title: Microvascular anastomosis using a photochemical tissue bonding technique.
abstract: OBJECTIVE
  Photochemical tissue bonding (PTB) combines photoactive dyes with visible light to create fluid-tight seals between tissue surfaces without causing collateral thermal damage. The potential of PTB to improve outcomes over standard of care microsurgical reanastomoses of blood vessels in ex vivo and in vivo models was evaluated.
  
  
  METHODS
  The mechanical strength and integrity of PTB and standard microsurgical suture repairs in ex vivo porcine brachial arteries (n = 10) were compared using hydrostatic testing of leak point pressure (LPP). Femoral artery repair in vivo was measured in Sprague-Dawley rats using either standard microvascular sutures (n = 20) or PTB (n = 20). Patency was evaluated at 6 hours (n = 10) and 8 weeks post-repair (n = 10) for each group.
  
  
  RESULTS
  PTB produced significantly higher LPPs (1,100+/- 150 mmHg) than suture repair (350+/-40 mmHg, P<0.001) in an ex vivo study. In an in vivo study all femoral arteries in both suture and PTB repair groups were patent at 6 hours post-repair. At 8 weeks post-repair the patency rate was 80% for both groups. No evidence of aneurysm formation was seen in either group and bleeding was absent from the repair site in the PTB-treated vessels, in contrast to the suture repair group.
  
  
  CONCLUSIONS
  PTB is a feasible microvascular repair technique that results in an immediate, mechanically robust bond with short- and long-term patency rates equal to those for standard suture repair.
authors.affiliation: Plastic Surgery Research Laboratory, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
authors.forename: Anne C
authors.initials: AC
authors.lastname: O'Neill
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Winograd
authors.forename: José L
authors.initials: JL
authors.lastname: Zeballos
authors.forename: T Shane
authors.initials: TS
authors.lastname: Johnson
authors.forename: Mark A
authors.initials: MA
authors.lastname: Randolph
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Bujold
authors.forename: Irene E
authors.initials: IE
authors.lastname: Kochevar
authors.forename: Robert W
authors.initials: RW
authors.lastname: Redmond
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D001916:Brachial Artery / Q000293:injuries*; D004195:Disease Models, Animal; D005240:Feasibility Studies; D005263:Femoral Artery / Q000293:injuries*; D066298:In Vitro Techniques; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008866:Microsurgery; D010777:Photochemistry; D051381:Rats; D017207:Rats, Sprague-Dawley; D012395:Rose Bengal / Q000494:pharmacology*; D013536:Suture Techniques; D013552:Swine; D014014:Tissue Adhesives / Q000494:pharmacology*; D014654:Vascular Patency
chemical_list: D014014:Tissue Adhesives; D012395:Rose Bengal