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用于无缝合血管吻合术的聚(L-乳酸)支架的评估。

Evaluation of a poly(L-lactic acid) stent for sutureless vascular anastomosis.

作者信息

Nakano Yoshiyuki, Hori Yoshio, Sato Akira, Watanabe Tetsuo, Takada Shuji, Goto Hitoshi, Inagaki Akiko, Ikada Yoshito, Satomi Susumu

机构信息

Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Japan.

出版信息

Ann Vasc Surg. 2009 Mar;23(2):231-8. doi: 10.1016/j.avsg.2008.07.004. Epub 2008 Sep 6.

Abstract

We have developed a sutureless anastomosis device consisting of a biodegradable stent and stainless steel band for end-to-end anastomosis. The aim of this acute phase study was to evaluate the feasibility of a sutureless anastomotic procedure with a bioabsorbable stent during a 4-week period in a swine model. The porcine infrarenal aorta was replaced with an expanded polytetrafluoroethylene graft. A proximal anastomosis was completed using a sutureless anastomotic procedure employing a bioabsorbable stent made of poly(L-lactic acid) (PLLA) and a stainless steel plate. A distal anastomosis completed by manual suturing served as a control. At 4 weeks after surgery, angiography was performed. The animals were then killed, and the specimens were evaluated histologically. The sutureless anastomotic procedure required significantly less time than the suturing technique. Angiograms showed patency of the grafts, and no signs of either stenosis or leakage. Both pressure-proof and tensile tests confirmed the adequate mechanical strength of the anastomoses. Sutureless anastomosis with a PLLA stent appears to be feasible, at least within an observation period of 4 weeks. This simple procedure shortened the time of surgery and would contribute to reducing the risks of operation-related complications.

摘要

我们研发了一种用于端端吻合的无缝合吻合装置,该装置由一个可生物降解支架和不锈钢带组成。本急性期研究的目的是评估在猪模型中,使用生物可吸收支架进行无缝合吻合手术在4周内的可行性。用膨体聚四氟乙烯移植物替换猪的肾下腹主动脉。近端吻合采用使用聚(L-乳酸)(PLLA)制成的生物可吸收支架和不锈钢板的无缝合吻合手术完成。通过手工缝合完成的远端吻合作为对照。术后4周进行血管造影。然后处死动物,并对标本进行组织学评估。无缝合吻合手术所需时间明显少于缝合技术。血管造影显示移植物通畅,无狭窄或渗漏迹象。耐压和拉伸试验均证实吻合口具有足够的机械强度。至少在4周的观察期内,使用PLLA支架进行无缝合吻合似乎是可行的。这种简单的手术缩短了手术时间,将有助于降低手术相关并发症的风险。

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