Experimental microvascular sleeve anastomosis in size discrepancy vessels

Anastomosis in vessels of different caliber may predispose to irregularities and thrombosis. Techniques have been described to manage the discrepancy such as mechanical expansion, end to side anastomosis, oblique cut, sleeve procedure, mechanical devices, grafts, adhesives and glues. We performed sleeve anastomosis introducing the superficial inferior epigastric artery (SIEA) into the femoral artery of 20 Wistar rats. Permeability, endothelialization and anastomosis remodeling was assessed. Although slight narrowing of the anastomosis was found in 30% of cases, 100% permeability was achieved and endothelialization was completed in the second week. We conclude that the sleeve procedure is a reliable method to manage SIEA discrepancies in microvascular anastomosis.