title: A Novel Vascular Coupling System for End-to-End Anastomosis.
abstract: Vascular anastomosis is common during reconstructive surgeries. Traditional hand-suturing techniques are time consuming, subject to human error, and require high technical expertise and complex instruments. Prior attempts to replace hand-suturing technique, including staples, ring-pin devices, cuffing devices, and clips, are either more cumbersome, are unable to maintain a tight seal, or do not work for both arteries and veins. To provide a more efficient and reliable vessel anastomosis, a metal-free vascular coupling system that can be used for both arteries and veins was designed, fabricated and tested. A set of corresponding instruments were developed to facilitate the anastomosis process. Evaluation of the anastomosis by scanning electron microscopy and magnetic resonance imaging, demonstrated that the installation process does not cause damage to the vessel intima and the vascular coupling system is not exposed to the vessel lumen. Mechanical testing results showed that vessels reconnected with the vascular coupling system could withstand 12.7 ± 2.2 N tensile force and have superior leak profiles (0.049 ± 0.015, 0.078 ± 0.016, 0.089 ± 0.008 mL/s at 160, 260, 360 mmHg, respectively) compared to hand sutured vessels (0.310 ± 0.014, 1.123 ± 0.033, 2.092 ± 0.072 mL/s at 160, 260, 360 mmHg, respectively). The anastomotic process was successfully demonstrated on both arteries and veins in cadaver pigs.
authors.affiliation: Department of Mechanical Engineering, University of Utah, 50 S Central Campus Drive Rm 2110, Salt Lake City, UT, 84112, USA. lizzylee2526@gmail.com.
authors.forename: Huizhong
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Mechanical Engineering, University of Utah, 50 S Central Campus Drive Rm 2110, Salt Lake City, UT, 84112, USA.
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Gale
authors.affiliation: Department of Mechanical Engineering, University of Utah, 50 S Central Campus Drive Rm 2110, Salt Lake City, UT, 84112, USA.
authors.forename: Himanshu
authors.initials: H
authors.lastname: Sant
authors.affiliation: Department of Surgery, School of Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT, 84132, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Shea
authors.affiliation: Department of Bioengineering, University of Utah, Salt Lake City, UT, 84112, USA.
authors.forename: E
authors.initials: E
authors.lastname: David Bell
authors.affiliation: Department of Surgery, School of Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT, 84132, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Agarwal
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation* / Q000379:methods*; D057868:Anastomotic Leak; D000818:Animals; D002339:Carotid Arteries / Q000601:surgery* / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D012756:Sheep; D034421:Sus scrofa; D013718:Tensile Strength
keywords: Biocompatible; Blood vessel; MRI; Microsurgery; SEM