Importance of vessel tension in end-to-end and end-in-end anastomoses

Arterial end-in-end and end-to-end microanastomoses were done experimentally under natural tension and without tension. Intraluminal plastic casts were made at different postoperative time intervals, and the resulting stenosis at the site of anastomosis compared by lumen area measurements. Both anastomotic techniques revealed marked stenosis at the first hour postoperative, even when there was no tension applied to the vessels. The end-in-end technique (EIE) showed a luminal area decrease with increasing longitudinal tension. The end-to-end (ETE) did not, however, show any significant difference in stenosis, either in the nontension or the normal tension groups. No occluded anastomosis was found in either the EIE or ETE technique groups. This was remarkable, because it is during the first postoperative hour that residual luminal areas were as low as 23 percent in the successful EIE anastomoses.