An intraluminal stent facilitates light-activated vascular anastomosis. Issue 1 (July 2017)

• Record Type: Journal Article
• Authors: Senthil-Kumar, Prabhu; Ng-Glazier, Joanna H.; Randolph, Mark A.; Bodugoz-Senturk, Hatice; Muratoglu, Orhun K.; Kochevar, Irene E.; Winograd, Jonathan M.; Redmond, Robert W.
• Is Part Of: Journal of trauma and acute care surgery. Volume 83:Issue 1(2017)Supplement 1
• Publication Date: 2017-07
• Subjects: Anastomosis -- wound closure -- photochemical tissue bonding -- microvascular -- rose bengal; Surgical intensive care -- Periodicals; Surgical emergencies -- Periodicals; Wounds and injuries -- Surgery -- Periodicals; 617.026
• DOI: 10.1097/TA.0000000000001487
• Languages: English
• ISSNs: 2163-0755

Abstract

Abstract : BACKGROUND: Photochemical tissue bonding (PTB) is a sutureless, light-activated technique that produces a watertight, microvascular repair with minimal inflammation compared to standard microsurgery. However, it is practically limited by the need for a clinically viable luminal support system. The aim of this study was to evaluate a hollow biocompatible stent to provide adequate luminal support to facilitate vascular anastomosis using the PTB technique. METHODS: Forty rats underwent unilateral femoral artery transection. Five rats were used to optimize the stent delivery method, and the remaining 35 rats were randomized into three groups: (1) standard suture repair with 10-0 nylon microsuture (SR), (2) standard suture repair over the stent (SR + S), or (3) PTB repair over stent (PTB + S). For the PTB group, a 2-mm overlapping cuff was painted with 0.1% (wt/vol) Rose Bengal then illuminated for 30 seconds on each side (532 nm, 0.5 W/cm 2, 30 J/cm 2 ). Anastomotic leak and vessel patency (immediate, 1 hour, and 1 week postoperatively) were assessed. RESULTS: Vessels in all three groups were patent immediately and at 1 hour postoperatively. After 1 week, all animals displayed patency in the SR group, while only 5 of 14 and 2 of 8 surviving animals had patent vessels in the PTB + S and SR + S groups, respectively. CONCLUSIONS: This study demonstrated successful use of an intraluminal stent for acute microvascular anastomosis using the PTB technique. However, the longer-term presence of the stent at the anastomotic site led to thrombosis in multiple cases. A rapidly dissolvable stent should facilitate a light-activated microvascular anastomosis with excellent long-term patency.