Wednesday, August 31, 2011

Sutureless Blood Vessel Repair

If this works in humans as it has in rats, then it will be a huge advance in microvascular repair.  The full article is referenced below (I did not read in it’s entirety due to pay wall).   (photo credit)

We have developed a new method of sutureless and atraumatic vascular anastomosis that uses US Food and Drug Administration (FDA)-approved thermoreversible tri-block polymers to temporarily maintain an open lumen for precise approximation with commercially available glues. We performed end-to-end anastomoses five times more rapidly than we performed hand-sewn controls, and vessels that were too small (<1.0 mm) to sew were successfully reconstructed with this sutureless approach. Imaging of reconstructed rat aorta confirmed equivalent patency, flow and burst strength, and histological analysis demonstrated decreased inflammation and fibrosis at up to 2 years after the procedure. This new technology has potential for improving efficiency and outcomes in the surgical treatment of cardiovascular disease.

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Currently, vascular microanastomosis (photo credit) is done by suturing.  Arteries 1 mm in diameter usually require 5 to 8 stitches, and veins require 7 to 10 stitches.  There is a risk of thrombosis even with the most meticulous repair -- total thrombosis rate 8%, with  no significant patency difference noted between the continuous suture technique and the interrupted suture technique in any vessel category.

 

REFERENCE

1.  Vascular anastomosis using controlled phase transitions in poloxamer gels; Edward I Chang, Michael G Galvez, Jason P Glotzbach, Cynthia D Hamou, Samyra El-ftesi, C Travis Rappleye, Kristin-Maria Sommer, Jayakumar Rajadas, Oscar J Abilez, Gerald G Fuller, Michael T Longaker, Geoffrey C Gurtner;  Nature Medicine, 2011; DOI: 10.1038/nm.2424

2.  Sutureless Method for Joining Blood Vessels Invented; ScienceDaily (Aug. 28, 2011)

3.  Technique for Microanastomosis; Wheeless Textbook of Orthopaedics, June 28, 2011

4.  Vascular Skills Lab Two (pdf)

1 comment:

ER's Mom said...

What a breakthrough, especially for some of those complex transplant (I'm thinking of the face in particular).

Super glue is cool...what will they clever folks do with duct tape? ;)