Microvascular anastomosis using fibrin glue and venous cuff in rat carotid artery

Abstract

Conventional anastomosis with interrupted sutures can be time-consuming, can cause vessel narrowing, and can lead to thrombosis at the site of repair. The amount of suture material inside the lumen can impair the endothelium of the vessel, triggering thrombosis. In microsurgery, fibrin sealants have the potential beneficial effects of reducing anastomosis time and promoting accurate haemostasis at the anastomotic site. However, there has been a general reluctance to use fibrin glue for microvascular anastomoses because the fibrin polymer is highly thrombogenic and may not provide adequate strength. To overcome these problems, a novel technique was defined for microvascular anastomosis with fibrin glue and a venous cuff. Sixty-four rats in two groups are included in the study. In the experimental group (n = 32), end-to-end arterial anastomosis was performed with two stay sutures, fibrin glue, and a venous cuff. In the control group (n = 32), conventional end-to-end arterial anastomosis was performed. Fibrin glue assisted anastomosis with a venous cuff took less time, caused less bleeding at the anastomotic site, and achieved a patency rate comparable to that provided by the conventional technique. Fibrin sealant assisted microvascular anastomosis with venous cuff is a rapid, easy, and reliable technique compared to the end-to-end arterial anastomosis.

Comparison of a coupling system and the suture method in end‐to‐side microvascular anastomosis in head and neck reconstruction

“…Various methods have been introduced for microvascular anastomosis other than conventional suture. Coupling devices are widely used, and stapling devices (Cope et al, 2000; Yamamoto, Nakai, et al, 1999), laser‐assisted vascular microanastomoses (Leclere et al, 2011; Nakadate et al, 2017), methods using adhesive (Heitzer et al, 2021; Sacak et al, 2015), and methods using a stent (Bauer et al, 2015; Bossut & Barbier, 2011) have been introduced. Except for the coupling device, these methods have not been used widely clinically, and they have not been introduced in ETS anastomosis.…”

Evaluation of BioGlue surgical adhesive for the performance of microsurgical arterial anastomoses: impact on the flow of vessels greater than 1 mm (rat aorta) and less than 1 mm (rat femoral)

“…On the other hand, they may not provide sufficient sealing force at the suture site. There are authors who use fibrin together with vein patches to ensure the success of the intervention [18].…”

Reduction of Anastomotic Time Through the Use of Cyanoacrylate in Microvascular Procedures

“…Fibrin adhesive has been shown to have good histocompatibility, haemostasis, and adhesive properties; furthermore, several studies have reported that its use could reduce the foreign body reactions by reducing the total number of sutures, shorten the operation time, and improve the vascular patency rate. 12,13,18 However, fibrin adhesives are relatively expensive and more difficult to prepare, do not provide adequate strength and can potentially transmit blood-borne disease. 10,13,19 Chemical synthetic adhesives such as cyanoacrylates have been widely used in various fields and have gained popularity over the past years.…”