| Objective: The study established an experiment model of carotid artery end-to-end anastomoses in rabbits, it used a novel biodegradable photosensitive medical adhesive poly(glycerol sebacate acrylate)(PGSA) combined with thermosensitive materials poloxamer407 to anastomose vascular,and the way based on the three needle stitching method(methods H-P). Through animal experiments a comparative traditional hand-sewn method was performed to explore and explain whether or not the method of H-P is efficient and superior in vascular anastomosis than conventional suturing anastomosis technique.Methods: The PGS prepolymer was synthesized by polycondensation of equimolar glycerol and sebacic acid, then the PGS prepolymer reacted with acryloyl chloride to obtain the biodegradable photosensitive medical adhesive PGSA. P407 formula with Specific thermal properties for vascular anastomosis was prepared to open vessel lumen and prevent the photosensitive glue seeping into the vascular. 20 healthy adult rabbits of either gender were randomly devided into two group: with 10 rabbits in each group and named group A and group B. The right carotid artery was choosed as anastomoses vascular(caliber 2.0~3.0mm, average 2.4mm) and the methods of anastomosis is end-to-end. Group A used methods H-P and the group B used traditional suturing anastomosis technique. During the experiment, the time taken for vascular anastomosis was noted for all rabbits. Six weeks later, a part of rabbits were killed to to make specimens and slice. Methods HE staining was used to figure out the situation of tissue inflammatory reaction and necrosis, scars formation. The imaging examination of ultrasonic doppler, CTA were used to detect the patency of vessels and the size of blood vessel diameter.Specimens are taken from the rest of rabbits to obtain scanning electronic microscope inspection results. The results deal with statistics.Results:1. In this study we have synthesized PGSA with biocompatibility and reliable cohesiveness. At the same time, we have prepared P407 formula with specific thermal properties. The study successfully anastomosed rabbits carotid artery in experiment model by the method of H-P.2. We have noted the time taken for vascular anastomosis for all rabbits. The time requied to anastomose vascular by methods H-E was(12±3.7)min. The time needed for conventional suturing was(27±6.3)min. Results obvious differenceces exist in the two ways(p<0.01).3. Ultrasonic Doppler and CTA suggest the patency rate of vascular after 6 weeks of sugery: H-P group was 100% has the same pantency with hand-swen group. At postoperative week 6, the anastomotic stoma size were measured(n=5)(H-P group: 2.246 ± 0.165 mm, 2.114 ± 0.117 mm, P>0.05), differences among two groups were not significant, there were no difference between tow groups of the anastomotic stoma size.At the same time we compared contralateral side and the side of anastomosis anastomotic stoma size(contralateral side: 2.369 ± 0.157 mm, the side of anastomosis: 2.180 ± 0.151)(P<0.05), differences among two groups were significant. The scanning electron microscopic image of two group all showed obvious persistence intimal injury on persistence the intima, but the H-P group was repaired better than hand-swen group. The former could hardly see scars repair and vascular wall defect, fibrosis.4. Histologic changes: observe the repair endothelial cells of blood vessels, by contrasting the H-P group and hand-swen group, The results suggest that the H-P group endothelium regeneration early, less tissue toxicity, less inflammatory cell infiltration, more intact intima.Conclusion: The method of H-P is feasible for vascular anastomosis and the biological glue PGSA have little tissue toxicity to vessel wall, no significant influence in vascular patency rate. The method of H-P takes less surgery time, more efficiency and superior in vascular anastomosis than conventional suturing anastomosis technique and it have the potential to be a novel vascular ananstomosis in clinic. |
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