USE OF A MICROPUNCH FOR ARTERIOTOMY IN END-TO-SIDE ANASTOMOSIS

A micropunch can mechanically create a precise, clean microarteriotomy that is a simple and perhaps more accurate method, especially in athe rosclerotic vessels where plaque or the risk of intimal dissection may sometimes interfere with conventional incision or excision techniques . A 1.5-mm. prototype micropunch was tested in seven Sprague-Dawley ra ts to create an end-to-side femoral vein to artery fistula, with a tra ditional traction suture method used on the contralateral side as a co ntrol. All anastomoses were patent immediately and at 2 weeks, implyin g no compromise, even in small vessels, by using a micropunch. However , the technique had to be modified, as the 1.5-mm anvil could not be i nserted directly into the vessel lumen because of the small size of th e rat femoral artery. This indicates a significant limitation of this device for use in vessels with an internal diameter less than that of the chosen anvil size.