Efficacy of direct repair to partial arterial lacerations

These are differences of opinion as to the best method of reconstituting flow following partial laceration of a small artery. This study was undertaken to determine how narrowing of a small vessel by direct repair affects patency rates. Partial arterial lacerations of varying widths were made in both femoral arteries of 30 Sprague-Dawley rats. The vessels were randomized to groups of longitudinal and transverse partial lacerations. Flow was reestablished in experimental vessels with direct repair (with reduction of vessel cross-sectional area ranging from 22% to 62%). In control vessels, resection and end-to-end repair or resection with vein grafting was performed. Two weeks postoperatively all vessels were explored to confirm patency and calculate flow. Immediately after repair all vessels were patent. At 2 weeks all direct and end-to-end repairs remained patent, while two of seven vein grafts had thrombosed. Immediately following repair there were no significant hemodynamic differences between repair groups. The final flow rate measured distal to the repair site averaged 2.5 mm2KHz for vessels with resection and either end-to-end repair or vein grafting (control group) versus 2 mm2KHz for vessels with direct repair of the laceration (experimental group); however, comparisons for specific groups showed no significant velocity or flow differences between control and experimental vessels. Direct repair of a partial arterial laceration with up to 62% narrowing of cross-sectional area gives patency rates equal to or better than those of alternate methods; however, blood flow rates may be altered distal to such a repair site.