Department of Orthopaedics, Catholic University of Louvain, Bruxelles, Belgium.
J Reconstr Microsurg. 2011 Oct;27(8):461-8. doi: 10.1055/s-0031-1284241. Epub 2011 Jul 21.
The intravascular stenting (IVaS) method was published by Narushima and Koshima in 2008. This method involves using a monofilament nylon stent to make the anastomosis of small vessels easier. The aim of this study was to explore the IVaS technique to determine its advantages, disadvantages, and usefulness for inexperienced microsurgeons and also for more experienced practitioners during difficult anastomoses. The study was approved by the Catholic University of Louvain Animal Experimentation Ethics Committee. The study was done on 20 Wistar rats; each rat acting as his own control. Group 1 had an anastomosis done with the IVaS technique on the femoral artery. Group 2 had a classic end-to-end anastomosis without a stent. All anastomoses were performed by the same trainee surgeon with 4 months experience in microsurgery. The diameter of the external artery, distance between the double clamp forceps, stent length, number of sutures, stent preparation, and installation time and suture time were all measured. Anastomotic patency was verified using O'Brien's Patency test. The rats were anesthetized 1 week later to reassess the patency of the vessels. While the anastomotic time was shorter in the stent group, the preparation time was longer and so the total time to perform the anastomosis in both groups was the same. All vessels were patent at the completion of the anastomosis. At 1 week, patency rates were identical (83.3%) in both groups. The study shows an improvement in suturing time in the IVaS group. The time saved is equivalent to the time required for preparation and installation of the stent. At 7 days, the Patency test was identical for the two groups (83.3%). IVaS technique is a useful method of vessels anastomosis especially for junior surgeons. The reason why the patency rate was not 100% at 1 week may be because of excessive manipulation of the stent causing thrombosis in the IVaS group and imperfections in suturing technique by a trainee surgeon. Different aspects of the method are open for discussion such as consideration of the stent size and execution of the anastomosis. The IVaS technique helps in the execution of anastomosis in microsurgery and allows for more precise suturing. Care, however, must be taken in its execution and manipulation so as to avoid any lesions of the intima of the vessels.
血管内支架置入术（IVaS）方法由 Narushima 和 Koshima 于 2008 年发表。该方法涉及使用单丝尼龙支架使小血管吻合更容易。本研究旨在探讨 IVaS 技术，以确定其对经验不足的显微外科医生的优缺点和有用性，以及在困难吻合时对更有经验的医生的优缺点和有用性。该研究得到了鲁汶天主教大学动物实验伦理委员会的批准。该研究在 20 只 Wistar 大鼠上进行；每只大鼠都作为自己的对照。第 1 组在股动脉上进行 IVaS 技术吻合，第 2 组进行经典的无支架端端吻合。所有吻合均由一位有 4 个月显微外科经验的受训外科医生完成。测量了外动脉直径、双夹钳之间的距离、支架长度、缝线数量、支架准备和安装时间以及缝合时间。使用 O'Brien 通畅性试验验证吻合口通畅性。1 周后，大鼠被麻醉以重新评估血管通畅性。支架组吻合时间更短，但准备时间更长，因此两组吻合的总时间相同。所有血管在吻合完成时均通畅。1 周时，两组的通畅率相同（83.3%）。研究表明，IVaS 组的缝合时间有所改善。节省的时间相当于支架准备和安装所需的时间。7 天时，两组的通畅率测试结果相同（83.3%）。IVaS 技术是一种特别适用于初级外科医生的血管吻合方法。1 周时通畅率不是 100%的原因可能是支架过度操作导致 IVaS 组血栓形成，以及受训外科医生缝合技术不完美。该方法的不同方面都可以进行讨论，例如考虑支架的大小和吻合的执行。IVaS 技术有助于在显微外科中进行吻合，并允许更精确的缝合。然而，在执行和操作时必须小心，以避免血管内膜的任何损伤。
