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.