title: Comparative study of different combinations of microvascular anastomoses in a rat model: end-to-end, end-to-side, and flow-through anastomosis.
abstract: BACKGROUND
  This study aimed to compare several microvascular anastomotic techniques by patency rate using a free flap model in rats.
  
  
  METHODS
  A microsurgical transfer model of a pectoral skin flap to the cervical region was used. In experiment 1, 120 rats were divided into four groups (n = 30 in each group) depending on the type of microvascular anastomotic technique. For group 1, end-to-end anastomoses were performed for arteries and veins. For group 2, end-to-side anastomoses were performed for arteries and end-to-end anastomoses were performed for veins. For group 3, flow-through anastomoses were performed for arteries and end-to-end anastomoses were performed for veins. For group 4, end-to-end anastomoses were performed for arteries and end-to-side anastomoses were performed for veins. Flap survival was assessed on day 3 and the success rates of the four groups compared. In experiment 2 (n = 10), postoperative blood flows of end-to-end and flow-through arterial anastomoses were measured.
  
  
  RESULTS
  : In experiment 1, the success rates in groups 1, 2, 3, and 4 were 76.7, 83.3, 100, and 83.3 percent, respectively. Differences between group 3 and the other groups were statistically significant. In experiment 2, the blood flow of flow-through arterial anastomosis (1.8 ml/minute) was much higher than that of end-to-end anastomosis (0.18 ml/minute).
  
  
  CONCLUSIONS
  : Flow-through arterial anastomosis presented a higher blood flow through the anastomotic site, resulting in a higher success rate than conventional anastomoses. In veins, end-to-side anastomosis was equivalent to end-to-end anastomosis even though the diameter of the donor vein was larger than the recipient vein.
authors.affiliation: Tokyo, Japan From the Department of Plastic and Reconstructive Surgery, Kyorin University School of Medicine.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Okazaki
authors.forename: Norihiko
authors.initials: N
authors.lastname: Ohura
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Shiraishi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takushima
authors.forename: Kiyonori
authors.initials: K
authors.lastname: Harii
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D001783:Blood Flow Velocity / Q000502:physiology; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008866:Microsurgery / Q000379:methods*; D009336:Necrosis; D051381:Rats; D017208:Rats, Wistar; D013524:Surgical Flaps / Q000098:blood supply*; D013927:Thrombosis / Q000473:pathology; D014654:Vascular Patency / Q000502:physiology