Intravascular stenting (IVaS) for safe and precise supermicrosurgery.

Area of Science:

• Vascular surgery
• Microsurgery techniques
• Biomaterials in surgery

Background:

• Supermicrosurgery involving vessels <0.5 mm diameter presents challenges.
• Difficulties include forceps manipulation and inadvertent back wall catching during anastomosis.
• Existing methods struggle with precise vessel wall control in ultra-small caliber vessels.

Purpose of the Study:

• To evaluate the efficacy of intravascular stenting (IVaS) using nylon monofilaments for supermicrosurgery.
• To assess the safety and patency rates of IVaS in small vessel anastomosis.
• To demonstrate the feasibility of IVaS for vessels with diameters down to 0.15 mm.

Main Methods:

• Implantation of superficial inferior epigastric arterial (SIEA) flaps in 10 rats.
• Performance of supermicroanastomosis (0.15 mm diameter) using SIEA flaps in mice.
• Application of intravascular stenting (IVaS) with selectable nylon monofilaments.

Main Results:

• The IVaS method prevented inadvertent back wall catching in all cases.
• Immediate vascular patency rate achieved was 100%.
• Successful anastomosis of vessels with a minimum diameter of 0.15 mm was demonstrated.

Conclusions:

• Intravascular stenting (IVaS) with nylon monofilaments is a safe and effective technique for supermicrosurgery.
• IVaS facilitates precise and secure anastomosis of ultra-small vessels, overcoming previous limitations.
• This method offers versatility through selectable nylon sizes, enabling precise repair even in the smallest vessels.