[Effect of commonly practiced manoeuvres in vascular microsurgery. Study under the scanning electron microscope...

The authors studied in 100 Wistar rats the manoeuvres that may commonly be carried out during vascular microanastomosis of diameter less than 3 mm (aorta and posterior vena cava): clamping for 30 to 45 minutes, bipolar electrocoagulation of the collateral arteries, more or less marked pinching of the vascular wall. The risk of thrombosis seems all the greater when: --the surgeon is inexperienced: viz. trauma with the forceps, parietal tears at the level of the stitches, two many threads passed for hemostasis (all these factors accentuate the fibrinoid and platelet deposits); --bipolar electrocoagulation of a collateral artery applied too close to the vessel to be anastomosed (less than 1 mm.)The formation of a smooth and regular fibrinous pseudo-intima appears within 48 to 72 hours which may explain the elective onset of thromboses before this delay.