A Novel Technique to Perform Microvascular Anastomosis Revisions without Clamps (original) (raw)
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Endothelialization after arterial and venous micro-anastomosis
Plastic surgery, 1995
Knowledge of the initial time required to repair the endothelial surface of small vessels after microsurgical vascular anastomosis of veins and arteries is required to determine the preferable duration of antiplatelet prophylaxis and anticoagulation after emergency or elective microsurgery. To determine this, the femoral arteries and veins of 16 Sprague-Dawley rats were isolated, sectioned and repaired with microsurgical technique. The animals were then killed at one day intervals from the first to the 16th postoperative day. Femoral veins and arteries were harvested, sectioned and prepared for scanning electron microscopy. The results show that endothelialization of the repair line is begun by day 3 and completed by day 7 in the veins and arteries. Endothelialization of the intraluminal protruding sutures takes nine days in the veins while it is only starting at day 15 in the arteries. If this model can be extended to the human clinical situation, antiplatelet prophylaxis or anticoagulation should be administered for at least seven days. Further study is required to evaluate the thrombogenic potential of intraluminal protruding sutures.
Continuous versus interrupted suture technique in microvascular anastomosis in rats
Acta cirurgica brasileira, 2017
To compare the continuous and interrupted suture technique on femoral artery on rats after vessel repair and 14 days after. Twenty rats were operated randomly divided into two group matched according to the suture technique used: interrupted or continuous. We performed a femoral anastomosis on the right femoral artery. We analyzed weight, arterial caliber, anastomosis time and patency after vessel repair and 14 days after. There was no significant difference between groups in the weight (p=0.64), diameter of the femoral artery (p=0.95) and patency (p=1.00). The time spent in the anastomosis was 451 seconds in the continuous group and 718 seconds in the interrupted group, presenting significant difference (p<0.01). The continuous suture technique shows a similar patency rates than interrupted technique, however with a shorter time to perform the anastomosis.
Coupled suturing: A new technique for microvascular anastomosis
Microsurgery, 1991
The left carotid artery of 12 Sprague-Dawley rats was sectioned and anastomoses immediately performed utilizing a new technique termed coupled suturing. Patency and constriction were assessed immediately postoperatively and at 1,2, and 3 weeks. Specimens were also evaluated by light microscopy and scanning electron microscopy. Vessels healed well with excellent patency and edge eversion. With the development of a specialized needle, coupled suture could prove to be a reasonable alternative to current methods of anastomosis. Its main advantage is better intimal eversion, which decreases the risk of thrombosis.
Microsurgical anastomosis with the ‘PCA’ technique
Journal of Plastic, Reconstructive & Aesthetic Surgery, 2008
Background: In this study, we introduce a new microvascular anastomosis technique called 'PCA' (Posterior wall first e Continuous interrupted e Airborne). The conventional microvascular anastomosis (CI), with single interrupted stitches, requires a long time to be completed, as each suture must be tied before starting the following stitch.
Microsurgical techniques for vascular anastomoses
2018
Today, microsurgical techniques have become an integral part of the armamentarium for hand surgeons, allowing for soft tissue coverage and functional reconstruction after trauma or oncologic resections. One of the most important factors for successful finger revascularization, replantation, and free flap transfer is a well-executed anastomosis. Thrombosis, leakage and stenosis are the main complications and the only way to prevent them is continuous training and a perfect technique. In this chapter, we present the basic microsurgical techniques for vascular microanastomosis and introduce some alternatives to conventional anastomosis.
Indian Journal of Plastic Surgery
Background: The art of microvascular repair progressed slowly over a century after Carrel′s original description of ′vascular repair′ in 1902. Reports of the successful repair of vessels smaller than one mm in diameter are currently commonplace. However, the art of microvascular surgery has not yet been perfected, as evidenced by frequent reports of clinical failure. This study was undertaken to determine the effect of a ′temporary stent′ on the patency rates of vessels and to study the vascular endothelium under electron microscope to determine the changes caused by both conventional and the experimental technique. Materials and Methods: This study consisted of two distinct arms. In the first part (27 rats) we studied the effect of temporary stenting on end to end anastomosis vis a vis its patency rates. While in the second part (30 rats) the same experiment was performed with a view to examine the anastomosis under electron microscope at different time frames to study the state of...
Comparative Study of Microanastomosis with Distinct 10-0 Nylon Sutures in Rats
Acta Ortopédica Brasileira, 2016
Objective: The aim of this study is to compare micro-sutures commonly used in our midst. Methods: In this double-blind study, 30 Wistar rats were operated randomly divided into three groups matched according to the suture used (Nylon 10-0, 75micron, brands Microsuture ® , Polysuture ® and Ethicon ®). We analyzed the number of surgical nodes required, bleeding, surgical time and histological evaluation. Results: There was no significant difference between the amount of stitches of arterial suture per anastomosis. Surgical time was longer in Microsuture ® group as compared to Polysuture ® (p ≤ 0.05). Bleeding in Microsuture ® group was higher when compared to the others (p <0.01). In the histological analysis, the Microsuture ® group showed a greater tendency to develop fibrosis and aneurysm in surgical site than the others (p <0.01 and p≤0,05, respectively). Similarly, the Ethicon ® group showed less tendency to myointimal proliferation than the rest. (p = 0.025). Conclusion: The results confirm the relevance of the choice of surgical thread as an independent determining factor for the success of the procedure, besides serving as a rational subsidy for a better cost-benefit analysis. Level of Evidence I, Experimental Study, Controlled Animal Study.
Microvascular anastomosis using modified micro-stents: A pilot in vivo study
Journal of Cranio-Maxillofacial Surgery, 2015
Introduction: Microvascular sutured anastomosis remains the gold standard in microvascular flap surgery but is technically challenging, time-consuming, and sometimes unreliable. The goal of our study has been to develop a microvascular stenting system that can be used for microvascular anastomosis, even without the use of a microscope.