title: A simple method for evaluating the quality of microvascular anastomoses performed in vitro.
abstract: OBJECTIVE
  The aim of this paper is to describe a simple and effective method for evaluating the quality of microvascular anastomoses performed in vitro.
  
  
  METHODS
  After the microvascular anastomosis has been performed in vitro, the vessel is cannulated at a distance of several millimeters from the anastomosis site with a catheter that is connected to a syringe filled with commercially available silicone glue. The silicone glue is slowly injected into the artery until the whole specimen is filled. Small leaks at the anastomosis site can be seen directly as the silicone glue will slowly extrude at the point of a leak. Then, the catheter is withdrawn and the specimen, filled with silicone, is left for several hours to solidify. Subsequently, the specimen is immersed in H(2)O(2) for several hours in order to dissolve the tissue from the silicone cast. In this manner, the cast of the silicone represents the virtual lumen of the blood vessel and the print of the lumen surface.
  
  
  RESULTS
  Using this method, several important technical aspect of the anastomosis can be easily evaluated, such as diameter differences of the blood vessel, stricture, narrowing, irregularities of the vessel wall, leakage through the anastomotic site, and the alignment of the vessel walls.
  
  
  CONCLUSIONS
  The silicone cast method as described in this study can be used to evaluate some technical aspect of a microvascular anastomosis performed in vitro. Moreover, it can be used to monitor the progress of the trainee and as an aid in improving and mastering vascular microsurgery.
authors: Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium. tomas.menovsky@uza.be
authors: Tomas
authors: T
authors: Menovsky
authors: Katrin
authors: K
authors: Van Loock
authors: Wei-Te
authors: WT
authors: Wang
authors: Heber
authors: H
authors: Ferraz-Leite
authors: Dirk
authors: D
authors: De Ridder
mesh_terms: D000269:Adhesives; D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D002196:Capillaries / Q000033:anatomy & histology / Q000601:surgery*; D002645:Chickens; D005263:Femoral Artery / Q000033:anatomy & histology / Q000601:surgery; D005268:Femoral Vein / Q000033:anatomy & histology / Q000601:surgery; D006861:Hydrogen Peroxide / Q000737:chemistry; D008866:Microsurgery / Q000379:methods*; D008953:Models, Anatomic; D012826:Silicone Elastomers; D014656:Vascular Surgical Procedures / Q000379:methods*
chemical_list: D000269:Adhesives; D012826:Silicone Elastomers; D006861:Hydrogen Peroxide