The End-to-Side Anastomosis: A Comparative Analysis of Arterial Models in the Rat

Meybodi, Ali Tayebi; Belykh, Evgenii; Aklinski, Joseph; Kaur, Pareena; Preul, Mark C.; Lawton, Michael T.

doi:10.1016/j.wneu.2018.07.271

Cited by 7 publications

(7 citation statements)

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“…There are many types of end-to-side microvascular anastomosis training models, such as those that are ipsilateral to contralateral common carotid arteries ( 9 , 10 ), common carotid artery to external jugular vein ( 11 , 12 ), ipsilateral to contralateral common iliac arteries ( 7 , 9 ), and femoral artery to vein ( 13 – 15 ). Previously, Tayebi Meybodi et al ( 9 ), Hall ( 20 ), and we ( 7 ) have described Prox. CIA-Cont.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the anatomical features, the rat CIA and CIV are tightly adhered to each other due to the thick layer of connective tissue between them, which makes the CIA and CIV dissection more difficult than dissection of the rat common carotid artery ( 9 ). In addition, multiple small branches from the CIA and CIV need to be coagulated and divided to fully isolate them; thus, dissection of the CIA and CIV carries the risk of potential vascular injury and hemorrhage, which may not be suitable for beginners of microvascular training when compared with the rat common carotid artery and femoral artery ( 9 ). However, delicate meticulous microsurgical dissection techniques are a prerequisite in neurosurgical interventions, especially when dealing with vital fragile structures.…”

Section: Discussionmentioning

confidence: 99%

“…Regardless of whether the CIA was transected either distally or proximally, the CIAs retracted significantly. Tayebi Meybodi et al reported that the CIA retracts to almost one-third of its original length ( 9 ). Although the transected donor CIA retracted significantly, it had no obvious tension on the vessels or the anastomosis sites in the Dist.…”

Section: Discussionmentioning

confidence: 99%

“…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. The posterior wall could not be completed extraluminally in any of their anastomosis training rats due to the high amount of tension on the CIA, and they also sutured the posterior wall in the intraluminal suturing technique ( 9 ). However, in 1980, Hall ( 20 ) performed the same CIA end-to-side anastomosis with the help of an Acland approximator.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, 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. Previously, many types of end-to-side microvascular anastomosis training models have been described, such as those that are ipsilateral to contralateral common carotid arteries ( 9 , 10 ), common carotid artery to external jugular vein ( 11 , 12 ), ipsilateral to contralateral common iliac arteries ( 7 , 9 ), and femoral artery to vein ( 13 – 15 ). In this article, three types of end-to-side microvascular anastomotic configurations using the rat common iliac artery (CIA), one with the proximal end of the CIA to the contralateral side of the CIA (Prox.…”

Section: Introductionmentioning

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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