Side-to-Side Microvascular Anastomosis Using Rat Cervical Vessels

Xiao, Zongyu; Ji, Wang

doi:10.1016/j.wneu.2021.09.133

Cited by 3 publications

(13 citation statements)

References 32 publications

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“…Theoretically, the ideal end-to-side microvascular anastomosis should be performed between two perfectly matched arteries under tension-free suturing conditions; however, different nonideal anastomotic situations are encountered in real operations and include different degrees of tension and discrepancies in the diameter, thickness, texture and consistency between the donor and recipient arteries, vessel direction, surgical corridor and depth, etc. ( 6 , 7 , 16 , 18 ). Yarsagil emphasized that the microvascular anastomosis technique should be fully mastered in microsurgical laboratories before its application in human beings ( 7 , 8 ).…”

Section: Discussionmentioning

confidence: 99%

“…After full isolation of the donor and recipient vessels, the microvascular anastomosis working space is also important. As we described previously in a side-to-side microvascular anastomosis training model using rat cervical vessels, the minimum distance between the corner of the arteriotomy or venotomy and the temporary aneurysm clip should be at least 1 mm to guarantee the following side-to-side microvascular anastomotic procedures ( 6 ). In the end-to-side microvascular anastomosis study, we found that the rule is also applicable; the end-to-side microvascular anastomosis arteriotomy or venotomy is approximately 2.00–2.50 mm; and the distance between the aneurysm clips on the recipient CIA or CIV is approximately 4.00–7.00 mm, which is slightly longer than the length of the arteriotomy or venotomy.…”

Section: Discussionmentioning

confidence: 99%

“…However, the intraluminal suturing technique is more challenging than the extraluminal suturing technique, and the risk of injury to the vascular endothelium is relatively high. Thus, its anastomotic thrombosis rate is higher than that of the traditional extraluminal suturing technique, but proficiency in the intraluminal suturing technique can be gained in microsurgical training laboratories ( 6 , 7 ). Tayebi Meybodi et al tried to rotate the vessel and tried to suture them extraluminally in the same CIA end-to-side anastomosis training model, and the same findings were reported.…”

Section: Discussionmentioning

confidence: 99%

“…Theoretically, the diameter, thickness, texture, and consistency of the donor and recipient arteries should be matched perfectly ( 6 ). In the study, the Dist.…”

Section: Discussionmentioning

confidence: 99%

“…CIA arterial end-to-side anastomosis models mimic the end-to-side anastomosis between perfectly matched arteries. However, mismatched vessels are inevitably encountered in cerebrovascular bypass surgery even if there is careful preoperative planning ( 6 , 22 ), and the difficulty of anastomosis increases when very thin-walled vessels are encountered ( 23 ). The artery-to-vein microvascular training model is a good model to mimic this situation because veins are thinner, more fragile, easier to damage, and more prone to collapse than arteries.…”

Section: Discussionmentioning

confidence: 99%

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Three types of end-to-side microvascular anastomosis training models using rat common iliac arteries

et al. 2023

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Background: Instead of only practicing these perfectly matched end-to-side anastomoses in microsurgical laboratories, we must learn how to perform these so-called “imperfect” end-to-side anastomoses in the laboratory.MethodsThree types of end-to-side microvascular anastomoses using the rat common iliac artery (CIA), one with the proximal end of the CIA to the contralateral side of the CIA, another with the distal end of the CIA to the contralateral side of the CIA, and the third with the distal end of the CIA to the ipsilateral side of the common iliac vein (CIV), were presented to simulate different end-to-side anastomosis situations in a microsurgical laboratory. Diameters of CIA and CIV, distances between temporary clips, the length of arteriotomy or venotomy, and the distribution of stitches were recorded. The patency rates were evaluated immediately after the anastomosis was completed and 30 min later. After animal euthanasia, the donor vessel was cut close to the anastomotic site, and the orifice size and intimal attachment were evaluated by inspecting them through inside the vessel.ResultsThe diameters of the CIA and CIV were 0.8–1.2 mm and 1.2–1.5 mm, respectively. The end-to-side microvascular anastomosis arteriotomy or venotomy is approximately 2.00–2.50 mm, the distance between the aneurysm clips on the recipient CIA or CIV is approximately 4.00–7.00 mm, and the distance between the corner of the arteriotomy or venotomy and the temporary aneurysm clip was 1.00–3.00 mm. Three types of end-to-side anastomoses using the CIA were successfully performed, and 100% patency rates were achieved immediately and 30 min postoperatively. Good distribution of stitches, wide orifice, and intimal attachment were recorded in the study in all groups.ConclusionsThree types of end-to-side anastomoses using rat CIAs could be efficiently used to mimic three different anastomotic situations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Theoretically, the diameter, thickness, texture, and consistency of the donor and recipient arteries should be matched perfectly ( 6 ). In the study, the Dist.…”

Section: Discussionmentioning

confidence: 99%