New end-to-end microvascular anastomosis with geometrically adaptable ends technique: an experimental study on rats

The aim of this study was to develop an effective arterial anastomosis model with a high patency rate and low operation time. We introduced a new end-to-end microvascular anastomosis with geometrically adaptable ends.

In this technique, two triangular flaps were prepared at the end of the vessels and four stitches applied on the tip of those flaps. During this study, 15 new technique anastomoses were compared to 15 conventional 8 stitches anastomoses in 30 rat femoral arteries. Operating time, patency rates and number of stitches with consequential effects on the vessel wall were analyzed statistically. The anastomotic patency of both groups was assessed by: (1) in vivo observation using the milking test under the operating microscope and (2) flow study using laser Doppler ultrasound. Healing was assessed by the light and electron microscopy.

According to statistical results and compared to the conventional method, the new technique was associated with a significant time savings (mean 18 vs 26 minutes, p < 0.001). The patency rates were equivalent to the conventional technique by observation and laser Doppler ultrasound (p > 0.05). Histological evaluation of both techniques showed that rats operated with the new technique healed faster and with less endothelial damage.

This new "Geometrically Adaptable Ends Technique" is faster, easier to perform and a reliable method with patency and flow characteristics similar to those of the conventional end-to-end anastomoses (Fig. 7, Ref. 20).