title: An intraluminal stent facilitates light-activated vascular anastomosis.
abstract: Photochemical tissue bonding (PTB) is a sutureless, light-activated technique that produces a watertight, microvascular repair with minimal inflammation compared to standard microsurgery. However, it is practically limited by the need for a clinically viable luminal support system. The aim of this study was to evaluate a hollow biocompatible stent to provide adequate luminal support to facilitate vascular anastomosis using the PTB technique.
  
  
  
  Forty rats underwent unilateral femoral artery transection. Five rats were used to optimize the stent delivery method, and the remaining 35 rats were randomized into three groups: (1) standard suture repair with 10-0 nylon microsuture (SR), (2) standard suture repair over the stent (SR + S), or (3) PTB repair over stent (PTB + S). For the PTB group, a 2-mm overlapping cuff was painted with 0.1% (wt/vol) Rose Bengal then illuminated for 30 seconds on each side (532 nm, 0.5 W/cm, 30 J/cm). Anastomotic leak and vessel patency (immediate, 1 hour, and 1 week postoperatively) were assessed.
  
  
  
  Vessels in all three groups were patent immediately and at 1 hour postoperatively. After 1 week, all animals displayed patency in the SR group, while only 5 of 14 and 2 of 8 surviving animals had patent vessels in the PTB + S and SR + S groups, respectively.
  
  
  
  This study demonstrated successful use of an intraluminal stent for acute microvascular anastomosis using the PTB technique. However, the longer-term presence of the stent at the anastomotic site led to thrombosis in multiple cases. A rapidly dissolvable stent should facilitate a light-activated microvascular anastomosis with excellent long-term patency.
authors.affiliation: From the Wellman Center for Photomedicine (P.S.-K., J.H.N.-G., I.E.K., R.W.R.), Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, Division of Plastic and Reconstructive Surgery, Department of Surgery (P.S.-K., J.H.N.-G., M.A.R., J.M.W.), Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, and Department of Orthopedic Surgery (H.B.-S., O.K.M.), Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Prabhu
authors.initials: P
authors.lastname: Senthil-Kumar
authors.forename: Joanna H
authors.initials: JH
authors.lastname: Ng-Glazier
authors.forename: Mark A
authors.initials: MA
authors.lastname: Randolph
authors.forename: Hatice
authors.initials: H
authors.lastname: Bodugoz-Senturk
authors.forename: Orhun K
authors.initials: OK
authors.lastname: Muratoglu
authors.forename: Irene E
authors.initials: IE
authors.lastname: Kochevar
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Winograd
authors.forename: Robert W
authors.initials: RW
authors.lastname: Redmond
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods*; D057868:Anastomotic Leak / Q000175:diagnosis; D000818:Animals; D001672:Biocompatible Materials; D004195:Disease Models, Animal; D005263:Femoral Artery / Q000601:surgery*; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D018613:Microscopy, Confocal; D008866:Microsurgery / Q000379:methods; D010777:Photochemistry; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D015607:Stents; D013536:Suture Techniques; D014654:Vascular Patency
chemical_list: D001672:Biocompatible Materials