An alternative microsurgical method for achieving vessel union without applying sutures is presented. The basic principles of the technique involve the creation of an extraluminal cuff that permits exact adaptation of both endothelial layers, without intraluminal damage or application of foreign material. When used for microsurgical procedures, the method can be further simplified by using a Teflon cuff secured by means of a mini-clip. The anastomosis can be accomplished quickly, in an uncomplicated and precise fashion. On the basis of preliminary experiments, this method appears to offer a wide range of applications, particularly if absorbable material is used.
The nonabsorbable cuff used for nonsuture anastomosis can cause residual vessel stenosis as well as regional wall rigidity. Resulting disturbances in laminar flow promote the development of irregularities in the intimal endothelial vessel lining distal to the anastomosis. Using absorbable cuffs, the degree of stenosis can be appreciably reduced, thereby diminishing thrombogenic flow turbulence. The absorbable cuff can thus facilitate clinical application of nonsuture microsurgical vessel anastomosis.
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