Scanning electron microscopy studies of needle and suture damage in rat carotid and femoral arteries.
Using the scanning electron microscope (SEM), we compared the areas of endothelial disruption 45 minutes after penetration of rat femoral and carotid artery walls with 75- and 100-mu taper point and taper cut microsurgical needles, with and without restoration of blood flow. Four experimental groups were designated: needle puncture only, single loose, suture loop, end-to-end anastomosis, and end-to-side anastomosis. The vessels were perfused with normal saline, immersed in 3% buffered glutaraldehyde, and mounted under slight tension to simulate physiological wall distention before SEM examination. Endothelial craters at vessel puncture sites were measured on SEM photomicrographs at 300 X magnification. All vessels were patent when examined. Crater diameters averaged less than double the needle size. Although taper cut needles produced craters that were 25% larger (P less than 0.05), vessel penetration was easier than with the taper point needle and bleeding times were the same. Suture loop produced craters that were 36% larger (P less than 0.05) than needle puncture alone. Craters were 20% larger when blood flow was restored and 50% larger in the femoral than in the carotid artery. Although craters seen after end-to-end anastomosis were not significantly larger than those after end-to-side anastomosis, interrupted sutures appeared to cause more endothelial damage than continuous sutures. These results suggest that the use of cutting needles, passage and tying of sutures, vessel distention by blood flow, and suturing of more muscular and less elastic vessel walls (femoral artery) may increase endothelial disruption but do not reduce patency.
D000818:Animals; D002339:Carotid Arteries / Q000648:ultrastructure*; D020212:Carotid Artery Injuries; D005263:Femoral Artery / Q000293:injuries / Q000648:ultrastructure*; D008855:Microscopy, Electron, Scanning; D008866:Microsurgery / Q000295:instrumentation*; D009339:Needles; D051381:Rats; D011919:Rats, Inbred Strains; D013536:Suture Techniques; D013537:Sutures