Microvascular anastomosis using histoacryl glue and an intravascular soluble stent

Objective: The purpose of this study was to assess a new technique for micr ovascular anastomosis on small arteries using Histoacryl glue and an intrav ascular soluble stent. Methods: Sprague-Dawley rats were randomly assigned to either of two experi mental groups or one control group. The first author (DL, a postgraduate ye ar 4 resident) performed 12 end-to-end anastomoses on rat carotid arteries (1-mm vessel) (group A) using the experimental technique with Histoacryl gl ue and an intravascular stent. Thirteen microsuture carotid anastomoses per formed by the senior author (DD), an experienced microsurgeon, served as co ntrol (group C). Permeability was assessed at 1 week for half of the animal s and at 6 weeks for the others. Pathologic examination was done on both gr oups. To evaluate the influence of vessel size on the experimental techniqu e, eight end-to-end anastomoses on rat abdominal aorta (2 mm) (group B) wer e also done by the first author. Permeability was assessed at 24 to 48 hour s for this group. Result: In the experimental groups (A and B), two predictable failures (bot h in group A) were observed. Median anastomosis times were 11 minutes and 7 minutes, respectively. The control group had no failure and a median time of 17 minutes. Pathologic examination revealed more inflammation in group A than in group C. Coagulative necrosis of the arterial wall was observed ex clusively in group A. Conclusion: This new technique is easy to learn and readily accessible to l ess experienced microsurgeons. The technique is fast and efficient. The cal ibre of the vessel has a great influence on ease and speed of the technique . However, histotoxicity of Histoacryl glue was observed. This technique ca n be valuable for free-tissue transfer in head and neck reconstruction. A l ess toxic glue would be useful.