title: Comparison of experimental microvascular end-to-end anastomosis via VCS-Clips versus conventional suture technique in an animal model.
abstract: In this experimental study on 96 CD rats, microvascular end-to-end anastomoses created via suture or alternatively by means of a VCS-Clip-Application-System, were compared. The aorta abdominalis of the animals, with a diameter of 1.5 +/- 0.2 mm, was experimentally dissected, and the free ends of the vessel then anastomosed. The results were evaluated using sonography, microangiography, histologic examination, and vascular imprints. Postoperative examination was carried out after 1, 3, 7, 14, or 30 days. Major advantages of the VCS-Clip technique over suturing were that it was easy to learn, significantly faster to perform (execution of anastomosis 10.9 +/- 2.6 min versus 19.4 +/- 5.0 min), and produced significantly more favorable histologic results in terms of less inflammatory response, foreign body reaction, necrosis of the tunica media, hyperplasia of the intima, and thrombosis of the vessel lumen. The main disadvantage of the clip technique was a significantly higher rate of stenoses (15.8 +/- 6.0 versus 4.1 +/- 6.6 percent).
authors.affiliation: Department of Plastic and Reconstructive Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Klöppel
authors.forename: C
authors.initials: C
authors.lastname: Tudor
authors.forename: L
authors.initials: L
authors.lastname: Kovacs
authors.forename: N A
authors.initials: NA
authors.lastname: Papadopulos
authors.forename: C
authors.initials: C
authors.lastname: Höhnke
authors.forename: I
authors.initials: I
authors.lastname: Himsl
authors.forename: N T
authors.initials: NT
authors.lastname: Hoang
authors.forename: E
authors.initials: E
authors.lastname: Biemer
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation*; D000818:Animals; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D001025:Aortitis / Q000517:prevention & control; D001027:Aortography; D003251:Constriction, Pathologic / Q000209:etiology; D004867:Equipment Design; D005549:Foreign-Body Reaction / Q000517:prevention & control; D006965:Hyperplasia; D008852:Microradiography; D008866:Microsurgery / Q000295:instrumentation*; D023421:Models, Animal; D009336:Necrosis; D011183:Postoperative Complications / Q000517:prevention & control; D051381:Rats; D011919:Rats, Inbred Strains; D013536:Suture Techniques; D013537:Sutures / Q000009:adverse effects; D013927:Thrombosis / Q000517:prevention & control; D013997:Time Factors; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology; D014463:Ultrasonography; D014656:Vascular Surgical Procedures / Q000379:methods*