Abstract
Background A novel arterial everter device was engineered to simplify microvascular coupling
of arteries by reliably securing the stiff, muscular wall of arteries over coupler
pins. We compare microvascular coupling with the everter device to manual suturing
for arterial anastomoses in a live large animal model.
Materials and Methods In this preliminary study, bilateral external femoral arteries of five male swine
were exposed and sharply divided. Arteries were anastomosed using either interrupted
sutures (n = 5) or the everter device and Synovis Coupler (n = 5). The efficiency in engaging coupler pins, the time taken to perform the anastomosis,
and vessel patency immediately post-op and at 1-week postanastomosis were evaluated.
Vessel wall injury and luminal stenosis were compared between groups using histomorphometric
analyses.
Results On an average, 80% of coupler pins engaged the vessel walls after a single pass of
the everter. The average time to perform the anastomosis was significantly less when
using the everter/coupler compared with manual suturing (6:35 minutes versus 25:09
minutes, p < 0.001). Immediately post-op, 100% patency was observed in both groups. At 1 week
post-op, four of five (80%) of coupled arteries and all five (100%) of hand-sewn arteries
were patent. The degree of arterial wall injury, neointimal formation, and luminal
stenosis for patent arteries were similar between groups.
Conclusions Successful arterial anastomoses using the everter device with the Synovis Coupler
was easier and significantly more efficient when compared with a standard hand-sewn
technique. Both techniques had acceptable patency rates and similar effects on the
vessel wall and intima.
Keywords
microsurgery - artery - coupler - anastomosis
