title: Bipolar anastomosis technique (BAT) enables "fast-to-do", high-quality venous end-to-end anastomosis in a new vascular model.
abstract: The interrupted suture technique is most commonly used for microsurgical venous anastomosis. Needle-stitch trauma and intraluminal suture, however, potentially cause vascular wall damage, thrombosis, intimal hyperplasia or even stenosis. Therefore, the present study aimed to show the feasibility and reliability of a modified cuff technique (bipolar anastomosis technique (BAT)) for venous end-to-end anastomosis in a new chicken throat vascular model. In ex vivo experiments, freshly resected chicken jugular veins (N = 96) were used to find ideal BAT time to current settings for venous end-to-end anastomosis. Thereafter, the left jugular vein of chickens (N = 40) was dissected in vivo and subsequently anastomosed using BAT. The quality of anastomosis was evaluated by Doppler sonography immediately, at two hours and at two, six, 12, 16, and 29 weeks after surgery. Additional histological examination took place at two hours (N = 8) and at two (N = 6), six (N = 6), 12 (N = 6), 16 (N = 6) and 29 (N = 6) weeks after surgery. Immediately after surgery (N = 40) and at two hours (N = 38) venous anastomoses were found to be patent in Doppler sonography. Anastomotic rupture caused death in two animals within one hour after surgery. Thrombotic occlusion was found in one animal at six weeks after surgery. In the remaining animals (N = 37) only minimal stenosis which decreased to almost normal levels was sonographically found. The average time needed for anastomosis using BAT was less than two minutes. BAT allows fast venous end-to-end anastomosis in a chicken throat vascular model.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Medical University of Innsbruck, Austria. Heinrich.Schubert@uibk.ac.at
authors.forename: Heinrich M
authors.initials: HM
authors.lastname: Schubert
authors.forename: Matthias
authors.initials: M
authors.lastname: Hohlrieder
authors.forename: Peter
authors.initials: P
authors.lastname: Falkensammer
authors.forename: Hans Christian
authors.initials: HC
authors.lastname: Jeske
authors.forename: Patrizia L
authors.initials: PL
authors.lastname: Moser
authors.forename: Christian
authors.initials: C
authors.lastname: Kolbitsch
authors.forename: Matthias
authors.initials: M
authors.lastname: Biebl
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D001783:Blood Flow Velocity / Q000502:physiology; D002645:Chickens; D003251:Constriction, Pathologic / Q000209:etiology; D004564:Electrocoagulation / Q000379:methods*; D004730:Endothelium, Vascular / Q000473:pathology; D005240:Feasibility Studies; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008866:Microsurgery / Q000379:methods*; D023421:Models, Animal; D011183:Postoperative Complications; D015203:Reproducibility of Results; D012422:Rupture, Spontaneous; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D018608:Ultrasonography, Doppler; D014654:Vascular Patency / Q000502:physiology; D014656:Vascular Surgical Procedures / Q000379:methods*