A new method for microvascular anastomosis: report of experimental and clinical research.
Principles of microvascular anastomotic surgery are uncertain in contrast to the standardized suture methods for the repair of large arteries. Complications of early thromboses or late stricture at the microvascular anastomotic line can be related to the inherent biologic response of these delicate tissues to penetrating needle and suture. A new method for microvascular reconstruction based on the principle of flanged, nonpenetrated, intimal approximation by an arcuate-legged clip has proven biologically and technically superior to the penetrating microsuture. These conclusions are based on extensive testing in multiple surgical laboratories of the following parameters: long- and short-term patency, morphology of wound repair, and burst and tensile strength. Details of the new surgical system and experimental studies are described.
Kirsch
W M
WM
Division of Neurosurgery, Loma Linda University Medical Center, California 92350.
Zhu
Y H
YH
Hardesty
R A
RA
Chapolini
R
R
D000714:Anastomosis, Surgical / Q000295:instrumentation*; D000818:Animals; D001696:Biomechanical Phenomena; D001794:Blood Pressure; D003331:Coronary Vessels / Q000601:surgery; D004867:Equipment Design / Q000592:standards; D005069:Evaluation Studies as Topic; D005263:Femoral Artery / Q000601:surgery; D005268:Femoral Vein / Q000601:surgery; D006801:Humans; D008866:Microsurgery / Q000295:instrumentation*; D011312:Pressure; D011817:Rabbits; D012501:Saphenous Vein / Q000637:transplantation; D013525:Surgical Instruments / Q000592:standards*; D013536:Suture Techniques / Q000592:standards; D013718:Tensile Strength; D014654:Vascular Patency; D014945:Wound Healing