Microvascular anastomosis with clips

A modified version of Payr's method for rapid vascular anastomosis was evaluated for high flow jugulo carotid anastomosis in rat. The end to end anastomosis is performed by mounting the artery on a cylinder by passing it through the lumen and cuffing the end back over the tube. The cylinder with the artery graft mounted on it is then telescoped into the vein and secured with an external circular clip. To allow easy introduction of the cylinder with the artery on it, into the vein, we used cylinderswith external diameter corresponding to the diameter of the carotid artery. The results suggest that the technique is simple and easy to execute requiring a short clamping time to complete the anastomosis using a prepared artery graft. Although the grafts remained patent, the histopathology studies done within one hour showed inflammation, platelet deposition and disruption of the venous endothelium. The arterial side of the anastomosis showed intact endothelium. The junctional area however, showed onlyminimal changes. Chronic specimens showed complete endothelisation over the junctional area. This nonsuture technique provides a rapid and a relatively atraumatic method of performing an anastomosis.