Experimental Studies in Nonsuture End-to-side Microvascular Anastomosis

概要

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A fast, easy anastomotic technique with a high patency rate would facilitate the development of microvascular surgery. This article describes a new nonsuture method of end-to-side microvascular anastomosis using a soluble polyvinyl alcohol (PVA) T -shaped tube as an internal stent and plastic adhesive. Two kinds of T -shaped tubes were used: Type I tube had a short straight tube connected to a long straight tube at the midpoint and the Type II tube was a long bent tube with a short straight tube connected to it. The walls of each tube consisted of three concentric layers made of two PVA's with different solubilities. Seventy end-to-side anastomoses were performed using both common carotid arteries of rats. These consisted of three groups, I, IIA, and IIB. I and II were the types of T -tubes employed, and A had less plastic adhesive than B. Evaluations were performed 2 weeks and 3 months after surgery. The anastomotic technique was easily accomplished, taking approximately 8 minutes to complete. On the first evaluation the patency rates were more than 90% in all groups, but anastomotic aneurysms developed in I (7%) and IIA(19%). No aneurysms were observed in IIB where the anastomotic sites were reinforced by adding plastic adhesive after the blood flow was reestablished. Moreover, a high patency rate (95%) was maintained even at the second evaluation in IIB.
日本脳神経外科学会の論文
1981-07-15