Increasing vessel diameter with the open Y technique for diameter discrepancy.

Area of Science:

• Plastic Surgery
• Microsurgery
• Vascular Surgery

Background:

• Free tissue transfers are standard in plastic surgery.
• Vessel size discrepancy is a common challenge in microsurgery, impacting anastomosis patency.
• Improving microvascular anastomosis techniques is crucial for surgical outcomes.

Purpose of the Study:

• To devise and evaluate a novel technique for improving microvascular anastomosis in cases of vessel diameter discrepancy.
• To assess the patency rates and efficacy of the Y-technique in a rat model and cadaveric specimens.

Main Methods:

• A Y-shaped vessel modification technique was performed on the external jugular vein in Wistar rats.
• An end-to-end anastomosis was created between the modified vein and the carotid artery, forming an arteriovenous shunt.
• Patency was assessed in rats after 2 weeks; sheep cadaveric arterial specimens were also used to evaluate the technique's applicability.

Main Results:

• The Y-technique successfully increased the diameter of the manipulated vein, reducing size discrepancy.
• A high patency rate of 94.1% was achieved in the microvascular anastomosis.
• Evaluation of fresh sheep cadaveric specimens demonstrated a significant improvement in vessel diameter matching.

Conclusions:

• The devised Y-technique is an effective method for overcoming vessel size discrepancy in microvascular anastomosis.
• This technique significantly improves anastomosis patency, offering a valuable solution for challenging free tissue transfers.
• The findings suggest this method has broad applicability in reconstructive microsurgery.