Experimental nonsuture microvascular anastomosis using a soluble PVA tube and plastic adhesive

This article describes a new nonsuture method for microvascular anastomoses that uses plastic adhesives and soluble tube stents made of polyvinyl alcohol (PVA). Three soluble tubes were studied: one tube with a monolayered wall and two bilayered tubes of different thicknesses. The layers of the bilayered tubes consisted of PVA of different degrees of solubility. As plastic adhesives, ethyl 2-cyanoacrylate, isopropyl 2-cyanoacrylate, isobutyl 2-cyanoacrylate, and methyl 2-cyanoacrylate were employed; methyl 2-cyanoacrylate was by far the least effective. Anastomoses were performed on the common carotid artery of rats, and macroscopic, angiographic, and histologic investigations were carried out at intervals ranging from seven days to six months. The patency rates were 81% for the monolayered tube, and 92% and 98% for the bilayered tubes. The principal advantage of this method is that blood flow can be reestablished through the anastomosed site immediately after release of the hemostatic clamps.