EFFICACY OF DIRECT REPAIR TO PARTIAL ARTERIAL LACERATIONS

These are differences of opinion as to the best method of reconstituti ng flow following partial laceration of a small artery. This study was undertaken to determine how narrowing of a small vessel by direct rep air affects patency rates. Partial arterial lacerations of varying wid ths were made in both femoral arteries of 30 Sprague-Dawley rats. The vessels were randomized to groups of longitudinal and transverse parti al lacerations. Flow was reestablished in experimental vessels with di rect repair (with reduction of vessel cross-sectional area ranging fro m 22% to 62%). In control vessels, resection and end-to-end repair or resection with vein grafting was performed. Two weeks postoperatively all vessels were explored to confirm patency and calculate flow. Immed iately after repair all vessels were patent. At 2 weeks all direct and end-to-end repairs remained patent, while two of seven vein grafts ha d thrombosed. Immediately following repair there were no significant h emodynamic differences between repair groups. The final flow rate meas ured distal to the repair site averaged 2.5 mm(2)KHz for vessels with resection and either end-to-end repair or vein grafting (control group ) versus 2 mm(2)KHz for vessels with direct repair of the laceration ( experimental group); however, comparisons for specific groups showed n o significant velocity or flow differences between control and experim ental vessels. Direct repair of a partial arterial laceration with up to 62% narrowing of cross-sectional area gives patency rates equal to or better than those of alternate methods; however, blood flow rates m ay be altered distal to such a repair site.