Sutureless anastomoses of rabbit carotid arteries with BioGlue.
OBJECTIVE
Sutureless anastomoses for coronary artery surgery are being investigated for a minimally invasive setup because they are easy to perform and less time-consuming than are sutured anastomoses. The short-term effects of the biocompatible adhesive BioGlue on vascular tissue have been described as potentially unfavorable. The present study investigates the medium-term macroscopic and histologic effects associated with the use of BioGlue on rabbit carotid arteries.


METHODS
Thirty-four carotid arteries of 17 New Zealand White rabbits were available. Nine carotid arteries were left unmanipulated and free of glue, 9 carotid arteries had BioGlue applied as a control, and 16 carotid arteries were transected and reanastomosed with the aid of BioGlue and an endovascular balloon. Of the 16 transected arteries, 4 had to be excluded from further evaluation. Angiographic scanning was performed 60 days postsurgery, after which the animals were euthanized and tissue samples were obtained for macroscopic and histologic examination.


RESULTS
The application of BioGlue resulted in a marked invasion of inflammatory cells. The glue partially degraded and was replaced with connective tissue. Obvious calcification of the arterial wall and the capsule that had formed around the glue was present. Stenoses, thrombi, and pseudoaneurysms were predominantly noted in the glued anastomosis group.


CONCLUSIONS
The results of this study raise concerns about the safety of BioGlue in coronary artery surgery. In light of our results, the use of BioGlue in large-vessel vascular surgery should be considered with great care for each individual patient.
Schiller
Wolfgang
W
Clinic for Cardiac Surgery, University Clinic Bonn, Bonn, Germany.
Rudorf
Heike
H
Welzel
Christoph B
CB
Kiderlen
Martin J
MJ
Probst
Chris
C
Dewald
Oliver
O
Welz
Armin
A
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D002339:Carotid Arteries / Q000473:pathology / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000209:etiology*; D020212:Carotid Artery Injuries / Q000209:etiology; D002341:Carotid Artery Thrombosis / Q000209:etiology; D016893:Carotid Stenosis / Q000209:etiology; D005260:Female; D023421:Models, Animal; D011506:Proteins / Q000009:adverse effects / Q000627:therapeutic use*; D011817:Rabbits; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000009:adverse effects / Q000627:therapeutic use*; D014656:Vascular Surgical Procedures / Q000379:methods*
C472676:Bio-glue; D011506:Proteins; D014014:Tissue Adhesives