more energy efficient than 30 W in coagulating a placental vein. A more perpendicular laser firing angle resulted in more efficient coagulation. Furthermore, bleeding due to vessel wall disruption occurred more often with lower power and a more tangential approach.<\/jats:p>","DOI":"10.1159\/000464323","type":"journal-article","created":{"date-parts":[[2017,3,28]],"date-time":"2017-03-28T21:02:32Z","timestamp":1490734952000},"page":"204-209","source":"Crossref","is-referenced-by-count":4,"title":["Impact of Laser Power and Firing Angle on Coagulation Efficiency in Laser Treatment for Twin-Twin Transfusion Syndrome: An ex vivo Placenta Study"],"prefix":"10.1159","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2274-8357","authenticated-orcid":false,"given":"Joost","family":"Akkermans","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loes","family":"van der Donk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne H.P.","family":"Peeters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sjoerd","family":"van Tuijl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna M.","family":"Middeldorp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Lopriore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dick","family":"Oepkes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2017,3,29]]},"container-title":["Fetal Diagnosis and Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/464323","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/464323","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/464323","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T17:33:10Z","timestamp":1745429590000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000464323"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2017,10,17]]},"published-print":{"date-parts":[[2017,10,19]]}},"URL":"https:\/\/doi.org\/10.1159\/000464323","archive":["Portico"],"relation":{},"ISSN":["1015-3837","1421-9964"],"issn-type":[{"value":"1015-3837","type":"print"},{"value":"1421-9964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017]]}}}