Evaluation of Different Microsurgical Techniques for Arterial Anastomosis of Vessels of Diameter Less Than One Millimeter

ABSTRACT

The purpose of this study was to compare four different methods of microsurgical arterial anastomosis. One hundred and sixty rabbit popliteal artery anastomoses were performed. The following techniques were employed in each of four equal groups. Group I: end-to-end technique with asymmetrical sleeving of the adventitia; Group 2: end-to-end technique with symmetrical sleeving of the adventitia and wrapping of the suture site with a collagen cuff; Group 3: end-to-end technique with symmetrical trimming of the adventitia; Group 4: end-in-end (sleeve) technique. A fifth group served as the control and omitted the division and anastomosis of the vessel.

At one hour, 24 hr, three days, seven days, two weeks, six weeks, three months, and six months, the anastomosis was re-examined, and arterial segments were excised and prepared for evaluation. Long-term patency rates for the above techniques were found within the range of 87.5 to 92.5 percent. The healing process of anastomosed arteries occurred within three to seven days. A different pattern of arterial wall healing was found in the end-in-end, compared to the end-to-end, techniques.

The study showed that the end-in-end technique is comparable in long-term patency rates to the conventional end-to-end technique, with significant reduction of the time needed to perform the anastomosis.