A comparison by burst testing of three types of vascular anastomosis

Klein, Sanford L.; Chen, Helen; Israel-Graff, Jaimie

doi:10.1002/(sici)1098-2752(1998)18:1<29::aid-micr7>3.0.co;2-p

Cited by 8 publications

(5 citation statements)

References 17 publications

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“…Moreover, the infusion rate of 1 and 10 mL/min were selected for burst pressure measurements based on a range obtained from previous studies . However, in another study, a higher infusion rate up to 100 mL/min was applied .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of an elastic decellularized tendon‐derived scaffold for the vascular tissue engineering application

Ghazanfari

Alberti

et al. 2019

J Biomedical Materials Res

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Due to the limited success rate of currently available vascular replacements, tissue engineering has received tremendous attention in recent years. A main challenge in the field of regenerative medicine is creating a mechanically functional tissue with a well‐organized extracellular matrix, particularly of collagen and elastin. In this study, the native collagen scaffold derived from decellularized tendon sections, as a scaffold having the potential to be used for vascular tissue engineering applications, was studied. We showed that the elasticity of the scaffolds was improved when crosslinked with the bovine elastin. The effect of different concentrations of elastin on mechanical properties of the collagen scaffolds was evaluated of which 15% elastin concentration was selected for further analysis based on the results. Addition of 15% elastin to collagen scaffolds significantly decreased Young's modulus and the tensile stress at the maximum load and increased the tensile strain at the maximum load of the constructs as compared to those of the collagen scaffolds or control samples. Moreover, tubular elastin modified collagen scaffolds showed significantly higher burst pressure compared to the control samples. Smooth muscle cells and endothelial cells cultured on the elastin modified collagen scaffolds showed high viability (>80%) after 1, 3, and 7 days. Furthermore, the cells showed a high tendency to align with the collagen fibers within the scaffold and produced their own extracellular matrix over time. In conclusion, the results show that the decellularized tendon sections have a great potential to be used as scaffolds for vascular tissue engineering applications. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 1225–1234, 2019.

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Section: Discussionmentioning

confidence: 99%

Evaluation of an elastic decellularized tendon‐derived scaffold for the vascular tissue engineering application

Ghazanfari

Alberti

et al. 2019

J Biomedical Materials Res

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“…First, the relatively low welding strengths produced with LAVW often require additional sutures to reinforce the anastomosis, ultimately defeating the purpose of the modality. [3,[5][6][7][8]10,[12][13][14]18,20,22,24,26,28,30,32,[34][35][36]40,67,69,70] Second, extensive thermal damage may extend to the basal membrane of the intima ( Figure 1) and cause intimal hyperplasia [7,20], thrombosis [7,26], and aneurysm formation [13,15,21,34,38,71,72]. To overcome these disadvantages, several more refined welding techniques have been developed, including sLAVW, scaffold-and solder-enhanced LAVW (ssLAVW) (Figure 2), and photochemical laser-assisted tissue bonding.…”

Section: Introductionmentioning

confidence: 50%

“…A lower power output is favorable because this typically produces higher welding strengths ( Figure 5B) [5,7,18,26,35,38]. Irradiance and pulse duration are the most important parameter to define thermodynamics during welding.…”

Section: Summary Of Experimental Resultsmentioning

confidence: 99%

“…Unfortunately, several drawbacks associated with current (native) LAVW techniques [6,18,20,26,34,44,45] have hampered its transition from the experimental to the clinical setting [40,44,45]. First, the relatively low welding strengths produced with LAVW often require additional sutures to reinforce the anastomosis, ultimately defeating the purpose of the modality.…”

Section: Introductionmentioning

confidence: 99%

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Laser-assisted vessel welding: state of the art and future outlook

