Comparison of Experimental Microvascular End-to-End Anastomosis via VCS^®-Clips versus Conventional Suture Technique in an Animal Model

Abstract

In this experimental study on 96 CD rats, microvascular end-to-end anastomoses created via suture or alternatively by means of a VCS-Clip-Application-System, were compared. The aorta abdominalis of the animals, with a diameter of 1.5 +/- 0.2 mm, was experimentally dissected, and the free ends of the vessel then anastomosed. The results were evaluated using sonography, microangiography, histologic examination, and vascular imprints. Postoperative examination was carried out after 1, 3, 7, 14, or 30 days. Major advantages of the VCS-Clip technique over suturing were that it was easy to learn, significantly faster to perform (execution of anastomosis 10.9 +/- 2.6 min versus 19.4 +/- 5.0 min), and produced significantly more favorable histologic results in terms of less inflammatory response, foreign body reaction, necrosis of the tunica media, hyperplasia of the intima, and thrombosis of the vessel lumen. The main disadvantage of the clip technique was a significantly higher rate of stenoses (15.8 +/- 6.0 versus 4.1 +/- 6.6 percent).

An Attempt to Keep Flaps Alive with Artificial Perfusion in Rabbits

“…The ratio of vascular thrombosis reported in free flap surgery varies between 5.1% and 9.9% (11-13), and for the prevention of this complication, in addition to the suggestions of agents such as botulinum toxins, low molecular weight heparins, aspirin, prostaglandins, dextran inhibitors, and other various agents (14)(15)(16)(17)(18)(19)(20)(21)(22), studies on anastomosis have also been carried out (23)(24)(25)(26)(27)(28)(29).…”

Bioabsorbable device for small‐caliber vessel anastomosis

“…[1][2][3] However, no devices have been developed for anastomosis of small-caliber vessels (<2-mm diameter). 4,5 For example, although polyethylene ring device with steel pins for fixation (Unilink system; Synovis, St Paul, MN) are commercially available, 13,14 their application to 1-mm diameter grafts resulted in occlusion in 17% of implanted animals. 15 The variant of this device with the combination of bioabsorbable ring and steel pins was developed; although there are no reports about its application to small vessels.…”

“…Each sample was soaked in a test tube with 50 ml phosphate buffer solution (pH 7.4) and maintained in an incubator at 378C. After 0, 2,4,5,6,7,8,12, and 24 weeks of incubation, the respective samples (n 5 5 for each incubation period) were retrieved and subjected to a mechanical test using a testing machine (AGS-J; Simadzu, Kyoto, Japan) at a crosshead speed of 50 mm min 21 . The tensile strengths of the samples were determined from the measured maximum loads.…”

“…Although several anastomotic devices have been developed to date and applied clinically, most of them have been designed for large-caliber vessels (>2-mm diameter), [1][2][3] and there are no available devices for anastomosis of small-caliber vessels. 4,5 Because small-vessel anastomosis is a laborious task, the development of such devices has considerable importance. 6,7 Several anastomotic devices based on different techniques have been proposed.…”

Technology‐assisted and sutureless microvascular anastomoses: Evidence for current techniques

“…[40][41][42][43][44] It has been shown to be effective in 50 of its use in reconstructive microsurgery. It has, however, been compared favorably to other mechanical anastomotic aides in a small series.…”