Prevention of Vascular Anastomotic Stenosis With 2-Octylcyanoacrylate

Abstract

Although conventional microvascular anastomoses are well-studied, postoperative anastomotic stenoses remain a common surgical complication. The use of 2-octylcyanoacrylate to stabilize vascular anastomoses using a rabbit anastomosis model was investigated. A carotid artery anastomosis model was established in 20 New Zealand rabbits (2.5-3.0 kg): 10 underwent conventional anastomosis surgery with sutures only, while 10 underwent suture ligation, followed by the application of 2-octylcyanoacrylate. Vascular patency and pulse strength were observed after adhesive solidification. The artery diameter was measured preoperatively and at 5 minutes, 2 weeks, and 4 weeks postoperatively. An angiography was performed at 4 weeks postoperatively. Hyperplasia and the induced nitric oxide synthase (iNOS) content of the intima and media layers from the anastomotic stoma were assessed using immunohistochemistry. The artery inner diameter of experimental group decreased at each time point postoperatively (1.686 ± 0.066 cm; 1.656 ± 0.069 cm; 1.646 ± 0.074 cm) (P ≤ 0.01). At 4 weeks postoperatively, the intima and the media around the anastomosis was both significantly thinner in the experimental group (13.21 ± 0.84 μm; 234.86 ± 13.84 μm) than in the control group (17.06 ± 0.96 μm; 279.88 ± 34.22 μm) (P < 0.05). At 4 weeks postsurgery, intravascular iNOS expression was increased in both groups but was higher in the experimental group (82.5% versus 47.5%). The above results indicated that 2-octylcyanoacrylate adhesive can inhibit stenosis of vascular anastomoses.

Biodegradation and Immunological Parameters of Polyurethane‐Based Tissue Adhesive in Arterial Microvascular Anastomoses—A Long‐Term In Vivo Study

“…Because of the limitations of suture techniques when dealing with small vessels, numerous attempts have been made to find alternatives to the application of various tissue adhesives in order to optimize microsurgical anastomosis. [1,[5][6][7]10,13,17,18,23] Among tissue adhesives, fibrin glue has been used most for microvascular anastomoses. [6] As described above, fibrin glue was originally developed as a local hemostatic agent, [9] which was also the case for the tissue adhesive VIVO used in this study.…”

“…[ 30 ] Cyanoacrylates have been used in many areas, such as, skin, bone, and cartilage transplantation, as well as, for the occlusion of esophageal varices. [ 5 ] Nevertheless, the histotoxicity of cyanoacrylates on vessel walls in microsurgical anastomoses has been a subject of lively debate. [ 1,5,7,31 ] Chang et al.…”

“…[2] To overcome these disadvantages, various adhesive-based methods for end-to-end coadaptation of microvessels have been proposed to optimize anastomosis. [1,[3][4][5][6][7][8] Two groups of adhesives have mainly been used for microvascular anastomosis. The first type, fibrin-thrombin adhesive, was originally developed as a local haemostyptic and has been used in microsurgical anastomoses since 1977.…”

“…[ 2 ] To overcome these disadvantages, various adhesive‐based methods for end‐to‐end coadaptation of microvessels have been proposed to optimize anastomosis. [ 1,3–8 ]…”

Evaluation of the long‐term results of vascular anastomosis using polyurethane adhesive and shape‐memory stent in the rat carotid artery model

“…Reported patency of anastomoses with protein-based adhesives of only 10% after an observation period of 14 days (Ritschl et al, 2017) represent clear limitations of the use of these adhesives. Contrary to protein-based adhesives, which poses a high risk of penetrating the vascular lumen, cyanoacrylates have been shown to avoid penetration and embolization in the area of anastomosis (Aizawa et al, 2018;Liang et al, 2019). The use of VIVO also showed no differences in vessel blood flow and 100% patency during One aspect that prevents adhesive penetration and vessel collapse during polymerization is the use of intraluminal devices (Aizawa et al, 2018;Davis et al, 2016;Heitzer, Mohlhenrich, et al, 2021;Qassemyar & Michel, 2015;Saegusa et al, 2017).…”