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sutureless vascular anastomosis

Noriko Saegusa, Shunji Sarukawa, Kunihiro Ohta, Kensuke Takamatsu, Mitsuhiro Watanabe, Takashi Sugino, Masahiro Nakagawa, Yasuto Akiyama, Masatoshi Kusuhara, Kazuo Kishi, Keita Inoue
Vascular anastomosis is the highlight of cardiovascular, transplant, and reconstructive surgery, which has long been performed by hand using a needle and suture. However, anastomotic thrombosis occurs in approximately 0.5-10% of cases, which can cause serious complications. To improve the surgical outcomes, attempts to develop devices for vascular anastomosis have been made, but they have had limitations in handling, cost, patency rate, and strength at the anastomotic site. Recently, indwelling metal stents have been greatly improved with precise laser metalwork through programming technology...
2017: PloS One
Anders J Davidson, Lucas P Neff, J Kevin Grayson, Nathan F Clement, Erik S DeSoucy, Meryl A Simon-Logan, Christopher M Abbot, James B Sampson, Timothy K Williams
INTRODUCTION: The small diameter of temporary vascular shunts for vascular trauma management may restrict flow and result in ischemia or early thrombosis. We have previously reported a clinical experience with direct, open surgical reconstruction using expanded polytetrafluoroethylene (ePTFE) stent grafts to create a "sutureless" anastomosis as an alternative to standard temporary vascular shunts. We sought to characterize patency and flow characteristics of these grafts compared to standard shunts in a survival model of porcine vascular injury...
July 8, 2017: Journal of Trauma and Acute Care Surgery
Zacharia Mbaidjol, David Kiermeir, Annemarie Schönfeld, Jörg Arnoldi, Martin Frenz, Mihai A Constantinescu
Microvascular surgery is time consuming and requires high expertise. Laser-assisted vascular anastomosis (LAVA) is a promising sutureless technique that has the potential to facilitate this procedure. In this study, we evaluate the handling of our soldering material and the 1-week patency rate in a porcine model. Six pigs were subjected to LAVA. For each pig, the saphenous artery on one side was transected while the contralateral side was used as control. A porous polycaprolactone scaffold soaked in 40% (w/w) bovine serum albumin solution in combination with 0...
August 2017: Lasers in Medical Science
Prabhu Senthil-Kumar, Joanna H Ng-Glazier, Mark A Randolph, Hatice Bodugoz-Senturk, Orhun K Muratoglu, Irene E Kochevar, Jonathan M Winograd, Robert W Redmond
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...
July 2017: Journal of Trauma and Acute Care Surgery
Anders J Davidson, Lucas P Neff, Joseph J DuBose, James B Sampson, Christopher M Abbot, Timothy K Williams
Peripheral vascular injuries carry significant risk for permanent functional impairment, limb loss, and death. Definitive correction of these injuries requires significant operative time and has traditionally been resource and skill set intensive. In the initial surgical treatment of the physiologically depleted trauma patient, faster techniques may prove more appropriate. Damage control techniques, including vascular shunting, rapidly restore distal flow but require additional vascular intervention and risk shunt thrombosis with prolonged use...
November 2016: Journal of Trauma and Acute Care Surgery
Anders J Davidson, Lucas P Neff, Joseph J Dubose, James B Sampson, Christopher M Abbot, Timothy K Williams
Peripheral vascular injuries carry significant risk for permanent functional impairment, limb loss, and death. Definitive correction of these injuries requires significant operative time and has traditionally been resource and skill set intensive. In the initial surgical treatment of the physiologically depleted trauma patient, faster techniques may prove more appropriate. Damage control techniques, including vascular shunting, rapidly restore distal flow, but require additional vascular intervention and risk shunt thrombosis with prolonged use...
September 16, 2016: Journal of Trauma and Acute Care Surgery
Aaron A R Tobian, Tigistu Adamu, Jason B Reed, Valerian Kiggundu, Youseph Yazdi, Emmanuel Njeuhmeli
Throughout East and Southern Africa, the WHO recommends voluntary medical male circumcision (VMMC) to reduce heterosexual HIV acquisition. Evidence has informed policy and the implementation of VMMC programmes in these countries. VMMC has been incorporated into the HIV prevention portfolio and more than 9 million VMMCs have been performed. Conventional surgical procedures consist of forceps-guided, dorsal slit or sleeve resection techniques. Devices are also becoming available that might help to accelerate the scale-up of adult VMMC...