Pabittei

Boon

Heger

et al. 2015

JCTRes

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Laser-assisted vascular welding (LAVW) is an experimental technique being developed as an alternative to suture anastomosis. In comparison to mechanical anastomosis, LAVW is less traumatic, non-immunogenic, provides immediate water tight sealant, and possibly a faster and easier procedure for minimally invasive surgery. This review focuses on technical advances to improve welding strength and to reduce thermal damage in LAVW. In terms of welding strength, LAVW has evolved from the photothermally-induced microvascular anastomosis, requiring stay sutures to support welding strength, to sutureless anastomoses of medium-sized vessels, withstanding physiological and supraphysiological pressure. Further improvements in anastomotic strength could be achieved by the use of chromophore-containing albumin solder and the employment of (biocompatible) polymeric scaffolds. The anastomotic strength and the stability of welds achieved with such a modality, referred to as scaffold-and solder-enhanced LAVW (ssLAVW), are dependent on the intermolecular bonding of solder molecules (cohesive bonding) and the bonding between solder and tissue collagen (adhesive bonding). Presently, the challenges of ssLAVW include (1) obtaining an optimal balance between cohesive and adhesive bonding and (2) minimizing thermal damage. The modulation of thermodynamics during welding, the application of semi-solid solder, and the use of a scaffold that supports both cohesive and adhesive strength are essential to improve welding strength and to limit thermal damage.

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“…In der medizinischen Literatur finden wir eine Vielzahl an Testaufbauten zur Messung von Berstungsdrücken, mit deren Hilfe die Qualität von verschiedenen Verschluss-und Anastomosetechniken wie Nahtanastomosen [1][2][3], Plikatoren [4], Magnetverschlüssen [5,6], Klammernahtgeräten [7][8][9] und Clipligaturen [10,11] evaluiert wurden.…”

Section: Introductionunclassified

Entwicklung und Validierung eines vollautomatischen, experimentellen Set-ups zur Ex-vivo-Berstungsdruckmessung nach chirurgischem Gefäßverschluss

Wallimann

Menges

Hausen³

et al. 2017

Zentralbl Chir

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A growing number of operations are performed using minimally invasive techniques. Therefore, a lot of new requirements must be met by the staplers currently available. At the present time, the most widely used methods of minimally invasive vascular occlusion involve high-frequency energy, clips, and staplers. The most important quality parameter is burst pressure, which is measured with a variety of experimental set-ups, all of which are subject to criticism. With this study, we want to introduce a fully automated vascular burst pressure measuring system that largely mimics physiological conditions. An important feature of this set-up is the detection of very early leakage from the staple line (FAIR Leakage = First Appearance of Leakage requiring Intervention). Burst pressure was measured in vessel segments of porcine common carotid arteries. For vascular occlusion, we used the stapler device Micro Cutter XCHANGE by DexteraSurgical. Prior to closure, the vessel was filled to a pressure of 80 mmHg. The pressure was increased at a defined flow rate. Burst pressure was defined as staple line leakage requiring intervention. 30 staple lines were examined. The average burst pressure visually determined by two independent investigators was 515.8 mmHg ± 236.3 mmHg. Maximal burst pressure was 911 mmHg, and minimal burst pressure 80 mmHg. The average burst pressure detected electronically was 511.8 mmHg ± 239.1 mmHg. Statistically, there was a highly significant correlation of visually and electronically detected burst pressures. This is the first experimental set-up for a systematic burst pressure test that is fully automated and therefore eliminates any bias related to the investigator. The experimental set-up with a defined intravascular pressure prior to closure and the use of a liquid with blood-like viscosity enabled us to largely mimic intraoperative conditions. Since burst pressure is not defined as a complete rupture of the staple line, but as the moment of first occurrence of leakage requiring intervention, the results can be transferred into daily surgical practice.

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A comparison by burst testing of three types of vascular anastomosis

Cited by 8 publications

References 17 publications

Evaluation of an elastic decellularized tendon‐derived scaffold for the vascular tissue engineering application

Evaluation of an elastic decellularized tendon‐derived scaffold for the vascular tissue engineering application

Laser-assisted vessel welding: state of the art and future outlook

Entwicklung und Validierung eines vollautomatischen, experimentellen Set-ups zur Ex-vivo-Berstungsdruckmessung nach chirurgischem Gefäßverschluss

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