Department of Plastic and Reconstructive Surgery, School of Medicine & Institute for Medical Science, Keimyung University Dongsan Medical Center, Daegu, Korea.
Metabiomed, Chungbuk, Korea.
Sci Rep. 2019 Jul 29;9(1):10945. doi: 10.1038/s41598-019-47499-5.
The purpose of this study was to create a new absorbable vascular anastomotic coupler and evaluate the patency and degradation degree. Vascular anastomosis was performed in the jugular vein in 31 New Zealand white female rabbits. The coupler consisted of an inner and outer ring. One side of the jugular vein was passed through and overlapped the inner ring. The opposite side of the jugular vein overlapped the everted jugular vein on the inner ring. Then, the outer ring engaged with the inner ring and completed the anastomosis. The outer rings were also constructed with two shapes including an O-type that had no slit and a C-type with a slit on the outer ring of the O-type coupler to allows expandability of the diameter. A Phase I experiment was performed to evaluate the degradability of the source materials, including the poly (lactic-co-glycolic acid) (PLGA) and polycaprolactone (PCL) couplers. A Phase II experiment was performed to evaluate the patency and anastomosis time of the O-type PLGA and PCL couplers. A Phase III experiment was performed to evaluate the patency and anastomosis time of suture anastomosis (control) and the C-type PLGA coupler. The patency was determined by ultrasonography and open exploration. Histological analysis was performed to determine the degradability of the couplers. In Phase I, the PLGA couplers were completely degraded with good vascular wall remodeling at 8 months, while the PCL couplers demonstrated incomplete degradation. In Phases II and III, the anastomosis time was significantly shorter in the coupler groups than that in the control group. All of the coupler groups demonstrated complete patency of the anastomoses on ultrasonography. In Phase III, the C-type PLGA coupler also demonstrated patency and complete degradation at 8 months. PLGA is a suitable source material for absorbable couplers due to its fast degradability. We devised the O-shaped outer ring for the C-shaped outer ring to increase flexibility, which also demonstrated complete patency during the experimental period. Our absorbable microvascular anastomosis devices could provide rapid and reliable microvascular anastomosis without anastomotic failure.
本研究旨在研制一种新型可吸收血管吻合连接器，并评估其通畅性和降解程度。在 31 只新西兰白兔的颈静脉中进行血管吻合。连接器由内、外环组成。颈静脉的一侧穿过并重叠在内环上，颈静脉的对侧重叠在内环上的外翻颈静脉。然后，外环与内环啮合，完成吻合。外环也有两种形状，一种是 O 型，没有狭缝；另一种是 O 型外环上有狭缝的 C 型，允许直径的可扩展性。I 期实验评估了包括聚（乳酸-共-乙醇酸）（PLGA）和聚己内酯（PCL）连接器在内的源材料的可降解性。II 期实验评估了 O 型 PLGA 和 PCL 连接器的通畅性和吻合时间。III 期实验评估了缝线吻合（对照）和 C 型 PLGA 连接器的通畅性和吻合时间。通畅性通过超声检查和开放探查确定。组织学分析用于确定连接器的降解性。在 I 期，PLGA 连接器在 8 个月时完全降解，血管壁重塑良好，而 PCL 连接器则不完全降解。在 II 期和 III 期，连接器组的吻合时间明显短于对照组。所有连接器组的超声检查均显示吻合口完全通畅。在 III 期，C 型 PLGA 连接器在 8 个月时也显示通畅和完全降解。PLGA 是一种适合可吸收连接器的源材料，因为它具有快速的降解性。我们设计了 O 型外环代替 C 型外环，以增加灵活性，在实验期间也显示出完全通畅。我们的可吸收微血管吻合装置可以提供快速可靠的微血管吻合，而不会发生吻合失败。