December 2015: Nature Reviews. Urology
Lulzim Vokrri, Arsim Qavdarbasha, Hajriz Rudari, Halil Ahmetaj, Suzana Manxhuka-Kërliu, Nexhmi Hyseni, Paolo Porcu, Philippe Cinquin, Carmine Sessa
OBJECTIVE: The objective of this study is to explore the feasibility and efficacy of a new technique for sutureless vascular anastomosis, using glued prosthesis, as a sole anastomosis fixation method in rabbits. METHODS: Ten rabbits were randomly selected to conduct the experiment. Five rabbits underwent direct anastomosis of infrarenal abdominal aorta, with glued prosthesis. In five other rabbits, reconstruction was done by sutured anastomosis. All animals were immediately examined by echo-Doppler for patency of anastomosis...
2015: Vascular Health and Risk Management
Andrea Agostinucci, Pasqualina Cecere, Giacomo Forneris, Andrea Cumino, Roberta Suita, Andrea Bellan, Marco Trogolo, Ferruccio Ferrero
BACKGROUND: Multiple failed hemodialysis access and poor vascular anatomy can jeopardize an end-stage renal disease patient's survival, frequently leading to the urgent need for rapid and durable new vascular access. In these circumstances, the extensive use of central venous catheters (CVC) can led to serious complications, such as infection, thrombosis, and often vessel scarring with obstruction of the central veins. More recently, new self-sealing prosthetic grafts may be cannulated within a few days after implantation, avoiding the need for extensive CVC...
July 2015: Annals of Vascular Surgery
Lulzim Vokrri, Xhavit Krasniqi, Arsim Qavdarbasha, Nexhmi Hyseni, Philippe Cinquin, Paolo Porcu, Carmine Sessa
BACKGROUND: In recent years, several methods and new techniques have been studied and proposed for establishment of sutureless vascular anastomoses, streaming use of sutureless vascular surgery in the future. PRESENTATION OF THE HYPOTHESIS: The new vascular connector (NVC) is a hypothetical design of a vascular device, proposed for creation and maintenance of sutureless vascular anastomosis. Implication of NVC would introduce a new device and technique in establishment of sutureless vascular anastomosis in which surgical approach is minimized and so post-operation disorders...
2014: Annals of Surgical Innovation and Research
Rod R Jose, Waseem K Raja, Ahmed M S Ibrahim, Pieter G L Koolen, Kuylhee Kim, Abdurrahman Abdurrob, Jonathan A Kluge, Samuel J Lin, Gillian Beamer, David L Kaplan
Sutureless anastomosis devices are designed to reduce surgical time and difficulty, which may lead to quicker and less invasive cardiovascular anastomosis. The implant uses a barb-and-seat compression fitting composed of one male and two female components. The implant body is resorbable and capable of eluting heparin. Custom robotic deposition equipment was designed to fabricate the implants from a self-curing silk solution. Curing did not require deleterious processing steps but devices demonstrated high crush resistance, retention strength, and leak resistance...
October 2015: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Roberto Chiesa, Andrea Kahlberg, Daniele Mascia, Yamume Tshomba, Efrem Civilini, Germano Melissano
OBJECTIVE: The aim of this study was to assess the safety and short-term effectiveness of a novel hybrid vascular graft used to address renal revascularization during open thoracoabdominal aortic aneurysm (TAAA) repair, performing a sutureless distal anastomosis. METHODS: Between 2012 and 2013, 25 patients (16 men; mean age, 66 ± 8 years) underwent revascularization of one (24 patients) or both (one patient) renal arteries with the Gore Hybrid Vascular Graft (GHVG; W...
September 2014: Journal of Vascular Surgery
Fenglin Song, Wenwu Zhou, Tao Tang, Xiaobing Li, Xiaoming Wu, Jinfu Yang
To simplify the procedure of blood vessel replacement operation and shorten the vascular anastomosis time, we developed a special artificial blood vessel which can be connected to native blood vessels without suture. The self-made sutureless blood vessel (SMSBV) was made from two titanium connectors and a Gore-Tex graft. To investigate blood compatibility and histocompatibility of the SMSBV, we carried thoracic descending aorta replacement using either SMSBV or Gore-Tex, respectively, in pigs. The aortic clamp time and the operative blood loss in the experimental group (using SMSBV) were less than those in the control group (using Gore-Tex)...
2014: BioMed Research International
Meng-Ta Tsai, Cheng-Che Tseng, Chung-Dann Kan
PURPOSE: To present a modification of the Viabahn open revascularization technique (VORTEC) to facilitate right renal artery (RRA) revascularization via a limited thoracotomy and transaortic sheath during endovascular aneurysm repair (EVAR). CASE REPORT: A 51-year-old man with uncontrolled hypertension and limited respiratory reserve presented with a pararenal abdominal aortic aneurysm (AAA) measuring ∼15×8.5×8 cm extending into the iliac arteries. Via a limited low thoracoabdominal incision and retroperitoneal approach, 3 of the renovisceral branches were exposed, but there was difficulty in approaching the RRA...
