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Experimental study of sutureless vascular anastomosis with use of glued prosthesis in rabbits.

Vokrri L, Qavdarbasha A, Rudari H, Ahmetaj H, Manxhuka-Kërliu S, Hyseni N, Porcu P, Cinquin P, Sessa C - Vasc Health Risk Manag (2015)

Bottom Line: Macroscopically, the BioGlue did not demonstrate any adhesion to the surrounding tissue as it was covered by the vascular prosthesis.This technique may provide a feasible and successful alternative in vascular surgery.However, further long-term studies are necessary to elucidate the break pressure and degree of inflammation at the anastomotic site.

View Article: PubMed Central - PubMed

Affiliation: Department of Vascular Surgery, University Clinical Center of Kosovo, Republic of Kosovo ; Medical Faculty, University of Pristina, Republic of Kosovo ; Veterinary Institute, Pristina, Republic of Kosovo ; University of Grenoble Alpes/CNRS/TIMC-IMAG UMR 5525 (GMCAO team), Grenoble, 38000, France.

ABSTRACT

Objective: The objective of this study is to explore the feasibility and efficacy of a new technique for sutureless vascular anastomosis, using glued prosthesis, as a sole anastomosis fixation method in rabbits.

Methods: Ten rabbits were randomly selected to conduct the experiment. Five rabbits underwent direct anastomosis of infrarenal abdominal aorta, with glued prosthesis. In five other rabbits, reconstruction was done by sutured anastomosis. All animals were immediately examined by echo-Doppler for patency of anastomosis. The burst pressure of the glued anastomosis was measured and compared with that of a sutured artery. The animals were euthanized, and tissue samples were taken for histological examination immediately after the experiment.

Results: Compared to conventional anastomoses, sutureless vascular anastomoses required shorter time of creation and significantly reduced blood loss (P<5%). There was no significant difference on the average blood flow through the anastomosis between two groups at the end of surgery. All anastomoses with glued prosthesis, examined by echo-Doppler, were patent at the anastomotic site, except one, which was stenosed immediately after surgery. In the control group, except one with stenosis, all conventional anastomoses were patent. Mean burst pressure at the anastomotic site for sutureless anastomoses was lower than in control group. Macroscopically, the BioGlue did not demonstrate any adhesion to the surrounding tissue as it was covered by the vascular prosthesis. Histological examination showed low-grade inflammatory reaction in glued anastomoses versus no inflammatory reaction at the sutured anastomoses.

Conclusion: This technique may provide a feasible and successful alternative in vascular surgery. However, further long-term studies are necessary to elucidate the break pressure and degree of inflammation at the anastomotic site.

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Related in: MedlinePlus

Schematic representation of sutureless anastomosis with glued prosthesis.Notes: (A) Positioning of the ends of the aorta. (B) Insertion of balloon catheter. (C) Positioning of glued prosthesis around anastomosis. (D) Completion of anastomosis.
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f1-vhrm-11-211: Schematic representation of sutureless anastomosis with glued prosthesis.Notes: (A) Positioning of the ends of the aorta. (B) Insertion of balloon catheter. (C) Positioning of glued prosthesis around anastomosis. (D) Completion of anastomosis.

Mentions: After total transection of the infrarenal abdominal aorta, they underwent direct anastomosis (Figure 1A). In the study group initially, at the distal part of aorta (4 cm distally from the site of anastomosis), a percutaneous transluminal angioplasty balloon catheter 3 mm in diameter and 20 mm long (Boston Scientific, Marlborough, MA, USA) was inserted, as a temporary internal stent to create and seal the anastomosis during gluing. Then, both transected ends of aorta were drawn over the angioplasty catheter and aligned (Figure 1B). A longitudinal incision was made on 20-mm long ePTFE prosthesis with a 4 mm diameter. A small amount of BioGlue (0.5 mL) was applied to the inner surface of prosthesis. Subsequently, the endovascular balloon was inflated and glued prosthesis was applied from outside and around the anastomosis (Figure 1C). Glued prosthesis was essential to avoid inhomogeneous distribution of the glue. After allowing the adhesive to polymerize for 2 minutes, the vascular clamps were removed to reestablish the circulation. The surgical field was carefully kept dry. The site of catheter introduction at the aorta was sutured with one suture, after removal of the balloon catheter (Figure 1D).


