End-to-End Microvascular Anastomosis in the Rat Carotid Artery Using Continuous Horizontal Mattress Sutures

Abstract

This paper reports a continuous horizontal mattress suture technique with advantages such as decreased time for anastomosis, minimized anastomotic leakage, eversion around the vessel edges, and other advantages which the continuous anastomosis technique has. This technique was compared with the classical interrupted and classical continuous suture techniques on a total of 59 Sprague-Dawley rat common carotid arteries: Group 1 (n = 19), interrupted suture technique; Group 2 (n = 20), standard continuous technique, and Group 3 (n = 20), continuous horizontal mattress technique. Early (30 min) and late (21 days) patency rates, anastomosis time, leakage on clamp release, oozing duration, additional sutures needed, and total number of sutures placed were statistically compared between groups. Specimens were taken at the 21st day randomly, and light microscopy (LM), scanning electron microscopy (SEM), and angiographic studies were performed. Results revealed that the continuous mattress suture technique has the advantages of providing a water-tight anastomosis with less suture materials in a shorter time, and minimal intraluminal suture material which can incite thrombosis. On the other hand, a tendency to anastomotic stricture was found to be the sole disadvantage of this technique.

Continuous versus interrupted suture technique in microvascular anastomosis in rats

“…They weighed 200-320g and were kept in a controlled environment with food and water ad libitum. The sample size was determined at the beginning of the study through specific statistical tests, based in previous studies [6][7][8][9] . The risk management standards α (5%) and β (10%) were considered, as well as the diversity of variables.…”

“…The animals were randomly assigned into two groups: interrupted suture group (ISG, n = 10), for which femoral artery were sutured with eight simple stitches (the first two knots were perform in the angles 0° and 180°, and three points on the anterior and three on posterior wall on 60°, 90° and 150° angles) [7][8][9] , and continuous suture group (CSG, n = 10), for which femoral artery were sutured with simple continuous suture (the first two knots were…”

“…The continuous suture technique can save vascular anastomosis time over interrupted technique, and it has the advantage of swiftly reperfusing the involved tissues under conditions in which time is a factor 7,8 . Since the technique exerts compression circumferentially, anastomosis is less likely to leak.…”

“…Since the technique exerts compression circumferentially, anastomosis is less likely to leak. Nevertheless, it possesses certain disadvantages, such as lumen stenosis and formation of a rigid ring at the anastomosis site, as well as difficulties in elimination of vessel size discrepancy and leaves a greater amount of suture material in contact with the bloodstream, potentially leading to stasis and thrombosis 6,8,9 .…”

“…Clamps were approached and then sutured with the suture technique according the group using 10-0 nylon. Following the suture, the clamp was removed and the anastomosis patency was immediately tested by Acland test 4,[7][8][9][10][11][12][13] . Skin synthesis was achieved through continuous suture using 5-0 nylon.…”