Scanning electron microscope study of experimental microvascular anastomoses in the rabbit

Nightingale, Gemma; Fogdestam, Ingemar; O’Brien, Bernard McC.

doi:10.1016/0007-1226(80)90028-4

Cited by 56 publications

(18 citation statements)

References 8 publications

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“…Third a chronic stage (weeks to months) is reached, a stage of quiescence, where the SMC synthesize and secrete a complex extracellular matrix and a complete re-endothelialization occurs, as noted in our series after 28 days [17][18][19]. Already in 1971 the first report appeared citing intimal hyperplasia as a cause of late occlusion.…”

Section: Discussionmentioning

confidence: 83%

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Stapled versus Hand-Sewn Vascular Anastomoses

et al. 2000

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Objective: Narrowing of vascular anastomoses is a frequently encountered surgical problem, with intimal hyperplasia being one of its most important causes. The aim of the present study was to compare in a rabbit model ‘manual’ (hand-sewn) with ‘stapled’ anastomoses (using a staple device) with respect to occurrence and severity of intimal hyperplasia. Materials and Methods: Twenty-four male rabbits (mean weight 2,849 g) were randomly allocated to one of two groups (n = 12). An end-to-end anastomosis of the left femoral artery was performed in all animals under general anesthesia. The anastomosis was hand sewn in group 1, while a vascular closure stapler (VCS) was used in group 2. Both anastomotic time and total operation time were recorded. After 28 days, the rabbits were sacrificed. The femoral artery of operated and nonoperated sides were removed and prepared for anatomopathological examination. The I/M ratio (= difference between tunica intima and tunica media) was determined on hematoxylin-eosin stained slides. All results were analyzed using Student’s t test. Results: Mean anastomotic times were 25 ± 7 min for the ‘manual’ group and 17 ± 9 min for the ‘stapled’ group (p = 0.02). There was no significant difference in the total operation time (55 ± 15 vs. 41 ± 18 min, p = 0.057). All animals survived the anastomosis procedure. In the group of ‘manual’ anastomosis, morbidity was significantly higher. At the moment of sacrifice, all anastomoses were patent. There was no difference in the I/M ratio between the groups. Conclusions: The use of VCS is a promising alternative to hand-sewn anastomoses. It takes less time to perform a stapled anastomosis, the technique has a shorter learning period and morbidity seems to be lower when vascular anastomoses are applied with the VCS in this rabbit model.

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Section: Discussionmentioning

confidence: 83%

“…Moreover, certain pharmacological substances have proven to be effective in one animal model but not in another [1,3,4,7,8,11,12,19].…”

Section: Discussionmentioning

confidence: 99%

Stapled versus Hand-Sewn Vascular Anastomoses

et al. 2000

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“…1,2,[10][11][12][13] They are also found in conditions in which tissue is undergoing contraction, for instance in the hand in Dupuytren's contracture, 14 and in a wide range of other pathological conditions associated with fibrogenesis and organ remodeling. 3,[15][16][17] A number of investigators have published descriptions of the histological [18][19][20][21][22][23][24][25] and scanning electron microscopic 24,[26][27][28] features of the healing process in microvascular anastomoses. One of the interesting features associated with this process is the development of intimal hyperplasia ( Fig.…”

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confidence: 99%

An ultrastructural study of the intimal hyperplasia in healing microarterial anastomoses

et al. 1998

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The purpose of the study was to investigate the ultrastructure of intimal hyperplastic cells. End-to-end microarterial anastomoses were studied in a rabbit free-tissue-transfer model. There were five experimental groups, with 1, 3, 7, 14, or 28 days follow-up. At sacrifice the anastomoses were tested for patency and then examined by light and electron microscopy. At days 1 and 3 the repaired intima was covered with macrophages and extravasated erythrocytes. At day 7 spindle-shaped fibroblasts with copious rough endoplasmic reticulum were seen. Some of these cells also contained pinocytotic vesicles, filaments with focal densities, and subplasmalemmal attachment sites, the features of smooth muscle cells. At day 14, more cells contained smooth muscle features and these features were also more pronounced. These young myofibroblasts were plumper than adjacent fibroblasts. At day 28 mature myofibroblasts with a full complement of organelles were present. The results, therefore, supported the hypothesis that myofibroblasts are present in the intimal hyperplasia of healing microarterial anastomoses.

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“…Therefore, to decrease the risk of thrombosis at the site of anastomosis, antiplatelet agents or anticoagulation has been advised by some for a duration varying from five days to two weeks. The endpoint of therapy is the time for reendothelialization of the blood vessel which has been noted to vary from seven days to four weeks by different authors (1)(2)(3)(4)(5)(6). Since complications from antiplatelet and anticoagulation therapy exist in terms of bleeding, hematoma, allergic reaction, and that the associated cost of those therapies can be significant, it is important to find out more precisely how long the duration of endothelialization is in small veins and arteries in order to determine better when to stop the prophylactic therapy safely.…”

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confidence: 99%

Endothelialization after arterial and venous micro-anastomosis

Harris¹,

Chase²

1995

CAN J PLAST SURG

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Knowledge of the initial time required to repair the endothelial surface of small vessels after microsurgical vascular anastomosis of veins and arteries is required to determine the preferable duration of antiplatelet prophylaxis and anticoagulation after emergency or elective microsurgery. To determine this, the femoral arteries and veins of 16 SpragueDawley rats were isolated, sectioned and repaired with microsurgical technique. The animals were then killed at one day intervals from the first to the 16th postoperative day. Femoral veins and arteries were harvested, sectioned and prepared for scanning electron microscopy. The results show that endothelialization of the repair line is begun by day 3 and completed by day 7 in the veins and arteries. Endothelialization of the intraluminal protruding sutures takes nine days in the veins while it is only starting at day 15 in the arteries. If this model can be extended to the human clinical situation, antiplatelet prophylaxis or anticoagulation should be administered for at least seven days. Further study is required to evaluate the thrombogenic potential of intraluminal protruding sutures. Key words: Anti-platelet therapy, Endothelial trauma, Endothelialization, Microsurgery, Prophylactic anticoagulation, Vascular anastomosisEndothélialisation après micro-anastomose artérielle et veineuse RÉSUMÉ : La connaissance du temps initial nécessaire pour réparer la surface endothéliale des petits vaisseaux après une anastomose vasculaire microchirurgicale de la veine et des artères est nécessaire afin de déterminer la durée préférable de la prophylaxie antiplaquettaire et de l'anticoagulation après une microchirurgie urgente ou non. Pour mesurer le phénomène, les fartères et veines fémorales de 16 rats Sprague-Dawley ont été isolées, sectionnées et réparées par technique microchirurgicale. Les animaux ont par la suite été euthanasiés à un jour d'intervalle, du jour 1 au jour 16 postopératoire. Les veines et les artères fémorales ont été mises en culture, sectionnées et préparées en vue d'une microscopie électronique par balayage. Les résultats démontrent que l'endothélialisation de la ligne de réparation commence dès le jour 3 et est achevée dès le jour 7 au niveau des veines et des artères. L'endothélialisation des sutures intraluminales prend neuf jours dans les veines et ne commence qu'au jour 15 dans les artères. Si ce modèle peut être

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Scanning electron microscope study of experimental microvascular anastomoses in the rabbit

Cited by 56 publications

References 8 publications

Stapled versus Hand-Sewn Vascular Anastomoses

Stapled versus Hand-Sewn Vascular Anastomoses

An ultrastructural study of the intimal hyperplasia in healing microarterial anastomoses

Endothelialization after arterial and venous micro-anastomosis

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