Experimental study of sutureless vascular anastomosis with use of glued prosthesis in rabbits.

Vokrri L, Qavdarbasha A, Rudari H, Ahmetaj H, Manxhuka-Kërliu S, Hyseni N, Porcu P, Cinquin P, Sessa C - Vasc Health Risk Manag (2015)

Schematic representation of sutureless anastomosis with glued prosthesis.Notes: (A) Positioning of the ends of the aorta. (B) Insertion of balloon catheter. (C) Positioning of glued prosthesis around anastomosis. (D) Completion of anastomosis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4383148&req=5

f1-vhrm-11-211: Schematic representation of sutureless anastomosis with glued prosthesis.Notes: (A) Positioning of the ends of the aorta. (B) Insertion of balloon catheter. (C) Positioning of glued prosthesis around anastomosis. (D) Completion of anastomosis.
Mentions: After total transection of the infrarenal abdominal aorta, they underwent direct anastomosis (Figure 1A). In the study group initially, at the distal part of aorta (4 cm distally from the site of anastomosis), a percutaneous transluminal angioplasty balloon catheter 3 mm in diameter and 20 mm long (Boston Scientific, Marlborough, MA, USA) was inserted, as a temporary internal stent to create and seal the anastomosis during gluing. Then, both transected ends of aorta were drawn over the angioplasty catheter and aligned (Figure 1B). A longitudinal incision was made on 20-mm long ePTFE prosthesis with a 4 mm diameter. A small amount of BioGlue (0.5 mL) was applied to the inner surface of prosthesis. Subsequently, the endovascular balloon was inflated and glued prosthesis was applied from outside and around the anastomosis (Figure 1C). Glued prosthesis was essential to avoid inhomogeneous distribution of the glue. After allowing the adhesive to polymerize for 2 minutes, the vascular clamps were removed to reestablish the circulation. The surgical field was carefully kept dry. The site of catheter introduction at the aorta was sutured with one suture, after removal of the balloon catheter (Figure 1D).

Bottom Line: Macroscopically, the BioGlue did not demonstrate any adhesion to the surrounding tissue as it was covered by the vascular prosthesis.This technique may provide a feasible and successful alternative in vascular surgery.However, further long-term studies are necessary to elucidate the break pressure and degree of inflammation at the anastomotic site.

View Article: PubMed Central - PubMed

Affiliation: Department of Vascular Surgery, University Clinical Center of Kosovo, Republic of Kosovo ; Medical Faculty, University of Pristina, Republic of Kosovo ; Veterinary Institute, Pristina, Republic of Kosovo ; University of Grenoble Alpes/CNRS/TIMC-IMAG UMR 5525 (GMCAO team), Grenoble, 38000, France.

ABSTRACT

Objective: The objective of this study is to explore the feasibility and efficacy of a new technique for sutureless vascular anastomosis, using glued prosthesis, as a sole anastomosis fixation method in rabbits.

Methods: Ten rabbits were randomly selected to conduct the experiment. Five rabbits underwent direct anastomosis of infrarenal abdominal aorta, with glued prosthesis. In five other rabbits, reconstruction was done by sutured anastomosis. All animals were immediately examined by echo-Doppler for patency of anastomosis. The burst pressure of the glued anastomosis was measured and compared with that of a sutured artery. The animals were euthanized, and tissue samples were taken for histological examination immediately after the experiment.

Results: Compared to conventional anastomoses, sutureless vascular anastomoses required shorter time of creation and significantly reduced blood loss (P<5%). There was no significant difference on the average blood flow through the anastomosis between two groups at the end of surgery. All anastomoses with glued prosthesis, examined by echo-Doppler, were patent at the anastomotic site, except one, which was stenosed immediately after surgery. In the control group, except one with stenosis, all conventional anastomoses were patent. Mean burst pressure at the anastomotic site for sutureless anastomoses was lower than in control group. Macroscopically, the BioGlue did not demonstrate any adhesion to the surrounding tissue as it was covered by the vascular prosthesis. Histological examination showed low-grade inflammatory reaction in glued anastomoses versus no inflammatory reaction at the sutured anastomoses.

Conclusion: This technique may provide a feasible and successful alternative in vascular surgery. However, further long-term studies are necessary to elucidate the break pressure and degree of inflammation at the anastomotic site.

Show MeSH
Related in: MedlinePlus