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Microvascular Anastomosis Devices: A Scoping Review
Myiah P Quach1, Emily E Zona1, Doruk Orgun1,2
1Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States.
Journal of Reconstructive Microsurgery
|April 10, 2026
Summary
Microvascular anastomotic devices significantly reduce procedure time and maintain vessel patency compared to traditional sutures. While efficient, limitations like thrombosis risk and learning curves require further investigation.
Area of Science:
- Microsurgery
- Vascular Surgery
- Biomedical Engineering
Background:
- Hand-sewn microvascular anastomosis is complex and impacts patient outcomes.
- Prolonged ischemia time is a critical concern in microvascular procedures.
- Evaluating alternative anastomotic devices is crucial for improving surgical efficiency and results.
Purpose of the Study:
- To review and synthesize evidence on microvascular anastomotic devices.
- To compare device utility against traditional suture-only methods.
- To identify areas for innovation in anastomotic techniques.
Main Methods:
- Scoping review of PubMed, Scopus, Cochrane Library, and Web of Science.
- Included studies focused on microsurgery, anastomoses, and devices (couplers, clips, lasers, glue, stents).
- Excluded non-English studies, reviews, and robotic technology.
Main Results:
- 73 studies met inclusion criteria; couplers and clips were most common.
- Devices replacing sutures (clips, staplers, couplers) showed reduced anastomotic times with comparable or improved patency.
- Adjunctive devices like laser, stents, and glue demonstrated utility, though with noted limitations (e.g., thrombosis, inflammation).
Conclusions:
- Microvascular anastomotic devices offer improved efficiency and safety over conventional sutures.
- Limitations include vessel characteristics, thrombosis risk, inflammation, cost, and learning curves.
- High-quality trials are needed to validate findings in human and preclinical settings.
