Conventional methods of microvascular anastomosis using sutures cause
vessel narrowing, foreign body reactions, and intravascular thrombosis
. Although fibrin glue seems to be the ideal material to perform a mic
rovascular anastomosis, its success has been limited. Excess fibrin us
ed in some of the earlier methods has caused vessel narrowing and intr
avascular thrombosis. We evaluated the quality of end to-side anastomo
sis using fibrin glue applied with a new technique and minimal sutures
, and compared the results to those obtained with a standard suture te
chnique. End-to-side anastomosis of femoral vessels was performed in 3
2 male Sprague-Dawley rats. Fibrin glue was topically applied at the a
nastomotic site, after inserting only two corner sutures. The fibrinog
en component obtained from single donor human cryaprecipitate, was com
bined with bovine thrombin (500 IU per milliliter). in the control gro
up (N = 16), the anastomosis was performed using eight to ten interrup
ted 10/0 nylon sutures. Fibrin glue-assisted anastomosis took less tim
e, caused less bleeding at the anastomotic sites, and achieved a paten
cy rate comparable to that provided by the suture technique. We have s
hown that a new, atraumatic technique of microvascular anastomosis wit
h cryoprecipitate-thrombin glue and only two sutures, can produce exce
llent patency rates. This technique is easy to perform, inexpensive, a
nd does not involve new equipment.