Experimental studies in nonsuture end-to-side microvascular anastomosis.

A fast, easy anastomotic technique with a high patency rate would facilitate the development of microvascular surgery. This article describes a new nonsuture method of end-to-side microvascular anastomosis using a soluble polyvinyl alcohol (PVA) T-shaped tube as an internal stent and plastic adhesive. Two kinds of T-shaped tubes were used: Type I tube had a short straight tube connected to a long straight tube at the midpoint and the Type II tube was a long bent tube with a short straight tube connected to it. The walls of each tube consisted of three concentric layers made of two PVA's with different solubilities. Seventy end-to-side anastomoses were performed using both common carotid arteries of rats. These consisted of three groups, I, IIA, and IIB. I and II were the types of T-tubes employed, and A had less plastic adhesive than B. Evaluations were performed 2 weeks and 3 months after surgery. The anastomotic technique was easily accomplished, taking approximately 8 minutes to complete. On the first evaluation the patency rates were more than 90% in all groups, but anastomotic aneurysms developed in 117%) and IIA (19%). No aneurysms were observed in IIB where the anastomotic sites were reinforced by adding plastic adhesive after the blood flow was reestablished. Moreover, a high patency rate (95%) was maintained even at the second evaluation in IIB.