Background

Sutured anastomosis remains the gold standard in microvascular surgery. The procedure is not free of complications and is a time-consuming operation requiring a high level of experience. The aim of this study was to develop new methods for a stable, faster, and safer anastomosis using a novel biodegradable adhesive, VIVO, and a custom-made microvascular stent.

Methods

The VIVO medical adhesive was used for a total of 30 anastomoses in rats in the right carotid artery: 15 anastomoses were performed with a temporary intraluminal catheter, VIVO, and reduced sutures (VIVO + TC). A further 15 anastomoses were performed with nitinol stents, VIVO, and reduced sutures (VIVO + SM). Sutured anastomoses served as controls (C) and were performed on the left carotid arteries of the 30 rats. Operation and bleeding times were assessed, and patency was evaluated by Doppler flowmetry and indocyanine green (ICG) angiography. Subsequently, the anastomoses were evaluated histopathological.

Results

The overall patency was recorded as 100% in all groups. No thrombosis or circulatory disturbance was found. Compared to C and VIVO + SM, VIVO + TC proved to be significantly less traumatic, less demanding, and time-saving. The sealing properties of VIVO lead to shorter bleeding times and less oozing. In contrast, VIVO + SM proved to be the most technically demanding and time-consuming procedure.

Conclusion

The success of a microvascular sutured anastomosis is determined by a short ischemic interval. Compared to sutured anastomosis, VIVO + TC showed ease of use as well as shorter time taken for anastomosis, less trauma, and lower blood loss. More long-term studies on the functions, biological interactions, and survival rates of glue-based anastomoses need to be initiated.

中文翻译：

---

在大鼠颈动脉模型中使用医用粘合剂 VIVO 和可扩张微型支架的微血管吻合技术

背景

缝合吻合术仍然是微血管手术的金标准。该过程并非没有并发症，并且是一项需要高水平经验的耗时操作。本研究的目的是开发使用新型可生物降解粘合剂 VIVO 和定制微血管支架进行稳定、更快和更安全吻合的新方法。

方法

VIVO医用粘合剂用于大鼠右颈动脉共30次吻合：15次吻合使用临时管腔内导管VIVO和减少缝线（VIVO + TC）。使用镍钛诺支架、VIVO 和减少缝线 (VIVO + SM) 进行了另外 15 次吻合。缝合吻合术作为对照 (C) 并在 30 只大鼠的左颈动脉上进行。评估手术和出血时间，并通过多普勒血流仪和吲哚菁绿 (ICG) 血管造影术评估通畅性。随后，对吻合进行组织病理学评估。

结果

所有组的总体通畅率均记录为 100%。未发现血栓形成或循环障碍。与 C 和 VIVO + SM 相比，事实证明 VIVO + TC 的创伤更小、要求更低且更省时。VIVO 的密封特性导致更短的出血时间和更少的渗出。相比之下，VIVO + SM 被证明是技术要求最高和最耗时的程序。

结论

微血管缝合吻合术的成功取决于短的缺血间隔。与缝合吻合相比，VIVO + TC 显示出易用性以及吻合所需的时间更短、创伤更小、失血更少。需要启动关于胶基吻合的功能、生物相互作用和存活率的更多长期研究。