NONSURGICAL SUTURELESS TERMINOLATERAL VAS CULAR ANASTOMOSIS - IN-VIVOANIMAL TESTING OF A PERCUTANEOUS CONCEPT

Nonsurgical sutureless terminolateral vascular anastomosis: in vivo an imal testing of a percutaneous concept. Purpose: To test a percutaneou s concept for creation of a sutureless terminolateral Vascular anastom osis in vivo. Material and method: By creating sideholes into the midd le portion of a stent and a stentgraft, both implants could be arrange d in a Y-shaped configuration. An arteriovenous shunt was created in 3 sheep between the left carotid artery and the left external jugular v ein. A stent graft was partially inserted into the Venous lumen. Axial venous patency was restored by placing a stent through the sidehole i nto the graft lumen from an upstream puncture site. Graft patency was maintained by placing the sidehole of the stent at the bridging point between stent graft and stent with no stent struts crossing. Arterial end-to-end anastomosis was performed by retrograde placement of a sten t graft into the arterial lumen. Both anastomoses were connected by a silicone tube. Results: In all cases, a venous end-to-side anastomosis was created that was blood-tight and safely secured into the vascular lumen. Conclusion: Y-shaped configuration of stent and stentgrafts th rough sideholes allows creation of sutureless end-to-side anastomoses in vivo.