title: Microvascular stent anastomosis using N-fibroin stents: feasibility, ischemia time, and complications.
abstract: OBJECTIVE
  To evaluate a novel microvascular anastomosis technique using N-fibroin stents.
  
  
  METHODS
  Cylinder stents of 1 mm diameter and 5 mm length were fabricated using N-fibroin from silkworms. In 22 rats, aortas were dissected, and the stent was inserted into the two ends of the aorta and fixed using methylmethacrylate.
  
  
  RESULTS
  Stent anastomosis was successful in 21 (96%) rats. The mean ischemia time was 7.4 minutes, significantly shorter than the 15.9 minutes in the control group with conventional sutures (P < .0001). After 4 months, anastomosis was functionally patent in all cases. However, elastic fibers remained interrupted in all stent anastomosis cases, and marked host rejection was evident at the stent anastomosis sites. Around the stents, thrombi were frequent (52%).
  
  
  CONCLUSIONS
  Our study demonstrated the basic feasibility of stent anastomosis using N-fibroin stents and reduced ischemia time. However, thrombus formation, frequent and severe abdominal infections, and heavy host rejection remain critical issues.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Smeets
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Vorwig
authors.affiliation: Spintec Engineering GmbH, Aachen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Wöltje
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Gaudin
authors.affiliation: Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Luebke
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Benedicta
authors.initials: B
authors.lastname: Beck-Broichsitter
authors.affiliation: Spintec Engineering GmbH, Aachen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Rheinnecker
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Max
authors.initials: M
authors.lastname: Heiland
authors.affiliation: General, Visceral, and Thoracic Surgery Department and Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Grupp
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Gröbe
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: h.hanken@uke.de.
authors.forename: Henning
authors.initials: H
authors.lastname: Hanken
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D001011:Aorta / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D005349:Fibroins / Q000494:pharmacology*; D007511:Ischemia / Q000473:pathology*; D008768:Methylmethacrylates / Q000494:pharmacology; D051381:Rats; D017207:Rats, Sprague-Dawley; D012307:Risk Factors; D015607:Stents; D013997:Time Factors
chemical_list: D008768:Methylmethacrylates; D005349:Fibroins