Experimental Study Of Vascular Anastomosis With Titanium Microclips

Microvascular anastomosis is crucial to free tissue transfer and replantation. The conventional microvascular anastomosis method is suturing, also being named "gold standard" microvascular anastomosis method. However, the suturing anastomosis has some defects. For example, the procedure is technically difficult and time-consumed; it leads to serious damage to vessel wall, especially to the intima; suture material exposes into the vessel lumen, which would cause thrombocyte gathering and thrombogenesis. We attempt to seek an ideal microvascular anastomosis method. To evaluate the feasiblity and superiority of the vascular anastomosis with microclips, Titanium microclips developed by ourselves are used to anastomose carotid arteries of rabbits, and the results are compared with the conventional suturing anastomosis technique.Methods A comparative experimental study was performed in rabbits. One side of carotid artery was end-end anastomosed with anastomosis microclips, the other side was end-end anastomosed with suturing. TA (time for anastomosis) and patency rate were statisticated. The biodynamic changes of the anastomoses in rabbits were measured by biodynamic method at the 1st hour, 1st week, 2nd week, and 1st month after operation. By using Ultrasonic Doppler technique, the hemodynamic indexes of Vm (mean blood velocity) and RI (resistance index) of anastomosed vessels were measured at the 1-day, 7-day, 14-day and 30-day after operation. The vessel speciments were harvested at the same time and were analyzed by light microscopy andscanning electron microscopy. All the experimental data were statisticated.Results ①TA of the microvascular anastomosis with microclips is (9±2.4)min, is less than that with suturing, which is (16±2.7)min. ②There were no significant differences of patency rate between the two methods at the 24-hour and the 7-day after operation. ③AMSBF(the average maximal stretch breaking force) with microclips is stronger than that with suturing within 7 days after operation, but differences of AMSBF between the two methods are not significant after the 14-day postoperative. There were no significant differences of AMBP (the average maximal breaking pressure)between the two methods. ④The hemodynamic consequences with microclips are better than that with suturing. ⑤The histological results indicate that the vessel wall healing of the anastomosis with microclips is better than that with suturing. The endothelial cells regenerate earlier, and the intima is smoother. Conclusion The microvascular anastomosis technique with microclips was proved to be rapid and easy. It is also safe and reliable. This kind of microvascular anastomosis technique is feasible.