October 2013: Journal of Endovascular Therapy
Yasuhiro Kotani, Devin Chetan, Jiaquan Zhu, Vijay Anand, Christopher A Caldarone, Glen S Van Arsdell, John G Coles, Osami Honjo
BACKGROUND: Reconstruction of anomalous left pulmonary veins (ALPV) requires an anastomosis at a nonanatomic position, posing the potential risk of pulmonary vein obstruction (PVO). METHODS: The 514 patients who were diagnosed with a pulmonary vein abnormality from 1990 to 2010 were reviewed. Thirty-eight patients (7.4%; median age, 1.4 years; interquartile range, 0.1 to 5.7 years) were identified. ALPV was diagnosed as an isolated anomaly in 23 (61%) or as part of mixed total anomalous pulmonary venous drainage in 15 (39%)...
November 2013: Annals of Thoracic Surgery
Chih-Hsien Lee, Li-Wei Ko, Yi-Chang Lin, Chih-Chien Yen, Hsiang-Yu Yang, Chih-Hong Kao, Chien-Sung Tsai, Yi-Ting Tsai
Aortic intramural haematoma is similar to classic aortic dissection, which causes a life-threatening medical condition, and immediate diagnosis and treatment are crucial. The optimal therapy for intramural haematoma of the abdominal aorta remains controversial. Conservative medical management is usually the first choice of treatment for uncomplicated cases. Surgical intervention is usually required for complicated intramural haematomas of the abdominal aorta, including conventional open repair and endovascular treatment with stent-grafts...
July 23, 2013: Cardiovascular Journal of Africa
Shi-Qi Liu, Peng Lei, Xiao-Hai Cui, Yi Lv, Jian-Hui Li, Yu-Long Song, Ge Zhao
BACKGROUND: In the first posttransplant month, the most frequent complications are due to technical problems related to complex vascular and bile duct reconstructions during the operation. Moreover, despite great improvements in suturing technique and materials, severe organ ischemia-reperfusion caused by time-consuming hand suturing is still an important factor in graft survival. During the operation, severe hypotension, hypoxic acidosis, hyperkalemia, and renal dysfunction may occur during the anhepatic phase due to the prolonged venous clamping time required for hand suturing...
December 2013: Journal of Surgical Research
Bernard Segers, David Horn, Michel-Olivier Bazi, Jean Lemaitre, Vanessa Van Den Broeck, Etienne Stevens, Alain Roman, Thierry Bosschaerts
The classic procedure for aortobifemoral bypass is open surgery. Laparoscopy has been accepted by several authors as a minimal invasive alternative for aortoiliac occlusive disease. The totally retroperitoneal laparoscopic procedure has been described as an alternative to the transperitoneal approach. Whatever the approach, the aortoprosthetic anastomosis is a major difficulty making those techniques unpopular despite obvious advantages for the patients. We report a clampless and sutureless approach for the proximal anastomosis of a totally retroperitoneal laparoscopic aortobifemoral bypass using an EndoVascular REtroperitoneoScopic Technique (EVREST)...
June 2014: Vascular
Joseph J Naoum, Elias J Arbid
Polytetrafluoroethylene (PTFE) grafts have proven to be an adequate alternative conduit for peripheral bypass operations. Whether or not one uses PTFE depends on several factors: surgeon preference, individual patient circumstances, or when autologous greater saphenous vein is not available or adequate. These conventional grafts have evolved and undergone modification. The intraluminal surface has been coated with carbon or bonded with heparin. The structure of grafts has been modified with the creation of a hood or cuff, with the incorporation of a stent-graft segment for a sutureless anastomosis, or the fusion of PTFE with an outer polyester layer to minimize suture hole bleeding...
October 2012: Methodist DeBakey Cardiovascular Journal
Masashi Yamanami, Hatsue Ishibashi-Ueda, Akihide Yamamoto, Hidehiro Iida, Taiji Watanabe, Keiichi Kanda, Hitoshi Yaku, Yasuhide Nakayama
We developed autologous vascular grafts, called "biotubes," by simple and safe in-body tissue architecture technology, which is a practical concept of regenerative medicine, without using special sterile conditions or complicated in vitro cell treatment processes. In this study, biotubes of extremely small caliber were first auto-implanted to rat abdominal aortas. Biotubes were prepared by placing silicone rods (outer diameter 1.5 mm, length 30 mm) used as a mold into dorsal subcutaneous pouches in rats for 4 weeks...
March 2013: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
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