A Modified Method of Continuous Venous Anastomosis in Microsurgery

Abstract

The continuous suture technique for end-to-end vascular anastomosis is cautioned against because of the risk of vessel constriction. A modified method of continuous suture for end-to-end venous microanastomosis is presented in which vessel constriction does not occur. This technique was compared with the conventional interrupted suture technique in the rat femoral vein, with each rat serving as its own control. Forty-eight Long-Evans rats were used. The mean time taken to complete the anastomosis was 9.8 minutes (range, 8-14 minutes) for the modified continuous technique and 17.7 minutes (range, 14-24 minutes) for the conventional interrupted technique (p < 0.05, independent t-test). In addition, the veins were examined under the microscope for patency and the milk test was performed on each anastomosis 30 minutes postanastomosis, and 1 week and 1 month postoperatively. Two groups of rats were sacrificed, one at 1 week and one at 1 month, and the two different anastomoses were compared using vessel morphometry in 40 rats and corrosion casts in 8 rats. All veins were patent postoperatively, as well as at 1 week and 1 month postoperatively. Vessel morphometry confirmed a similar luminal surface area in all veins examined at 1 week and 1 month. A two-way analysis of variance of vessel morphometry indicated no significant interaction between the methods used and the postoperative time (p = 0.60). The modified continuous technique is twice as quick as the conventional interrupted technique for end-to-end microvenous anastomosis and does not lead to vessel constriction.