Anastomoses for vascular shunt, arterial graft, and flap vascularization performed using magnets

Abstract

Abstract Introduction: The purposes of these studies were to demonstrate the potential for using magnets to perform sutureless vascular anastomoses in clinically relevant models, including vascular arteriovenous shunts, arterial bypass grafting, and vascularization of surgical flaps. Methods: Oval 0.5mm thick magnets were used to perform vascular anastomoses in canines. In study one, eleven femoral arteries and veins were anastomosed creating fistulae in seven dogs. In study two, magnets were used to anastomose six interpositional vein grafts into the femoral arterial position in six dogs. In study three, the 1.5mm diameter saphenous artery feeding a 10cm × 8cm island musculocutaneous flap was transected and repaired using magnets in six dogs. In all studies, patency was confirmed under direct observation for at least one hour before closure. For the first two studies, patency was confirmed by Duplex Doppler ultrasound scans 6 and 13 weeks later. After explant, saline was perfused through all grafts and the hydrodynamic resistance was quantified. Results: All anastomoses were patent for the one hour of direct observation. All anastomoses in the shunt and graft models were patent for up to 14 weeks. The resistance after 14 weeks of implantation was not increased. Endothelialization of all blood-contacting surfaces was substantial. Conclusions: The magnets successfully created sutureless vascular anastomoses of three different types. Flaps were acutely successful. Approximation of non-vascular structures using this technology may be possible in the future.