["One-knot" microvascular anastomosis using glutide as an external splint--experimental arterio-arterial anastomosis...

Experimental microvascular anastomosis using a glutide copolymer (lactide: glycolide = 80: 20) as an external splint was undertaken in rats between the left and the right carotid arteries. Both arteries were dissected free over a 1-cm length, the left carotid artery was transected at the cranial end, and the right carotid artery was cut at the caudal end. The left carotid artery was then introduced into a glutide pipe-splint. The arterial wall was turned back 180 degrees over the edge of the splint. The reflected part of the artery and the glutide were covered with the freed-up right carotid artery. One stitch was made around the two arteries and the glutide in a manner similar to that of binding a barrel with steel wire. The "One-knot anastomosis" was then complete. We call this type of anastomosis "antegrade anastomosis". If, on the other hand, the right carotid artery is introduced into the pipe, turned back at the edge of the glutide, covered with the left carotid artery and secured with one stitch, the technique is known as "retrograde anastomosis". The patency rates of the resulting vessels were as follows: antegrade anastomosis, 83% (15/18); and retrograde anastomosis, 92% (23/25); so that the average patency rate was 88% (38/43). We measured the anastomosing time that is the time between the transection of one of the two arteries and the completion of the anastomosis. The average anastomosing time was 21 minutes for antegrade anastomosis and 14 minutes for retrograde anastomosis. But the 'pure anastomosing time' (the time taken to connect the two already prepared arteries) was 2-3 minutes. We believe that one-knot anastomosis technique for future clinical application is promising.