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Microvascular anastomosis using modified micro-stents: a pilot in vivo study
Florian Bauer1, Andreas M Fichter1, Denys J Loeffelbein1
1Department of Oral and Maxillofacial Surgery at the Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Summary
This study explored a novel microvascular stenting system for vessel repair, aiming to simplify microvascular anastomosis. While feasible, technical challenges like leakage and thrombosis require further refinement for clinical application.
Area of Science:
- Vascular Surgery
- Biomedical Engineering
- Surgical Innovation
Background:
- Microvascular sutured anastomosis is the current standard but presents technical challenges.
- Existing methods are complex, time-consuming, and can be unreliable.
- A microscope-free approach to microvascular anastomosis is desirable.
Purpose of the Study:
- To develop and evaluate a novel microvascular stenting system for anastomosis.
- To assess the feasibility of performing microvascular anastomosis without a microscope.
- To compare stent-based anastomosis with traditional sutured methods.
Main Methods:
- Custom-made stainless-steel stents were used in nine rats to repair severed abdominal aortic vessels.
- Vessel patency was assessed using Doppler flowmetry and indocyanine green (ICG) angiography.
- Microscopic examination was performed to detect thrombosis.
Main Results:
- Eight out of nine animals survived the procedure.
- Four stent anastomoses had an excellent fit; the remaining four required collagen membrane and fibrin glue for leakage, potentially impacting patency.
- Thrombus formation completely occluded blood flow in one case.
Conclusions:
- Microvascular stent anastomosis is a feasible technique.
- Stent-assisted anastomosis may offer advantages over sutured anastomosis in certain scenarios.
- Further technical improvements are necessary to address challenges such as leakage and thrombosis, and long-term outcomes are pending.
